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Introduction: In older people with a chronic respiratory disease, we explored (i) usual Smartphone application (App) use, (ii) the time taken to download and use an App, and (iii) changes in self-efficacy for downloading an App after a single practice session. Methods: Participants were invited to attend one or two separate assessment sessions (Part A and B). Those who attended Part A had data pertaining to their App usage over the previous week extracted from their Smartphone. Those who attended Part B were asked to download and use a pedometer App and "think out loud" during the task. Before and after the task, participants rated their self-efficacy for downloading an App using a Visual Analogue Scale (0–10). Results: Twenty-seven participants (mean ± SD 74 ± 5 years) completed Part A. Commonly used Apps related to communication (e.g., texting; median [interquartile range] 15 [9–25] min/day) and interest (e.g., news; 14 [4–50] min/day). Fifteen participants completed Part B (mean ± SD 73 ± 7 years). The median time taken to download and use the App was 24 (22–37) min. The "think out loud" data converged into four domains: (i) low self-efficacy for using and learning Apps; (ii) reliance on others for help; (iii) unpleasant emotional responses; and (iv) challenges due to changes associated with longevity. Self-efficacy increased by 4 (95% confidence interval: 3–6). Conclusion: This population used Apps mainly to facilitate social connection. It took participants almost half an hour to download and use an App, but a single practice session improved self-efficacy. [ABSTRACT FROM AUTHOR]

Increasing physical activity in daily life (PADL) in chronic obstructive pulmonary disease (COPD), mainly in short-term training programs, is still a challenge. The combination of functional exercises with aerobic and resistance training may be a strategy to improve PADL and limitations in activities of daily living (ADL) in COPD. To evaluated the short- and medium-term effects of the combination of functional exercises with aerobic and resistance training. Seventy-six patients were randomized into (1) functional training group who performed resistance and aerobic and functional exercises; (2) conventional training group (CTG) who performed resistance and aerobic exercise; or (3) usual care group who performed respiratory physiotherapy. Patients were evaluated for PADL (activity monitor), ADL limitations (London Chest Activity of Daily Living scale [LCADL]), functional exercise capacity (6-minute walk test [6MWT]), and peripheral muscle strength before and after eight weeks. Medium-term effects were evaluated 12 weeks after the training. There were no changes or differences between groups in PADL and in 6MWT post-intervention and 12 weeks post-training. Only CTG showed a reduction in the total score on LCADL scale after the intervention and increase at follow-up (score: 20 ± 8; 17 ± 6; 19 ± 8, pre-intervention, post-intervention, and 12 weeks post-training, respectively, p = 0.001), without differences between groups (p = 0.375). There were increases in the muscle strength of knee flexors (p = 0.016) and extensors (p < 0.001) after the intervention only in CTG. Combined aerobic and resistance training with functional exercises failed to improve PADL and ADL limitations in COPD. Eight weeks of conventional training improved ADL. This, however, was not superior to the results from the other groups and was not sustained at medium-term 12 weeks post-training. [ABSTRACT FROM AUTHOR]

Objective The purpose of this study was to investigate the effectiveness of elastic resistance training on improving muscle strength, functional exercise capacity, health-related quality of life (HRQoL), and dyspnea in people with stable chronic obstructive pulmonary disease (COPD). Methods For this systematic review, PubMed, The Cochrane Library, Embase (OVID), PEDro, SciELO, and CINAHL were searched from inception to November 2019. Included studies were randomized clinical trials in which people with stable COPD were allocated to (1) an experimental group that received lower-limb resistance training, upper-limb resistance training, or both using elastic resistance; or (2) a control group that received no or sham resistance training or conventional resistance training using weight machines. Data extraction was performed by 3 review authors. The methodological quality of the studies was assessed using the PEDro scale. Eight studies on 332 participants were included. Results Knee extensor strength was higher in the experimental group (standardized mean difference = 0.52, 95% CI = 0.09–0.95) compared with the non-exercise control group. Compared with the conventional exercise control, the experimental group presented similar effects for muscle strength, functional exercise capacity, HRQoL, and dyspnea (95% CI overlapped the line of no effect for all). Conclusions Elastic resistance training improves muscle strength in people with COPD. The current review suggests elastic resistance as a potential alternative to conventional resistance training using weight machines, as they show similar effects on muscle strength, functional exercise capacity, HRQoL, and dyspnea. Impact Due to its beneficial effects, including reduced risk of exacerbation-related hospitalizations, exercise training is viewed as the cornerstone of pulmonary rehabilitation in people with COPD. This study shows that elastic resistance training can be an effective, portable, practical, and low-cost alternative to conventional weight resistance training. Lay Summary Training with elastic resistance tubes or bands—which are easy to carry, easy to use, and relatively low cost—can be an effective way to improve strength for people with COPD and promote similar benefits to those achieved with weight machines. [ABSTRACT FROM AUTHOR]

Competing Interests: The authors declare no conflicts of interest.