Smart watch-based coaching with tiotropium and olodaterol ameliorates physical activity in patients with chronic obstructive pulmonary disease

Abstract

Combined therapy with tiotropium and olodaterol notably improves parameters of lung function and quality of life in patients with chronic obstructive pulmonary disease (COPD) compared to mono-components; however, its effect on physical activity is unknown. The present study evaluated whether combination therapy affects daily physical performance in patients with COPD under a smart watch-based encouragement program. This was a non-blinded clinical trial with no randomization or placebo control. A total of 20 patients with COPD were enrolled in the present study. The patients carried an accelerometer for 4 weeks; they received no therapy during the first 2 weeks but they were treated with combined tiotropium and olodaterol under a smart watch-based encouragement program for the last 2 weeks. The pulmonary function test, COPD assessment test, 6-min walk distance and parameters of physical activity were significantly improved (P<0.05) by combination therapy under smart watch-based coaching compared with values prior to treatment. To the best of our knowledge, the present study for the first time provides evidence that smart watch-based coaching in combination with tiotropium and olodaterol may improve daily physical activity in chronic obstructive pulmonary disease.

Keywords: chronic obstructive pulmonary disease; long-acting muscarinic antagonist; long-acting β2-agonist; physical activity; smart watch.

Figure 1.

Pulmonary function test results before and after treatment with a combination of tiotropium + olodaterol. The FEV1 (1.38±0.40 vs. 1.58±0.47 l) and FVC (3.12±0.88 vs. 3.33±0.90 l) were significantly increased following therapy compared to before treatment. The mean ± standard deviation of each group are presented adjacent to data points. Statistical analysis was performed by non-parametric Wilcoxon rank test. FEV1, forced expiratory volume in 1 sec; FVC, forced vital capacity.

Figure 2.

CAT and 6-min walk distance test results before and after treatment with a combination of tiotropium + olodaterol. CAT (13.0±5.7 vs. 9.2±6.9) was significantly decreased whereas the 6-min walk distance (459.9±64.3 vs. 489.2±53.6 m) was significantly increased following therapy compared to before treatment. The mean ± standard deviation of each group are presented adjacent to data points. Statistical analysis was performed by non-parametric Wilcoxon rank test. CAT, chronic obstructive pulmonary disease assessment test.

Figure 3.

Number of steps and energy expenditure in patients with chronic obstructive pulmonary disease before and after treatment with a combination of tiotropium + olodaterol. The number of daily steps (5.757±2.927 vs. 7.089±3.775 steps) and energy burned as calories (138.5±77.4 vs. 164.6±88.1 kilocalories) were significantly enhanced after therapy compared to values obtained before therapy. The mean ± standard deviation of each group are presented adjacent to data points. Statistical analysis was performed by non-parametric Wilcoxon rank test.

Figure 4.

METs in patients with chronic obstructive pulmonary disease before and after treatment with a combination of tiotropium + olodaterol. The degree of physical activity expressed as MET was measured using a Lifecorder. The total (1–9 METs; 47.935±9.345 vs. 50.445±8.944), low-intensity (1–3 METs; 47.221±9.193 vs. 49.533±8.821) and moderate-intensity (4–6 METs; 701±696 vs. 897±720) activities were significantly enhanced after combination therapy compared to values before initiation of therapy. There was no significant difference in high-intensity activity (13±15 vs. 15±20). The mean ± standard deviation of each group are presented adjacent to data points. Statistical analysis was performed by non-parametric Wilcoxon rank test. METs, metabolic equivalent of tasks; NS, not significant.