Full vs. light physical activity telecoaching similar in COPD

Key takeaways:

• Full vs. light coaching differed in smartphone app use, goal setting and contact frequency with a coach.
• The proportion of physical activity responders at 12 months was comparable between the two groups.

Changes in physical activity measures between baseline and 12 months in patients with COPD did not differ based on receipt of full vs. light physical activity telecoaching, according to study data.

These results were published in American Journal of Respiratory and Critical Care Medicine.

“Physical activity behavior change is not a one size fits all,” Astrid Blondeel, PhD, physiotherapist and postdoctoral researcher in the department of rehabilitation sciences at KU Leuven in Belgium, told Healio.

“The responder rates in our study showed that both coaching programs were effective in a subset of patients. We should tailor our coaching interventions towards the specific needs of our patients,” she said.

In a multicenter, single-blind randomized controlled trial, Blondeel and colleagues evaluated 149 patients with COPD to determine the impact of full vs. light physical activity coaching for 12 months on physical activity measures.

“Regular physical activity is a strong health-promoting behavior, also for patients with chronic lung disease,” Blondeel said. “Yet the best strategy to promote regular physical activity on the long-term in these patients was still unclear.”

Within this population, 76 patients (mean, 5,464 steps per day) received full physical activity coaching, and the study noted that this meant getting an activity tracker and a smartphone application with dynamic goal setting and regular feedback and contact with a coach (mean contact time per patient, 79 minutes).

The remaining 73 patients (mean, 5,730 steps per day) received light physical activity coaching, and this included an activity tracker, a fixed step goal and limited feedback/contact with a coach (mean contact time per patient, 42 minutes).

For the three physical activity measures assessed, researchers found that patients receiving full coaching did not significantly differ from those receiving light coaching at 12 months: number of steps per day measured via the Dynaport Movemonitor (mean difference, –44 steps per day), walking time via a Dynaport Movemonitor (–0.3 minutes) and physical activity intensity via a Dynaport Movemonitor (–0.003 m/s²).

Similarly, the two groups did not differ in changes in functional exercise capacity, quadriceps muscle force, dyspnea symptoms, health status, body weight, body composition and bone-mineral density between baseline and 12 months, according to the study.

“In contrast to our hypothesis, we could not find a meaningful difference in long-term effect between the full coaching program and light coaching program,” Blondeel told Healio. “No additional benefit of a fully deployed telecoaching intervention, with dynamic goal setting, daily and weekly feedback, and regular contact with a coach provided through a smartphone application, was observed in comparison with a light telecoaching intervention at 12 months follow-up.”

Among those receiving full coaching, researchers observed a non-significant rise in daily steps between baseline and 6 months (410 steps per day) and a significant reduction between 6 and 12 months (–552 steps per day).

Those receiving light coaching also had a non-significant rise in daily steps between baseline and 6 months (231 steps per day) and a reduction between 6 and 12 months (–327 steps per day), but this did not reach significance.

“The annual decline in physical activity in both groups was smaller than previously reported among patients with COPD, potentially indicating that both interventions might slow down the annual decline of physical activity in patients with chronic lung disease,” Blondeel said.

When limiting the set of patients receiving full coaching to only those who were compliant with the smartphone app (n = 48; 71%), the study again reported that this group did not significantly differ from the light coaching group in the physical activity measures.

In terms of responders, the study identified these patients as those who “exceeded the [minimal clinically important difference] of 1,000 steps per day.” At the 12-month mark, 19% of the full coaching group were deemed responders, which was comparable to the 22% of responders in the light coaching group.

“Future interventions need to focus on compliance and optimal patient selection,” Blondeel and colleagues wrote. “Frequent contact with a coach over the complete duration of the program, more mandatory interaction with the smartphone application, individualized approaches or more close supervision could affect long-term results.”

For more information:

Astrid Blondeel, PhD, can be reached at pulmonology@healio.com.