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Original Research: COPD |

An Internet-Mediated Pedometer-Based Program Improves Health-Related Quality-of-Life Domains and Daily Step Counts in COPDInternet-Mediated Physical Activity in COPD: A Randomized Controlled Trial

Marilyn L. Moy, MD; Riley J. Collins, BS; Carlos H. Martinez, MD; Reema Kadri, MLIS; Pia Roman, MA; Robert G. Holleman, MPH; Hyungjin Myra Kim, ScD; Huong Q. Nguyen, PhD, RN; Miriam D. Cohen, MSN; David E. Goodrich, EdD; Nicholas D. Giardino, PhD; Caroline R. Richardson, MD
Author and Funding Information

From the Department of Veterans Affairs, Rehabilitation Research and Development Service (Dr Moy), and the Pulmonary and Critical Care Medicine Section (Dr Moy), VA Boston Healthcare System, Boston, MA; the Harvard Medical School (Dr Moy), Boston, MA; the University of Michigan Medical School (Ms Collins), Ann Arbor, MI; the Pulmonary and Critical Care Division (Dr Martinez), University of Michigan Health System, Ann Arbor, MI; the VA Center for Clinical Management Research, Health Services Research and Development Center of Innovation (Mss Kadri and Roman; Mr Holleman; and Drs Kim, Goodrich, and Richardson), VA Ann Arbor Healthcare System, Ann Arbor, MI; the University of Michigan School of Public Health (Dr Kim), Ann Arbor, MI; the Department of Research and Evaluation (Dr Nguyen), Kaiser Permanente Southern California, Pasadena, CA; the VA New York Harbor (Ms Cohen), Brooklyn, NY; and the Department of Psychiatry (Dr Giardino) and the Department of Family Medicine (Dr Richardson), University of Michigan, Ann Arbor, MI.

CORRESPONDENCE TO: Caroline R. Richardson, MD, Department of Family Medicine, University of Michigan, 1018 Fuller St, Ann Arbor, MI 48104-1213; e-mail: caroli@umich.edu


FUNDING/SUPPORT: This study was funded by the Department of Veterans Affairs, Health Services Research and Development Service [Grant IIR 09-366 to Dr Richardson]; the Department of Veterans Affairs, Rehabilitation Research and Development Service [Career Development Award F6847W to Dr Moy]; and the National Institutes of Health Heart, Lung, and Blood Institute [Grant T32 HL007749-20 to Dr Martinez].

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2015;148(1):128-137. doi:10.1378/chest.14-1466
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BACKGROUND:  Low levels of physical activity (PA) are associated with poor outcomes in people with COPD. Interventions to increase PA could improve outcomes.

METHODS:  We tested the efficacy of a novel Internet-mediated, pedometer-based exercise intervention. Veterans with COPD (N = 239) were randomized in a 2:1 ratio to the (1) intervention group (Omron HJ-720 ITC pedometer and Internet-mediated program) or (2) wait-list control group (pedometer). The primary outcome was health-related quality of life (HRQL), assessed by the St. George’s Respiratory Questionnaire (SGRQ), at 4 months. We examined the SGRQ total score (SGRQ-TS) and three domain scores: Symptoms, Activities, and Impact. The secondary outcome was daily step counts. Linear regression models assessed the effect of intervention on outcomes.

RESULTS:  Participants had a mean age of 67 ± 9 years, and 94% were men. There was no significant between-group difference in mean 4-month SGRQ-TS (2.3 units, P = .14). Nevertheless, a significantly greater proportion of intervention participants than control subjects had at least a 4-unit improvement in SGRQ-TS, the minimum clinically important difference (53% vs 39%, respectively, P = .05). For domain scores, the intervention group had a lower (reflecting better HRQL) mean than the control group by 4.6 units for Symptoms (P = .046) and by 3.3 units for Impact (P = .049). There was no significant difference in Activities score between the two groups. Compared with the control subjects, intervention participants walked 779 more steps per day at 4 months (P = .005).

CONCLUSIONS:  An Internet-mediated, pedometer-based walking program can improve domains of HRQL and daily step counts at 4 months in people with COPD.

TRIAL REGISTRY:  Clinical Trials.gov; No.: NCT01102777; URL: www.clinicaltrials.gov

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