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A randomized controlled trial of telephone-mentoring with home-based walking preceding rehabilitation in COPD
Cameron-Tucker, HL and Wood-Baker, R and Joseph, L and Walters, JA and Schuz, N and Walters, EH, A randomized controlled trial of telephone-mentoring with home-based walking preceding rehabilitation in COPD, International Journal of Chronic Obstructive Pulmonary Disease, 11, (1) pp. 1991-2000. ISSN 1178-2005 (2016) [Refereed Article]
Copyright 2016 Cameron-Tucker et al. Licensed under Creative Commons Attribution-NonCommercial 3.0 Unported (CC BY-NC 3.0) https://creativecommons.org/licenses/by-nc/3.0/
Patients and methods: People with COPD were randomized to tele-rehab (intervention) or usual care (controls). Tele-rehab delivered by trained nurse health-mentors supported participants' home-based walking over 8-12 weeks. PR, delivered to both groups simultaneously, included 8 weeks of once-weekly education and self-management skills, with separate supervised exercise. Data were collected at three time-points: baseline (TP1), before (TP2), and after (TP3) PR. The primary outcome was change in physical capacity measured by 6-minute walk distance (6MWD) with two tests performed at each time-point. Secondary outcomes included changes in self-reported home-based walking, health-related quality of life, and health behaviors.
Results: Of 65 recruits, 25 withdrew before completing PR. Forty attended a median of 6 (4) education sessions. Seventeen attended supervised exercise (5±2 sessions). Between TP1 and TP2, there was a statistically significant increase in the median 6MWD of 12 (39.1) m in controls, but no change in the tele-rehab group. There were no significant changes in 6MWD between other time-points or groups, or significant change in any secondary outcomes. Participants attending supervised exercise showed a nonsignificant improvement in 6MWD, 12.3 (71) m, while others showed no change, 0 (33) m. The mean 6MWD was significantly greater, but not clinically meaningful, for the second test compared to the first at all time-points.
Conclusion: Telephone-mentoring for home-based walking demonstrated no benefit to exercise capacity. Two 6-minute walking tests at each time-point may not be necessary. Supervised exercise seems essential in PR. The challenge of incorporating exercise into daily life in COPD is substantial.
|Item Type:||Refereed Article|
|Keywords:||health mentoring, exercise, physical capacity, pulmonary rehabilitation, self-reported walking, structured self-management-based education|
|Research Division:||Health Sciences|
|Research Group:||Public health|
|Research Field:||Health promotion|
|Objective Group:||Evaluation of health and support services|
|Objective Field:||Health education and promotion|
|UTAS Author:||Cameron-Tucker, HL (Dr Helen Cameron-Tucker)|
|UTAS Author:||Wood-Baker, R (Professor Richard Wood-Baker)|
|UTAS Author:||Walters, JA (Dr Julia Walters)|
|UTAS Author:||Schuz, N (Dr Natalie Schuez)|
|UTAS Author:||Walters, EH (Professor Haydn Walters)|
|Web of Science® Times Cited:||22|
|Deposited By:||Health Sciences|
|Downloads:||197 View Download Statistics|
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