Gloeckl Rainer, Spielmanns Marc, Stankeviciene Asta, Plidschun Anne, Kroll Daniela, Jarosch Inga, Schneeberger Tessa, Ulm Bernhard, Vogelmeier Claus F, Koczulla Andreas Rembert
Institute for Pulmonary Rehabilitation Research, Schön Klinik Berchtesgadener Land, Schönau am Königssee, Germany
Department of Pulmonary Rehabilitation, German Center for Lung Research (DZL), Philipps-University, Marburg, Germany.
Thorax. 2025 Mar 18;80(4):209-217. doi: 10.1136/thorax-2024-221803.
Pulmonary rehabilitation (PR) is an essential element of chronic obstructive pulmonary disease (COPD) management. However, access to conventional face-to-face PR programmes is limited.
This multicentre, randomised controlled trial recruited patients with COPD from 18 sites in Germany and Switzerland, aiming to evaluate the impact of 12 weeks of a mobile app (intervention group; IVG) on quality of life, measured by COPD Assessment Test (CAT), and exercise capacity, assessed by 1-minute-sit-to-stand-test (1MSTST), compared with a control group (CTG) receiving 'enhanced standard-of-care'.
278 patients were included in the study with a median age of 65 years (IQR 60-70) and forced expiratory volume in 1 s 48% predicted (IQR 37-60). In the intention-to-treat analysis at week 12, CAT improved from baseline by median -4 points versus -3 points in the IVG versus CTG groups, respectively (difference: 0 points (95% CI: -1, 2); p=0.7); 1MSTST improved by 1 vs 2 repetitions, respectively (difference: 1 repetition (95% CI: 0, 2); p=0.12)). In a subset of the IVG, with patients grouped by application adherence (≥3 days/week for≥75% of the weeks), adherent users (40.4%) improved 1MSTST versus non-adherent users by median 2 repetitions (95% CI: 1, 3]; p=0.006. Application use did not raise any safety concerns.
Application-based PR improved outcomes in COPD compared with baseline, and adherent users improved exercise capacity more compared with non-adherent users. Although not statistically significant compared with enhanced standard-of-care, this study may support the use of this application for COPD management and addresses the healthcare challenge of access to PR interventions.
DRKS 00024390.
肺康复（PR）是慢性阻塞性肺疾病（COPD）管理的重要组成部分。然而，获得传统的面对面PR项目的机会有限。
这项多中心随机对照试验从德国和瑞士的18个地点招募了COPD患者，旨在评估一款移动应用程序（干预组；IVG）为期12周对生活质量（通过COPD评估测试（CAT）测量）和运动能力（通过1分钟坐立试验（1MSTST）评估）的影响，并与接受“强化标准治疗”的对照组（CTG）进行比较。
278名患者纳入研究，中位年龄65岁（四分位间距60 - 70），第1秒用力呼气量为预计值的48%（四分位间距37 - 60）。在第12周的意向性分析中，IVG组和CTG组的CAT分别较基线改善中位数 -4分和 -3分（差异：0分（95%置信区间：-1, 2）；p = 0.7）；1MSTST分别改善1次和2次重复（差异：1次重复（95%置信区间：0, 2）；p = 0.12）。在IVG的一个亚组中，根据应用程序依从性（≥75%的周数中每周≥3天）对患者进行分组，依从性使用者（40.4%）的1MSTST较非依从性使用者改善中位数2次重复（95%置信区间：1, 3]；p = 0.006）。应用程序的使用未引发任何安全问题。
与基线相比，基于应用程序的PR改善了COPD的结局，依从性使用者较非依从性使用者运动能力改善更多。尽管与强化标准治疗相比无统计学显著差异，但本研究可能支持将该应用程序用于COPD管理，并应对获得PR干预措施的医疗挑战。
DRKS 00024390。
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