inspiration point-a digital pulmonary rehabilitation tool management interventions

Conditions: COPD

Summary: the purpose of this study is to measure the feasibility of use of a digital pulmonary rehabilitation tool compared with standard care home program pulmonary rehabilitation.

the study design is a between subjects (usual care/app) repeated measures (pre/post) design to compare the feasibility of usual care compared with the digital app, inspiration point, used in the home for 8 weeks.

Eligibility criteria:
inclusion criteria: * participants will have physician permission and diagnosis copd (fev1 \>30%-80%), * gold level a-d, and * ability to perform the 6 minute walk test (6mwt). * this means that participants must meet the standard definition of copd and have a post-bronchodilator measurement of fev1/fvc \< 0.7. * all copd assessment test scores will be accepted. * patients must have an mmrc score = 1-4. * additionally, patients must have taken a pulmonary function test within 1 year or they must retake (for baseline measurement) before participating in the study. * patients must not have had a pulmonary rehabilitation class within the last 6 months. * if participants have had a recent cardiac event within 6 months (such as a myocardial infarction or an abnormal cardiac catheterization) they must obtain cardiologist approval before participating in the study. * in an effort to evaluate feasibility we will request that participants have their own wi-fi. participants may use their own mobile device if they prefer but blue marble will have ample supply to provide to participants a device for the purposes of this study. * target representativeness for gender, based on copd demography will be \~50% women, based on recent trends indicating that women have an equal, and perhaps slightly greater risk of copd compared to men3. * the ethnicity/race target recruitment, consistent with the us and the population at each site. * participants must speak, read, and understand english at or above the 6th-grade level (as indicated by having a driver's license or self-report of completion of some high school). exclusion criteria for participants with copd: * pulmonary functional fitness that precludes participation in outpatient/home pr program (i.e. requires in-patient supervision or severity of a co-morbidity that represents a contradiction to exercise in a self-directed program) will be exclusionary. * a participant who desaturates below sao2 \<88% during the pre-test 6mwt and does not have personal oxygen available will be referred for further evaluation and can be included once they have an o2 titration and supplemental oxygen. * other exclusions include if a patient's oxygen use exceeds 4 liters per minute (lpm) or those who score less than 100 meters during the entry 6-minute walk distance. * participants with coronary problems will be excluded based on specific morbidity and severity. these coronary exclusions include coronary artery disease with unstable angina. * additional exclusions include: any respiratory disorder other than copd that contraindicates participation in a home-based program. * the inability to learn how to use inspiration point * an acute neurological or cardiovascular condition such as stroke or acute heart surgery. * active cancer with an anticipated survival of less than 6 months or treatment that will preclude them from participating in pulmonary rehab. * a participant with high fall risk as per physician determination. * the presence of a neurologic disorder that precludes a potential participant from following a typical copd exercise program or demonstrating hand function sufficient to interface with the tablet. * this also includes patients with prior or current neurologic event/condition presenting fall risk or requiring assist device for ambulation will also be excluded.

Keywords: pulmonary rehabilitation digital telehealth software electronic health