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Pulmonary rehabilitation? There’s an app for that

Jairia Dela Cruz
06 Feb 2019

Digitalizing pulmonary rehabilitation (PR) using a smartphone app is feasible in the management of chronic obstructive pulmonary disease (COPD), with patients completing a 20-day core programme showing improvements in health-related quality of life, according to a study.

Indicated for self-management exercise training for COPD, the Kaia COPD app provides daily exercises tailored according to the user’s personal health status and physical limitations determined in an integrated onboarding process. This procedure ensures that the users are physically able to conduct the exercises and that they have no contraindications to exercise therapy.

In the present study, researchers examined the change in health-related quality of life (COPD assessment test and Chronic Respiratory Disease Questionnaire [CRQ]) in 34 Kaia COPD app users (mean age 59.6 years; 76 percent female) who completed the 20-day core programme.

Overall, the users took a mean of 33 days to complete the programme. Completion led to a significant reduction in COPD assessment test scores (mean, 2.5 units; from 21.6 units at baseline to 19.1 units; p=0.008). [Int J Chron Obstruct Pulmon Dis 2018;13:3831-3836]

Mean CRQ scores also showed favourable results, especially on the domains of fatigue (from 3.4 to 4.1; p<0.001), mastery (from 4.1 to 4.6; p<0.001) and emotional function (from 3.8 to 4.4; p<0.001). Finally, there was a statistically significant but not clinically relevant effect on the domain of dyspnoea (from 3.4 to 3.2; p<0.05).

The core programme included the following elements: 1) short videos of strength and mobility training exercises, 2) patient education based on established patient guidelines, and 3) mindfulness techniques for disease coping. Users could choose to complete one, two or all three elements.

A feeling thermometer (0–10 scale) verified for COPD facilitated daily tracking of disease progression, while a linear Borg scale was used for dyspnoea assessment. These measurements were reported to the user together with the physical activity based on the number of steps per day.

“A well-known problem is the effects of PR decline after completing the programme. Maintenance programmes are able to preserve the effects. Our digitalized PR programme could [therefore] be an easily accessible solution to serve not only as an initial but also as a maintenance programme, without [the] burden of traveling for the patients,” researchers pointed out.

“Furthermore, it could offer a valid solution to face the initially mentioned problem of lack of PR capacities … [and] could serve as alternative for patients in remote areas,” they added.

However, due to the short duration of the intervention, small population size and the observational nature of the study, additional prospective studies must be conducted to confirm the findings and assess the longer-term effects of the Kaia COPD PR app.

Where COPD is concerned, PR has a positive effect on disease progression and mortality, is cost-effective, and is part of recommendations of international guidelines, researchers noted. In spite of this, only a minority of patients benefit from conventional PR due to factors including lack of resources, physicians’ guideline adherence or patients’ motivation.

“Novel digital therapies like Kaia COPD, a smartphone application that digitizes PR in COPD, are promising solutions to fill this void,” they said, adding that the software is available on the Apple App Store and the Google Play Store.

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