Center for Clinical Management Research, VA Ann Arbor Healthcare System, 2215 Fuller Rd, 48105 Ann Arbor, MI, USA.
BMC Pulm Med. 2014 Feb 3;14:12. doi: 10.1186/1471-2466-14-12.
Low levels of physical activity are common in patients with chronic obstructive pulmonary disease (COPD), and a sedentary lifestyle is associated with poor outcomes including increased mortality, frequent hospitalizations, and poor health-related quality of life. Internet-mediated physical activity interventions may increase physical activity and improve health outcomes in persons with COPD.
METHODS/DESIGN: This manuscript describes the design and rationale of a randomized controlled trial that tests the effectiveness of Taking Healthy Steps, an Internet-mediated walking program for Veterans with COPD. Taking Healthy Steps includes an uploading pedometer, a website, and an online community. Eligible and consented patients wear a pedometer to obtain one week of baseline data and then are randomized on a 2:1 ratio to Taking Healthy Steps or to a wait list control. The intervention arm receives iterative step-count feedback; individualized step-count goals, motivational and informational messages, and access to an online community. Wait list controls are notified that they are enrolled, but that their intervention will start in one year; however, they keep the pedometer and have access to a static webpage.
Participants include 239 Veterans (mean age 66.7 years, 93.7% male) with 155 randomized to Taking Healthy Steps and 84 to the wait list control arm; rural-living (45.2%); ever-smokers (93.3%); and current smokers (25.1%). Baseline mean St. George's Respiratory Questionnaire Total Score was 46.0; 30.5% reported severe dyspnea; and the average number of comorbid conditions was 4.9. Mean baseline daily step counts was 3497 (+/- 2220).Veterans with COPD can be recruited to participate in an online walking program. We successfully recruited a cohort of older Veterans with a significant level of disability including Veterans who live in rural areas using a remote national recruitment strategy.
Clinical Trials.gov NCT01102777.
慢性阻塞性肺疾病（COPD）患者普遍活动量低，久坐的生活方式与较差的结局相关，包括死亡率增加、频繁住院和健康相关生活质量差。互联网介导的体力活动干预可能会增加 COPD 患者的体力活动并改善健康结局。
方法/设计：本文介绍了一项随机对照试验的设计和原理，该试验测试了 Taking Healthy Steps 的有效性，这是一项针对 COPD 退伍军人的互联网介导的步行计划。Taking Healthy Steps 包括上传计步器、网站和在线社区。符合条件并同意的患者佩戴计步器获取一周的基线数据，然后按照 2:1 的比例随机分配到 Taking Healthy Steps 或等待名单对照。干预组接受迭代计步反馈；个体化计步目标、激励和信息消息，以及访问在线社区。等待名单对照会被告知他们已注册，但他们的干预将在一年后开始；但是，他们保留计步器并可以访问静态网页。
参与者包括 239 名退伍军人（平均年龄 66.7 岁，93.7%为男性），其中 155 名随机分配到 Taking Healthy Steps 组，84 名分配到等待名单对照组；农村居住（45.2%）；曾经吸烟者（93.3%）和当前吸烟者（25.1%）。基线 St. George's Respiratory Questionnaire 总评分平均为 46.0；30.5%报告严重呼吸困难；平均合并症数量为 4.9。基线每日平均步数为 3497（+/-2220）。COPD 退伍军人可以被招募参加在线步行计划。我们使用远程全国招募策略成功招募了一群年龄较大、残疾程度较高的退伍军人，包括居住在农村地区的退伍军人。
ClinicalTrials.gov NCT01102777。
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