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. 2021 Nov 22;21(1):325.
doi: 10.1186/s12911-021-01694-5.

A home-based pulmonary rehabilitation mHealth system to enhance the exercise capacity of patients with COPD: development and evaluation

Ning Deng  1   2 , Leiyi Sheng  1 , Wangshu Jiang  1 , Yongfa Hao  3 , Shuoshuo Wei  3 , Bei Wang  3 , Huilong Duan  1 , Juan Chen  4
Affiliations

A home-based pulmonary rehabilitation mHealth system to enhance the exercise capacity of patients with COPD: development and evaluation

Ning Deng et al. BMC Med Inform Decis Mak. .

Abstract

Background: Patients with chronic obstructive pulmonary disease (COPD) experience deficits in exercise capacity and physical activity as their disease progresses. Pulmonary rehabilitation (PR) can enhance exercise capacity of patients and it is crucial for patients to maintain a lifestyle which is long-term physically active. This study aimed to develop a home-based rehabilitation mHealth system incorporating behavior change techniques (BCTs) for COPD patients, and evaluate its technology acceptance and feasibility.

Methods: Guided by the medical research council (MRC) framework the process of this study was divided into four steps. In the first step, the prescription was constructed. The second step was to formulate specific intervention functions based on the behavior change wheel theory. Subsequently, in the third step we conducted iterative system development. And in the last step two pilot studies were performed, the first was for the improvement of system functions and the second was to explore potential clinical benefits and validate the acceptance and usability of the system.

Results: A total of 17 participants were enrolled, among them 12 COPD participants completed the 12-week study. For the clinical outcomes, Six-Minute Walk Test (6MWT) showed significant difference (P = .023) over time with an improvement exceeded the minimal clinically important difference (MCID). Change in respiratory symptom (CAT score) was statistically different (P = .031) with a greater decrease of - 3. The mMRC levels reduced overall and showed significant difference. The overall compliance of this study reached 82.20% (± 1.68%). The results of questionnaire and interviews indicated good technology acceptance and functional usability. The participants were satisfied with the mHealth-based intervention.

Conclusions: This study developed a home-based PR mHealth system for COPD patients. We showed that the home-based PR mHealth system incorporating BCTs is a feasible and acceptable intervention for COPD patients, and COPD patients can benefit from the intervention delivered by the system. The proposed system played an important auxiliary role in offering exercise prescription according to the characteristics of patients. It provided means and tools for further individuation of exercise prescription in the future.

Keywords: Behavior change wheel; COPD; Pulmonary rehabilitation; mHealth.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Schematic describing the design process of home-based PR incorporating BCW guided by the MRC framework. BCW behavior change wheel, MRC medical research council
Fig. 2
Fig. 2
Structure of exercise prescription
Fig. 3
Fig. 3
The conceptual model of the proposed system and the intervention process
Fig. 4
Fig. 4
Compliance of the participants per week over the 12-weeks
Fig. 5
Fig. 5
The average score of each attributes of the questionnaire for technology acceptance
See this image and copyright information in PMC

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