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Randomized Controlled Trial
. 2016 Aug 25:11:1991-2000.
doi: 10.2147/COPD.S109820. eCollection 2016.

A randomized controlled trial of telephone-mentoring with home-based walking preceding rehabilitation in COPD

Helen Laura Cameron-Tucker  1 , Richard Wood-Baker  1 , Lyn Joseph  1 , Julia A Walters  1 , Natalie Schüz  2 , E Haydn Walters  1
Affiliations
Randomized Controlled Trial

A randomized controlled trial of telephone-mentoring with home-based walking preceding rehabilitation in COPD

Helen Laura Cameron-Tucker et al. Int J Chron Obstruct Pulmon Dis. .

Abstract

Purpose: With the limited reach of pulmonary rehabilitation (PR) and low levels of daily physical activity in chronic obstructive pulmonary disease (COPD), a need exists to increase daily exercise. This study evaluated telephone health-mentoring targeting home-based walking (tele-rehab) compared to usual waiting time (usual care) followed by group PR.

Patients and methods: People with COPD were randomized to tele-rehab (intervention) or usual care (controls). Tele-rehab delivered by trained nurse health-mentors supported participants' home-based walking over 8-12 weeks. PR, delivered to both groups simultaneously, included 8 weeks of once-weekly education and self-management skills, with separate supervised exercise. Data were collected at three time-points: baseline (TP1), before (TP2), and after (TP3) PR. The primary outcome was change in physical capacity measured by 6-minute walk distance (6MWD) with two tests performed at each time-point. Secondary outcomes included changes in self-reported home-based walking, health-related quality of life, and health behaviors.

Results: Of 65 recruits, 25 withdrew before completing PR. Forty attended a median of 6 (4) education sessions. Seventeen attended supervised exercise (5±2 sessions). Between TP1 and TP2, there was a statistically significant increase in the median 6MWD of 12 (39.1) m in controls, but no change in the tele-rehab group. There were no significant changes in 6MWD between other time-points or groups, or significant change in any secondary outcomes. Participants attending supervised exercise showed a nonsignificant improvement in 6MWD, 12.3 (71) m, while others showed no change, 0 (33) m. The mean 6MWD was significantly greater, but not clinically meaningful, for the second test compared to the first at all time-points.

Conclusion: Telephone-mentoring for home-based walking demonstrated no benefit to exercise capacity. Two 6-minute walking tests at each time-point may not be necessary. Supervised exercise seems essential in PR. The challenge of incorporating exercise into daily life in COPD is substantial.

Keywords: exercise; physical capacity; pulmonary rehabilitation; self-reported walking; structured self-management-based education.

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Figures

Figure 1
Figure 1
Flowchart depicting flow of participants through the study. Abbreviations: COPD, chronic obstructive pulmonary disease; PR, pulmonary rehabilitation.
See this image and copyright information in PMC

References

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