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Interactive web-based pulmonary rehabilitation programme: a randomised controlled feasibility trial
  1. Emma Chaplin1,
  2. Stacey Hewitt1,
  3. Lindsay Apps1,
  4. John Bankart2,
  5. Ruth Pulikottil-Jacob3,
  6. Sally Boyce1,
  7. Mike Morgan1,
  8. Johanna Williams1,
  9. Sally Singh1,4
  1. 1Leicester Respiratory Biomedical Research Unit, Department of Respiratory Medicine, Centre for Exercise and Rehabilitation Science, Glenfield Hospital, University Hospitals of Leicester, Leicester, UK
  2. 2Department of Primary Care and Health Sciences, Keele University, Keele, UK
  3. 3Health Sciences Research Institute, Medical School, University of Warwick, Coventry, UK
  4. 4School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
  1. Correspondence to Emma Chaplin; emma.chaplin{at}uhl-tr.nhs.uk

Abstract

Objectives The aim of this study was to determine if an interactive web-based pulmonary rehabilitation (PR) programme is a feasible alternative to conventional PR.

Design Randomised controlled feasibility trial.

Setting Participants with a diagnosis of chronic obstructive pulmonary disease were recruited from PR assessments, primary care and community rehabilitation programmes. Patients randomised to conventional rehabilitation started the programme according to the standard care at their referred site on the next available date.

Participants 103 patients were recruited to the study and randomised: 52 to conventional rehabilitation (mean (±SD) age 66 (±8) years, Medical Research Council (MRC) 3 (IQR2–4)); 51 to the web arm (mean (±SD) age 66 (±10) years, MRC 3 (IQR2–4)). Participants had to be willing to participate in either arm of the trial, have internet access and be web literate.

Interventions Patients randomised to the web-based programme worked through the website, exercising and recording their progress as well as reading educational material. Conventional PR consisted of twice weekly, 2 hourly sessions (an hour for exercise training and an hour for education).

Outcome measures Recruitment rates, eligibility, patient preference and dropout and completion rates for both programmes were collected. Standard outcomes for a PR assessment including measures of exercise capacity and quality of life questionnaires were also evaluated.

Results A statistically significant improvement (p≤0.01) was observed within each group in the endurance shuttle walk test (WEB: mean change 189±211.1; PR classes: mean change 184.5±247.4 s) and Chronic Respiratory disease Questionnaire-Dyspnoea (CRQ-D; WEB: mean change 0.7±1.2; PR classes: mean change 0.8±1.0). However, there were no significant differences between the groups in any outcome. Dropout rates were higher in the web-based programme (57% vs 23%).

Conclusions An interactive web-based PR programme is feasible and acceptable when compared with conventional PR. Future trials maybe around choice-based PR programmes for select patients enabling stratification of patient care.

Trial registration number ISRCTN03142263; Results.

  • SPACE for COPD
  • chronic obstructive pulmonary disease
  • Internet
  • Web-based
  • pulmonary rehabilitation

This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/

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Footnotes

  • Contributors All authors of the paper have contributed to the design of the work, acquisition, analysis and interpretation of the data. SS, JW, EC, LA, JB and SB were involved in the development of the intervention and design of the trial. EC and SS have been involved in drafting the work or revising it critically for important intellectual content and have given the final approval of the version published.

  • Funding This work was funded by the RfPB (PB-PG-0711-25127) which is part of the funding body NIHR.

  • Disclaimer The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health.

  • Competing interests None declared.

  • Ethics approval Ethics approval has been received from the Northampton Research Ethics Committee of the UK National Research Ethics Service (Ethics Ref: 12/EM/0351).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Additional unpublished data from the study are still being collected and analysed and are only available to members of the study team.

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