Participation in Physical Activity During Center and Home-Based Pulmonary Rehabilitation for People With COPD A SECONDARY ANALYSIS OF A RANDOMIZED CONTROLLED TRIAL

Purpose: To compare levels of physical activity during center and home-based pulmonary rehabilitation (PR) in people with chronic obstructive pulmonary disease. Methods: Forty-fi ve consecutive participants (23 male, n = 20, in the home-based group) with mean age of 68 +/- 8 yr and forced expiratory volume in the fi rst second of expiration (FEV 1) 53 +/- 18% predicted undertook physical activity monitoring using the SenseWear Armband during the fi nal week of the interventions of center or home-based PR. Differences in time spent in total physical activity (= 1.5 METs), time spent in moderate to vigorous intensity physical activity (= 3 METs), and steps were compared. Results: Home participants spent a median and interquartile range of 310 (199-328) min/ d engaged in total physical activity (29% moderate to vigorous intensity physical activity) compared with 300 (204-370) min/ d for the center group (28% moderate to vigorous intensity physical activity, P =.98). Daily step count did not differ between groups (home-based median 5232 [2067-7718] versus center-based median 4049 [1983-6040], P =.66). Of note, center-based participants took 38% more steps on days of program attendance compared with nonattendance days (mean difference: 761 steps/ d; 95% CI, -56 to 1579, P =.06). Conclusion: For people with chronic obstructive pulmonary disease undertaking PR, no differences in physical activity levels between center and home-based programs were demonstrated. Understanding the impact of the indirect supervision and motivational interviewing technique utilized during home-based PR on levels of physical activity in people with chronic obstructive pulmonary disease may support clinical implementation of the model as an alternative option to traditional care.