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A randomized controlled trial of telephone-mentoring with home-based walking preceding rehabilitation in COPD

Citation

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]


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Copyright Statement

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/

DOI: doi:10.2147/COPD.S109820

Abstract

Purpose: With the limited reach of pulmonary rehabilitation (PR) and low levels of daily physical activity in chronic obstructive pulmonary disease (COPD), a need exists to increase daily exercise. This study evaluated telephone health-mentoring targeting home-based walking (tele-rehab) compared to usual waiting time (usual care) followed by group PR.

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 (52 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 Details

Item Type:Refereed Article
Keywords:health mentoring, exercise, physical capacity, pulmonary rehabilitation, self-reported walking, structured self-management-based education
Research Division:Medical and Health Sciences
Research Group:Public Health and Health Services
Research Field:Health Promotion
Objective Division:Health
Objective Group:Health and Support Services
Objective Field:Health Education and Promotion
Author:Cameron-Tucker, HL (Dr Helen Cameron-Tucker)
Author:Wood-Baker, R (Professor Richard Wood-Baker)
Author:Walters, JA (Dr Julia Walters)
Author:Schuz, N (Dr Natalie Schuez)
Author:Walters, EH (Professor Haydn Walters)
ID Code:111708
Year Published:2016
Web of Science® Times Cited:5
Deposited By:Health Sciences
Deposited On:2016-09-30
Last Modified:2018-02-07
Downloads:78 View Download Statistics

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