Home-based Pulmonary Rehabilitation for COPD Patients

Study Overview
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Brief Summary
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Objectives The objective of this project is to motivate patients with COPD to incorporate the habit of doing daily mindful physical activity by using the proposed home-based pulmonary rehabilitation program that integrates video guided exercises, activity monitoring daily steps and health coaching. This program will allow patients to complete Pulmonary Rehabilitation (PR) at home and promote behavior change and lead to a more active lifestyle for patients with COPD who have been prescribed PR. The program will be able to effectively monitor daily step count. A health coach will receive more this detailed data and will guide weekly health coaching sessions designed to increase awareness of the physical activities completed and ignite inner motivation for healthy behaviors. The proposed PR program is innovative and responds to an unmet need in chronic care for COPD patients in the context of COVID-19 pandemic and it mitigates the common accessibility barriers.

Detailed Description
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Specific aims will guide the proposed project: Aim 1: To determine the feasibility of the proposed home-based PR program. We will additionally address adherence and appropriateness of the program. Aim 2: To determine improvements in quality of life and mental health of the proposed home-based PR determined. Aim 3: To evaluate if the average number of daily step counts increase after the home-based PR program

Official Title
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Home-based Pulmonary Rehabilitation for COPD Patients

Conditions
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COPD, Chronic Obstructive Pulmonary Disease

Intervention / Treatment
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* Behavioral: Home based exercise


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Men and women age 40 years and older FEV1 <80% or less (forced expiratory volume in one second) as documented by pulmonary function. Medical diagnosis of COPD, GOLD classification B,D, and C based on symptoms and history of exacerbations. The patients must be able to access a smart-phone or computer tablet with internet service. Exclusion Criteria: Unable to perform low intensity exercise. Patients with a high likelihood of being lost to follow-up or contact (patients with active chemical dependency), are planning to move, are not living in the healthcare area. Patients with an inability to provide good data or follow commands (patients who are disoriented, have a severe neurologic or psychiatric condition).

Ages Eligible for Study
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Minimum Age: 40 Years
Maximum Age: 100 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: starting with a small pilot and will follow with parallell design RCT - starting later
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Home based exercise<br>Home based exercise with health coaching | Behavioral: Home based exercise<br>* Exercise at home and behavioural change to increase daily exercise<br>|
| No Intervention: Usual care<br>Usual care, waiting list | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Disease specific quality of life | Chronic Respiratory Questionnaire (CRQ) | 8-12 weeks | 
| Modified Medical Research Council Dyspnea scale (mMRC), | Dyspnea | 8-12 weeks | 
| COPD assessment Test (CAT) | assess symptoms of breathing | 8-12 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| GAD to asses anxiety and depression symptoms | assessing anxiety and depression symptoms | 8-12 weeks | 
| Online breathing and mindful movement exercises/ exercise routine | Total time performing the breathing exercises | 8-12 weeks | 
| Activity monitoring | number of steps | 8-12 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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tele-health, behavioural change, motivational interviewing, home-based exercise, self-related health, quality of life