A Comparison of Physical Activity Between Home-Based and Centre-Based Pulmonary Rehabilitation: A Randomised Controlled Secondary Analysis

Abstract

Background: Pulmonary rehabilitation (PR) is a highly effective intervention for individuals with chronic obstructive pulmonary disease (COPD). Physical activity (PA) has been shown to increase after a centre-based programme, yet it is not clear if a home-based programme can offer the same benefit. This study aimed to evaluate the effect of home-based PR compared with the centre-based PR on the PA levels post 7 weeks of PR and 6 months follow-up.Method: In this study, 51 participants with COPD, of them, 36 (71%) men completed physical activity monitoring with a SenseWear Armband, at three time points (baseline, 7 weeks, and 6 months). The participants were randomly assigned to either centre-based supervised PR (n = 25; 69 ± 6 years; FEV1 55 ± 20% predicted) or home-based PR (n = 26; 68 ± 7 years; FEV1 42 ± 19% predicted) programmes lasting 7 weeks. The home-based programme includes one hospital visit, a self-management manual, and two telephone calls. The PA was measured as step count, time in moderate PA (3–6 metabolic equivalent of tasks [METs]) in bouts of more than 10 min and sedentary time (<2 METs).Results: Home-based PR increased step count significantly more than the centre-based PR after 7 weeks (mean difference 1,463 steps: 95% CI 280–2,645, p = 0.02). There was no difference in time spent in moderate PA was observed (mean difference 62 min: 95% CI −56 to 248, p = 0.24). Sedentary behaviour was also significantly different between the centre and home-based groups. The home group spent 52 min less time sedentary compared with the centre-based (CI −106 to 2, p = 0.039). However, after 6 months, the step count and time spent in moderate PA returned to baseline in both the groups.Conclusion: This study provides an important insight into the role of home-based PR which has the potential to be offered as an alternative to the centre-based PR. Understanding who may best respond from the centre or home-based PR warrants further exploration and how to maintain these initial benefits for the long-term.Trial Registry: ISRCTN: No.: ISRCTN81189044; URL: isrctn.com.

Changes in physical activity, sedentary behaviour and sleep following pulmonary rehabilitation: a systematic review and network meta-analysis

“…The most common interventions across all articles were CBPR (n=39) [ 27 , 28 , 45 – 50 , 52 , 54 , 56 – 62 , 64 – 71 , 73 , 75 – 81 , 84 – 89 ], HBPR (n=15) [ 27 , 28 , 51 , 53 – 56 , 63 , 80 – 83 , 87 , 89 , 90 ] and CBPR+physical activity promotion (n=12) [ 48 – 50 , 57 , 64 , 68 , 74 , 76 , 78 , 79 , 85 , 86 ]. The median duration of pulmonary rehabilitation-based interventions was 8 weeks (range 3 weeks to 1 year).…”

“…24 studies [ 28 , 45 , 47 , 48 , 50 , 52 , 54 , 56 – 58 , 60 , 64 , 66 , 70 , 73 , 76 , 78 – 81 , 83 , 84 , 86 , 88 ] (n=1691) were included in the NMA for pre–post changes in average daily step count (steps·day −1 ) in COPD. These consisted of 11 interventions and 55 pairwise comparisons (13 of which were direct data comparisons; supplementary material E ).…”

Benefits and Harms of Digital Health Interventions Promoting Physical Activity in People With Chronic Conditions: Systematic Review and Meta-Analysis

“…8). For objectively measured physical function, 4% (2/47) of the RCTs were classified as low risk of bias [110,158], 70% (33/47) of the RCTs had some concerns [54,55,64,71,74,79,82,87,94,96,97,102,105,108,117,118,120,121,124,133,136,147,156,159,167,171,175,178,183,185,186,190], and 26% (12/47) of the RCTs were classified as high risk of bias [57,63,91,112,126,149,[151][152][153][154]163,164,170,176] (Figure 9). The risk of bias profiles were similar for the secondary outcomes (Multimedia Ap...…”

“…objectively measured physical activity, 6% (3/51) of the RCTs were classified as low risk of bias[58,84,160], 55% (28/51) of the RCTs had some concerns[53,61,62,68,70,71,74,81,82,95,97,98,100,102,107,111,115,117,136,143,144,147,148,155,156,166,180,182,183,[188][189][190][191], and 39% (20/51) of the RCTs were classified as high risk of bias[60,65,69,81,91,94,99,104,125,[130][131][132]145,146,149,151,152,163,164,186] (Figure…”

“…The mean number of digital sessions was 97.98 (SD 109.29; range 2-377), whereas in-person sessions had a mean of 3.26 (SD 2.93; range 0-18). Of the included RCTs, 31[54,58,62,65,70,76,77,82,84,86,88,92,94,95,100,101,112,121,132,135,143,144,146,150,151,155,163,164,174,182,186,[189][190][191]197] had follow-up data, and the mean follow-up time was 45.38 (SD 21.74; range 12-104) weeks.…”