Pedometers to enhance physical activity in COPD: a randomised controlled trial

Abstract

Physical inactivity is a cardinal feature of chronic obstructive pulmonary disease (COPD), and is associated with increased morbidity and mortality. Pedometers, which have been used in healthy populations, might also increase physical activity in patients with COPD. COPD patients taking part in a 3-month individualised programme to promote an increase in their daily physical activity were randomised to either a standard programme of physical activity encouragement alone, or a pedometer-based programme. Assessments were performed by investigators blinded to treatment allocation. Change in average 1-week daily step count, 6-min walking distance (6MWD), modified Medical Research Council scale, St George's respiratory questionnaire (SGRQ) and COPD assessment test (CAT) were compared between groups. 102 patients were recruited, of whom 97 completed the programme (pedometer group: n=50; control group: n=47); 60.8% were male with a mean±sd age of 68.7±8.5 years, and forced expiratory volume in 1 s (FEV1) 66.1±19.4% and FEV1/forced vital capacity 55.2±9.5%. Both groups had comparable characteristics at baseline. The pedometer group had significantly greater improvements in: physical activity 3080±3254 steps·day(-1) versus 138.3±1950 steps·day(-1) (p<0.001); SGRQ -8.8±12.2 versus -3.8±10.9 (p=0.01); CAT score -3.5±5.5 versus -0.6±6.6 (p=0.001); and 6MWD 12.4±34.6 versus -0.7±24.4 m (p=0.02) than patients receiving activity encouragement only. A simple physical activity enhancement programme using pedometers can effectively improve physical activity level and quality of life in COPD patients.

FIGURE 1

CONSORT (Consolidated Standards of Reporting Trials) flow diagram of the study participants.

FIGURE 2

Significant differences in a) step count, b) health status, c) chronic obstructive pulmonary disease assessment test (CAT) and d) 6-min walking distance (6MWD) response between the control group and the pedometer group. SGRQ: St George’s Respiratory Questionnaire. ––––: mean; ······: zero values; - - -: level of minimal clinical difference for each variable [, –25].

FIGURE 3

Monthly increase in step count for patients in the pedometer group. Data are presented as mean with error bars representing sem of the daily steps obtained at each monthly visit during follow-up. ANOVA: p<0.001. Comparison between basal and 1 month of follow-up (p=0.026, CI=−3110–−125), 1–2 months of follow-up (p=0.071, CI=−2930–69.8) and 2–3 months of follow-up (p=0.20, CI=−1850–1160).