Effects of Pedometer-Based Step-Feedback on Physical Activity of Severe COPD Patients

Yasuhiko Tsujimura,1,2 Ayumu Akiyama,1 Tetsuo Hiramatsu,3 Kotaro Mikawa,4 Kazuyuki Tabira2 1Department of Rehabilitation, Hiramatsu Clinic of Internal and Respiratory Medicine, Komaki, Aichi, Japan; 2Division of Health Science, Graduate School of Health Science, Kio University, Kitakaturagi, Nara, Japan; 3Department of Respiratory Medicine, Hiramatsu Clinic of Internal and Respiratory Medicine, Komaki, Aichi, Japan; 4Department of Physical Therapy Faculty of Nursing and Rehabilitation, Chubu Gakuin University, Seki, Gifu, JapanCorrespondence: Kazuyuki Tabira, Division of Health Science, Graduate School of Health Science, Kio University, 4-2-2 Umami-naka, Koryo-cho, Kitakaturagi, Nara, Japan, Tel +81-745-54-1601, Fax +81-745-54-1600, Email k.tabira@kio.ac.jpPurpose: This study investigated whether adding step-feedback (step-FB) from a pedometer to pulmonary rehabilitation (PR) programs could increase the physical activity (PA) of low-activity patients with severe chronic obstructive pulmonary disease (COPD).Patients and Methods: We included low-activity patients with severe COPD (step-FB group: 14 patients; control group: 17 patients) who underwent PR for the first time. The usual PR program for patients with severe COPD consisted of two 8-week sessions (PR session 1: PR1, PR session 2: PR2). The step-FB group was provided a program with step-FB added to PR2 (PR2+step-FB). Furthermore, all patients were evaluated at pre-intervention (baseline), PR1, and PR2. The primary outcome of this study was the number of daily steps (steps) and energy expenditure from activity (energy expenditure), as measured by a pedometer. The secondary outcomes were dyspnea and exercise tolerance.Results: In PR1, dyspnea, exercise tolerance, steps, and energy expenditure were significantly improved as compared to baseline, in both groups. During PR2, dyspnea and exercise tolerance were significantly improved as compared to PR1, in both groups. Steps and energy expenditure were significantly improved in the step-FB group, but not in the control group.Conclusion: PR improved PA by improving physical function in severe COPD patients. Adding step-FB improved PA in severe COPD patients by presenting an activity goal for improving PA. Therefore, pedometer-based step-FB is a viable addition to PR and has the potential to improve PA continuously in these patients.Keywords: dyspnea, exercise tolerance, monitoring, pulmonary rehabilitation, step counter