Background: Pulmonary rehabilitation programs improve dyspnea and health status associated with chronic obstructive pulmonary disease (COPD), but benefits wane when patients return to a sedentary lifestyle. This study tested a simple, low-resource, low-cost home walking program. Methods: In this single center, 3-month study, 115 COPD patients were randomized to a control cohort or a goal setting cohort. Each patient met with study staff and received 5 telephone calls at 2-week intervals. During these contacts, the Goal group was assisted by a wellness coach who helped them set personal activity goals. All patients wore a pedometer to record daily steps, the primary study outcome. Results: Over the 12-week interval, the average step-per-days was 36% higher for the Goal cohort patients (Week 12 mean = 4390) than for Control patients (mean = 3790). No group differences emerged on the modified Medical Research Council (mMRC) dyspnea scale, the COPD Assessment Test, or the St. George's Respiratory Questionnaire. Secondary analyses indicated that even patients with greater disease severity, including those with an mMRC score >2 or forced expiratory volume in 1 second (FEV1) % predicted below 50%, increased their walking relative to Control patients. Almost half (48%) of Goal patients successfully reached at least one personal goal such as increasing stamina and activity, or decreasing shortness of breath or weight. Conclusions: A relatively low-resource wellness coaching, goal-setting intervention resulted in a small improvement in the activity level of COPD patients over a 12-week period including those with marked pulmonary impairment. Further investigation should be directed at understanding the optimal blend of in person and remote coaching needed to produce the greatest cost-to-benefit ratio.
RCT Entities:
Background: Pulmonary rehabilitation programs improve dyspnea and health status associated with chronic obstructive pulmonary disease (COPD), but benefits wane when patients return to a sedentary lifestyle. This study tested a simple, low-resource, low-cost home walking program. Methods: In this single center, 3-month study, 115 COPDpatients were randomized to a control cohort or a goal setting cohort. Each patient met with study staff and received 5 telephone calls at 2-week intervals. During these contacts, the Goal group was assisted by a wellness coach who helped them set personal activity goals. All patients wore a pedometer to record daily steps, the primary study outcome. Results: Over the 12-week interval, the average step-per-days was 36% higher for the Goal cohort patients (Week 12 mean = 4390) than for Control patients (mean = 3790). No group differences emerged on the modified Medical Research Council (mMRC) dyspnea scale, the COPD Assessment Test, or the St. George's Respiratory Questionnaire. Secondary analyses indicated that even patients with greater disease severity, including those with an mMRC score >2 or forced expiratory volume in 1 second (FEV1) % predicted below 50%, increased their walking relative to Control patients. Almost half (48%) of Goal patients successfully reached at least one personal goal such as increasing stamina and activity, or decreasing shortness of breath or weight. Conclusions: A relatively low-resource wellness coaching, goal-setting intervention resulted in a small improvement in the activity level of COPDpatients over a 12-week period including those with marked pulmonary impairment. Further investigation should be directed at understanding the optimal blend of in person and remote coaching needed to produce the greatest cost-to-benefit ratio.
Authors: Henrik Watz; Fabio Pitta; Carolyn L Rochester; Judith Garcia-Aymerich; Richard ZuWallack; Thierry Troosters; Anouk W Vaes; Milo A Puhan; Melissa Jehn; Michael I Polkey; Ioannis Vogiatzis; Enrico M Clini; Michael Toth; Elena Gimeno-Santos; Benjamin Waschki; Cristobal Esteban; Maurice Hayot; Richard Casaburi; Janos Porszasz; Edward McAuley; Sally J Singh; Daniel Langer; Emiel F M Wouters; Helgo Magnussen; Martijn A Spruit Journal: Eur Respir J Date: 2014-10-30 Impact factor: 16.671
Authors: Marilyn L Moy; Riley J Collins; Carlos H Martinez; Reema Kadri; Pia Roman; Robert G Holleman; Hyungjin Myra Kim; Huong Q Nguyen; Miriam D Cohen; David E Goodrich; Nicholas D Giardino; Caroline R Richardson Journal: Chest Date: 2015-07 Impact factor: 9.410
Authors: Fares Gouzi; Christian Préfaut; Aldjia Abdellaoui; Anne Vuillemin; Nicolas Molinari; Gregory Ninot; Gwenaelle Caris; Maurice Hayot Journal: Arch Phys Med Rehabil Date: 2011-09-08 Impact factor: 3.966
Authors: Ayedh D Alahmari; Anant R C Patel; Beverly S Kowlessar; Alex J Mackay; Richa Singh; Jadwiga A Wedzicha; Gavin C Donaldson Journal: BMC Pulm Med Date: 2014-06-02 Impact factor: 3.317
Authors: David B Coultas; Bradford E Jackson; Rennie Russo; Jennifer Peoples; Karan P Singh; John Sloan; Minyong Uhm; Jamile A Ashmore; Steven N Blair; Sejong Bae Journal: Ann Am Thorac Soc Date: 2018-04