[Evaluation of an app-based rehabilitation aftercare program focusing on physical activity promotion for persons with chronic obstructive pulmonary disease (COPD): Results of a pilot study].

Abstract

Purpose: To evaluate an app-based follow-up care program for individuals with chronic obstructive pulmonary disease (COPD) post-rehabilitation.

Methods: After a 3-week inpatient pulmonary rehabilitation, a 12-week app-based follow-up care program was conducted. The app-based program was based on the model of physical activity-related health competence. The core components were: (1) personalized endurance and resistance training plans, (2) activity monitors for self-monitoring, (3) e-learning modules, and (4) 1:1 coaching by sports therapists and physiotherapists of the rehabilitation clinic. The following outcomes were assessed with questionnaires at the start and the end of rehabilitation as well as after follow-up care: COPD Assessment Test, quality of life, depression, anxiety, fatigue, key symptoms of COPD, pain, sport-/exercise-related activities, leisure-time/transportation physical activity, physical activity-related health competence, and experiences with the follow-up care. An exploratory analysis examined changes in outcomes during rehabilitation and follow-up care (Wilcoxon signed-rank tests, α<0.05). Experiences with the follow-up care were analyzed descriptively.

Results: 42 participants (age: M=57.5; SD=5.6; BMI: M=29.1; SD=6.5; GOLD stage 1/2/3/4: 2.4%/50.0%/38.1%/9.5%) provided data at all measurement time points. Except for leisure-time/transportation physical activity and partnership-related anxiety, the outcomes improved significantly during rehabilitation. Exercise-induced dyspnea (d=-0.45) as well as the sub-competencies of physical activity-related health competence (movement competence: d=-0.69; control competence: d=-0.68; self-regulation competence: d=-0.80) showed further improvements during follow-up care. Sport- and exercise-related activity (d=-1.28) and sputum quantity (d=-0.64) improved during rehabilitation, but deteriorated during follow-up care (sport-/exercise related activity: d=-0.52; sputum quantity: d=-0.55). However, the values of sport- and exercise-related activity after follow-up care were higher than at the beginning of rehabilitation (d=-0.65). App-usability and the atmosphere during aftercare were high.

Conclusion: The effects of pulmonary rehabilitation were maintained or further improved in most outcomes over the course of the app-based intervention. These findings provide initial indications of the efficacy of the developed app-based follow-up care program.