Physical activity that is pedometer-based and internet-mediated was effective among patients with COPD, but the results were not maintained at 12 months.
To analyze the effects of an online, pedometer-based walking intervention — called Taking Healthy Steps — among patients with COPD at 12 months, the researchers randomly assigned 239 veterans into either an intervention group or a wait-list control group, at a 2:1 ratio. During the first 4 months, patients in the intervention group were instructed to wear a pedometer every day and upload the daily step counts at least once per week. In addition, they were provided access to a website that offered individualized goal setting, iterative feedback, educational and motivational content and a community forum. In the subsequent 8-month maintenance phase, the only change was that patients no longer received educational content.
Patients in the wait-list control group were instructed to wear a pedometer, but did not receive any step-count goals or instructions to increase physical activity. The primary outcome was health-related quality of life assessed by the St. George’s Respiratory Questionnaire Total Score (SGRQ-TS), and the secondary outcome was daily step count.
According to the researchers, there were no significant differences in SGRQ-TS or daily step count between the two groups at 12 months. The difference in daily step count between the two groups peaked, and was statistically significant at 4 months (P < .001), approached zero in months 8 to 12. A mean of 76.7% of the 366-day study period had valid step-count data provided by patients in the intervention group. The amount of valid step-count data decreased over the months of the study (P < .001). The mean number of log-ins to the website each month also decreased significantly over the months (P < .001). The online community forum was used at least once by 83.8% of the participants. Self-reported goal commitment and intervention engagement were not significantly different at 12 months compared to 4 months.