Mobile Application-Based Exercise Program Effects on Quality Of Life ın COPD; Randomized Experimental Study

Mobile Application-Based Exercise Program Effects on Quality Of Life ın COPD; Randomized Experimental Study

1. Introduction Chronic Obstructive Pulmonary Disease (COPD), is a common progressive but treatable disease characterized by airway obstruction. Symptoms such as shortness of breath and fatigue, especially during exercise, lead to a decrease in physical activity and fitness of these patients. 1, 2 This decrease in activity causes deterioration in the health-related quality of life of the individual. The primary goal of effective COPD treatment is to reduce the patient's symptoms and future risks. Respiratory rehabilitation, a non-pharmacological treatment method, is a first-line management strategy in patients with COPD. These rehabilitation programs reduces shortness of breath, increases exercise capacity and improves health-related quality of life.3 However, limited number of patients can benefit from respiratory rehabilitation due to various reasons such as lack of resources and motivation as well as accessibility problems. The insufficient number of rehabilitation centers and the fact that most centers are located in city centers create a significant limitation. In this respect, telemedicine-based rehabilitation can significantly facilitate the access of elderly population who have difficulty leaving their homes and who do not have access to these services due to the aforementioned factors. 3, 4, 5 The studies in literature report that rehabilitation utilizing technology performed in the home environment significantly improves the exercise capacity and quality of life of patients. 6, 7, 8 In this study, the investigators aimed to develop an alternative rehabilitation program for patients with COPD who can't access traditional rehabilitation applications. The effects of this developed mobile application-based program on the participants were evaluated statistically.
2. Methods In the present study, a mobile application that provided breathing and strengthening exercise training was developed to support the self-management of populations with COPD and to ensure their participation and continuity in an exercise program in their home environment. This application was developed with an aim to improve the dyspnea levels of populations with COPD, increase their exercise capacity, and improve their quality of life.

The study was a pre-test-post-test experimental study. The study was conducted on populations with COPD who presented to the pulmonary diseases clinic in a state hospital in a province. The study was carried out between October 2019 and June 2021, and the patients were followed at home for 10 weeks after exercise and self-management training.

The population of the study consisted of participants who were diagnosed with COPD and had no physical disability for exercise. Power analysis was performed to calculate the sample size. When α error was considered as 0.05 and the effect size was considered as 0.8, the sample size was determined to be 68 patients with COPD (34 in the experimental and 34 in the control group) with 90% power. However, considering that there would be dropouts, forty participants were included in both of the groups.

Patient Involvement: Patients aged 40 and over with COPD, who did not participate in the PR program during the last year and volunteered to participate in the study were included in the study. Patients with communication, mental, neurological and cognitive problems and those with disabilities to exercise were excluded from the study. The group that had a smartphone, met the inclusion criteria and volunteered to participate in the study was assigned to the experimental group. Participants who did not have a smartphone but, met the inclusion criteria were assigned to the control group. In addition, randomization was not performed. Assignment procedures to control and experimental groups were made by the researchers.The participants , who applied to the clinic during the study and met the criteria were assigned to the experimental and control groups until the number was completed.