Effect on health‐related quality of life of ongoing feedback during a 12‐month maintenance walking programme in patients with COPD: a randomized controlled trial

Abstract

Background and objective:In patients with COPD, this study evaluated the effect on health-related quality of life (HRQoL) of adding ongoing feedback to a 12-month unsupervised maintenance walking programme. Methods: Participants were randomized to either an intervention group (IG) or control group (CG). Both groups completed the same 2-month supervised, walking training programme followed by a 12-month unsupervised maintenance walking programme. During the maintenance programme, the IG received ongoing feedback (telephone calls, biofeedback and progressive goal setting) and the CG received no feedback. Results: A total of 75 participants completed the study (mean (SD): age 69 (8) years; forced expiratory volume in 1 s (FEV 1 ) 43 (15) % predicted). There was no between-group differences in the magnitude of change in HRQoL when data collected on completion of the 12-month maintenance programme were compared with that collected either before the 2-month supervised programme (mean between-group difference (MD) in total St George's Respiratory Questionnaire change scores: 1 point, 95% CI: −9 to 7) or on completion of the 2-month supervised programme (MD: 4 points, 95% CI −2 to 10). Conclusion: Following a 2-month supervised walking training programme, ongoing feedback was no more effective than no feedback in maintaining HRQoL during a 12-month unsupervised walking programme.

Maintaining the benefits following pulmonary rehabilitation: Achievable or not?

“…Unsupervised maintenance exercise has been used in a number of studies in patients with COPD . Many of these studies had additional features to support the unsupervised programmes such as regular phone calls, diaries and pedometers . The variation in terms of extra support makes it difficult to draw conclusions about the effectiveness of unsupervised home exercise alone as a maintenance exercise programme.…”

“…Exercise diaries combined with unsupervised maintenance exercise training programmes or monthly supervised exercise in patients with COPD have been used to improve motivation and measure adherence to the prescribed exercise (distance walked and time spent walking) and, in some cases, to record daily minutes of activity . HRQoL was maintained to 6 months when diary use was combined with monthly supervised exercise and with unsupervised walking exercise .…”

“…Studies that used support phone calls to improve adherence to exercise also used other modes of support which made it difficult to determine the impact of support phone calls alone. HRQoL but not exercise capacity was maintained to 12 months when support phone calls were combined with unsupervised exercise training with and without pedometers; when support phone calls were combined with monthly supervised exercise sessions; and when support phone calls were combined with a 12‐week adherence intervention that incorporated the use of activity monitors, diaries and weekly home visits …”

Contemporary Concise Review 2018: Asthma and chronic obstructive pulmonary disease

“…Although pulmonary rehabilitation is highly beneficial in COPD, there is a need to develop cost‐efficient ways of maintaining benefits . A key study assessed the provision of additional feedback over 1 year to support an unsupervised walking programme in COPD patients who had completed supervised pulmonary rehabilitation .…”

“…Although pulmonary rehabilitation is highly beneficial in COPD, there is a need to develop cost‐efficient ways of maintaining benefits . A key study assessed the provision of additional feedback over 1 year to support an unsupervised walking programme in COPD patients who had completed supervised pulmonary rehabilitation . Feedback included a combination of telephone calls, biofeedback from a pedometer and progressive goal setting, but this provided no additional benefit in maintaining quality of life …”