• Marilyn L Moy, Riley J Collins, Carlos H Martinez, Reema Kadri, Pia Roman, Robert G Holleman, Hyungjin Myra Kim, Huong Q Nguyen, Miriam D Cohen, David E Goodrich, Nicholas D Giardino, and Caroline R Richardson.
• Department of Veterans Affairs, Rehabilitation Research and Development Service, and the Pulmonary and Critical Care Medicine Section, VA Boston Healthcare System, Harvard Medical School, Boston, MA.
• Chest. 2015 Jul 1; 148 (1): 128137128-137.

BackgroundLow levels of physical activity (PA) are associated with poor outcomes in people with COPD. Interventions to increase PA could improve outcomes.MethodsWe tested the efficacy of a novel Internet-mediated, pedometer-based exercise intervention. Veterans with COPD (N = 239) were randomized in a 2:1 ratio to the (1) intervention group (Omron HJ-720 ITC pedometer and Internet-mediated program) or (2) wait-list control group (pedometer). The primary outcome was health-related quality of life (HRQL), assessed by the St. George's Respiratory Questionnaire (SGRQ), at 4 months. We examined the SGRQ total score (SGRQ-TS) and three domain scores: Symptoms, Activities, and Impact. The secondary outcome was daily step counts. Linear regression models assessed the effect of intervention on outcomes.ResultsParticipants had a mean age of 67 ± 9 years, and 94% were men. There was no significant between-group difference in mean 4-month SGRQ-TS (2.3 units, P = .14). Nevertheless, a significantly greater proportion of intervention participants than control subjects had at least a 4-unit improvement in SGRQ-TS, the minimum clinically important difference (53% vs 39%, respectively, P = .05). For domain scores, the intervention group had a lower (reflecting better HRQL) mean than the control group by 4.6 units for Symptoms (P = .046) and by 3.3 units for Impact (P = .049). There was no significant difference in Activities score between the two groups. Compared with the control subjects, intervention participants walked 779 more steps per day at 4 months (P = .005).ConclusionsAn Internet-mediated, pedometer-based walking program can improve domains of HRQL and daily step counts at 4 months in people with COPD.Trial RegistryClinical Trials.gov; No.: NCT01102777; URL: www.clinicaltrials.gov.

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