Participation in physical activity during hospital and home-based pulmonary rehabilitation for people with COPD

Introduction: Home-based pulmonary rehabilitation (PR) may be an alternative to conventional hospital-based programs to increase PR uptake in people with COPD. Both programs involve participation in exercise training, however in home-based PR this is largely unsupervised. Objective: To investigate the effect of model of program delivery on patterns of physical activity (PA) participation during PR in people with COPD. Methods: A subset of participants from the Home Base trial (Holland et al BMC Pulmonary Medicine 2013) undertook PA monitoring during the final week of an eight week PR program in home and hospital settings. The Sensewear armband (SWA) was used to collect PA data (minimum of four valid days, inclusive of one weekend day; valid day: minimum 10 hours wear). Total PA time (TPAT, ≥ 1.5 METs), including time spent in moderate to vigorous PA (MVPA, ≥ 3 METs), and steps were compared per day. Results: Forty-five people (23 male) with mean (SD) age 68 (8) years and FEV₁ 53.4 (18) %predicted were included. Participants wore the SWA a mean of five days. Home participants (n=20) engaged in TPAT a median of 310 [IQR: 200 to 372] min/day (90 in MVPA) compared to hospital group TPAT with median 300 [218 to 356] min/day (84 in MVPA, p= 0.79). Total weekly step count did not differ between home and hospital groups (mean 27113 vs 25863, p= 0.89). Of note, hospital participants took 38% more steps on supervised rehabilitation days compared to non-rehabilitation days (mean 762 more steps, 95% confidence interval -56 to 1579). Conclusion: These findings suggest no significant differences between PA participation in people with COPD undertaking home or hospital-based PR.