| Background:Chronic obstructive pulmonary disease (COPD) is characterized by progressive dyspnea, decreased exercise capacity and poor quality of life. Exercise training, as the cornerstone of pulmonary rehabilitation, was testified to improve the above symptoms. Home exercise training was recommended, but the problem was that patients’exercise adherence was poor, or the exercise training effects were unsatisfied. Pulmonary rehabilitation guidlines recommended that home exercise training could be supervised through the remote equipment, like mobile phone. The mobile application can change health behaviors and improve treatment adherence, through providing social surpport, instructions and information on how to perform a behavior, or feedback on a behavior.Objective:To develop and assess a mobile application to support home exercise training among COPD patients, and to explore the effects of mobile-application-based exercise training for COPD patients on exercise adherence, exercise capacity, dyspnea and quality of life.Methods:This study included two parts, the first part was the development of a mobile applicaition to support exercise, the second part was the home exercise training part. From January to October,2015, a mobile application was design and developed by coorperating with the Institute of Bio-Medical Informatics, National Yang-Ming University. The mobile application included six functional modules:exercise function, exercise reminder, ranking function, health education, questionnaire function and exercise statistics. From July to December,2015, a total of 65 COPD patients were recruited in the outpatient department of a tertiary hospital in Beijing by using the convenience sampling method. The participants were randomly assigned into the intervention group or the control group. The intervention group were asked to take a walking exercise at home using the mobile application at 80% of the average speed of 6-min walking test (6MWT)(a moderate exercise intensity) for 12 weeks, at least 40 minutes per day, five days per week. And the intensity of exercise was readjusted monthly according to the result of 6MWT. The control group received the same protocol and were verbally asked to take the walking exercise in the home environment for 12 weeks, but moderate fatigue was the required intensity of exercise, monitored by patients. The outcome measures included exercise adherence,6-min walking distance (6MWD), dypnea degree, quality of life (QoL), all of which were measured before intervention and at 4 and 12 weeks after the intervention, and the mobile application was assessed after 12-week intervention.Results:65 partitipants (33 in the intervention group,32 in the control group) completed the intervention. Results showed that (1) At 4 and 12 weeks,72.7% and 81.8% patients in the intervention group completely took the required exercise priscription, only 37.5%-.25.0% patients in the control group completely took the required exercise priscription. Exercise adherence at 4 and 12 weeks in the intervention group were significantly higher than in the control group (P<0.05); Exercise capacity in the intervention group significantely increased at 4 and 12 weeks compared to baseline (P<0.017), and significantly higher than in the control group (P<0.05); The total average score and the symptom domain score of QoL decreased after 12-week intervention (P<0.017), and significantly lower than in the control group (P<0.05); The scores of the function domain and the mental domain not significantly decreased in the intervention group and there were no signicant differences between two groups. (2) Participants expressed a high level of satisfaction and acceptance to the mobile application.Conclusion:The mobile application can provide a feasible and efficient home exercise training program in chronic obstructive pulmonary disease, which could improve exercise adhererance, exercise capacity and quality of life. |
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