Clinically relevant effects on physical activity with web-based self-management support in people with COPD: a randomized controlled trial

Background: The effectiveness of self-management support to increase physical activity (PA) in people with chronic obstructive pulmonary disease (COPD) has been shown, but it is still unclear whether web-based self-management support is effective. Aim: To investigate effects of web-based self-management support on PA in people with COPD. Methods: This trial randomly allocated 146 participants (47% women) with mild to severe COPD, mean (SD) age 69.5 (6.7) years, FEV1 pred 60.7 (19.1) % to the intervention group (IG) or control group (CG). Together with continued usual care, all participants received a pedometer and information about the importance of PA. Additionally, the IG were given access to the COPD Web, an interactive website to support self-management in COPD, with a focus on PA. PA at baseline and three months was measured using validated accelerometers for seven days. The primary outcome, the average number of steps per weekday, was analysed with ANCOVA, with missing values imputed using multiple imputation. Results: Baseline PA was similar between groups, median (IQR), IG: 5549 (3878, 8106) steps/day vs. CG: 5288 (3501,7614) steps/day, p>0.05). However, at three months, a significant mean difference of 1167 steps/day (95% confidence interval: 55-2279, p=0.04) was seen, favoring the IG compared to the CG. Conclusion: The use of web-based self-management support for people with COPD led to an objective, clinically relevant short-term increase in the level of PA compared to usual care. This RCT strengthens the evidence that web-based self-management support might be a promising strategy to improve PA in COPD.