Original articleA Randomized Clinical Trial of an Activity and Exercise Adherence Intervention in Chronic Pulmonary Disease
Section snippets
Design
The study was a randomized controlled trial of an exercise adherence intervention and used an intention-to-treat format. The study was approved by the institutional review board. Patients who completed an 8-week, outpatient pulmonary rehabilitation program were randomized to receive either the intervention (n=52) or usual care (n=54). There were several components to protocol implementation and randomization: (1) recruitment; (2) eligibility screening and time 1 (baseline) testing; (3)
Results
As seen in figure 1, 102 of 111 randomized subjects provided outcome data at week 20 while data were missing on 9 subjects at week 20. However, 4 of these 9 missing subjects did later provide data at week 52, so that the total number of subjects providing some follow-up data at either 20 or 52 weeks was 106, 54 in the control group and 52 in the intervention group. Eighty-five of the 106 subjects had COPD. Twelve subjects in the intervention group and 9 in the control group had interstitial
Discussion
This largely home-based intervention showed short-term maintenance of self-reported adherence to exercise and persistence of exercise capacity benefits compared with a nonintervention control group. Like other programs that used an adherence intervention post hoc, however, results persisted for only the duration of the intervention. The primary endpoint of daily activity measures by accelerometer did increase more during the exercise adherence intervention in the intervention group than in the
Conclusions
The benefits of the adherence intervention that included individualized coaching and a home visit provided only limited short-term improvement in exercise capacity and self-reported maintenance of exercise after pulmonary rehabilitation in this highly sedentary group of patients with chronic lung disease. No long-term benefits were evident. We recommend caution in the use of the RT3 accelerometer to measure free-living daily activity because of the unacceptably high signal-to-noise ratio
Acknowledgment
The views expressed in this article are those of the authors and do not necessarily represent the views of the U.S. Department of Veterans Affairs.
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Cited by (0)
Supported by the Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Service (grant no. NRI 98-194) and the University of Washington School of Nursing (research and intramural funding grant).
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the authors or upon any organization with which the authors are associated.