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Title: Findings of the Chronic Obstructive Pulmonary Disease-Sitting and Exacerbations Trial (COPD-SEAT) in reducing sedentary time using wearable and mobile technologies with educational support: Randomized controlled feasibility trial
Authors: Orme, Mark W.
Weedon, Amie E.
Saukko, Paula
Esliger, Dale W.
Morgan, Mike
Steiner, Michael
Downey, John
Sherar, Lauren B.
Singh, Sally
Keywords: Chronic obstructive pulmonary disease
Feasibility
Fitness trackers
Intervention
Physical activity
Sedentary lifestyle
Sedentary time
Self-monitoring
Wearable electronic devices
Issue Date: 2018
Publisher: JMIR Publications © The Authors
Citation: ORME, M.W. ... et al, 2018. Findings of the Chronic Obstructive Pulmonary Disease-Sitting and Exacerbations Trial (COPD-SEAT) in reducing sedentary time using wearable and mobile technologies with educational support: Randomized controlled feasibility trial. JMIR mHealth and uHealth, 6 (4), e84.
Abstract: Background: Targeting sedentary time post exacerbation may be more relevant than targeting structured exercise for individuals with chronic obstructive pulmonary disease. Focusing interventions on sitting less and moving more after an exacerbation may act as a stepping stone to increase uptake to pulmonary rehabilitation. Objective: The aim of this paper was to conduct a randomized trial examining trial feasibility and the acceptability of an education and self-monitoring intervention using wearable technology to reduce sedentary behavior for individuals with chronic obstructive pulmonary disease admitted to hospital for an acute exacerbation. Methods: Participants were recruited and randomized in hospital into 3 groups, with the intervention lasting 2 weeks post discharge. The Education group received verbal and written information about reducing their time in sedentary behavior, sitting face-to-face with a study researcher. The Education+Feedback group received the same education component along with real-time feedback on their sitting time, stand-ups, and steps at home through a waist-worn inclinometer linked to an app. Patients were shown how to use the technology by the same study researcher. The inclinometer also provided vibration prompts to encourage movement at patient-defined intervals of time. Patients and health care professionals involved in chronic obstructive pulmonary disease exacerbation care were interviewed to investigate trial feasibility and acceptability of trial design and methods. Main quantitative outcomes of trial feasibility were eligibility, uptake, and retention, and for acceptability, were behavioral responses to the vibration prompts. Results: In total, 111 patients were approached with 33 patients recruited (11 Control, 10 Education, and 12 Education+Feedback). Retention at 2-week follow-up was 52% (17/33; n=6 for Control, n=3 for Education, and n=8 for Education+Feedback). No study-related adverse events occurred. Collectively, patients responded to 106 out of 325 vibration prompts from the waist-worn inclinometer (32.62%). Within 5 min of the prompt, 41% of responses occurred, with patients standing for a mean 1.4 (SD 0.8) min and walking for 0.4 (SD 0.3) min (21, SD 11, steps). Interviews indicated that being unwell and overwhelmed after an exacerbation was the main reason for not engaging with the intervention. Health care staff considered reducing sedentary behavior potentially attractive for patients but suggested starting the intervention as an inpatient. Conclusions: Although the data support that it was feasible to conduct the trial, modifications are needed to improve participant retention. The intervention was acceptable to most patients and health care professionals.
Description: This is an Open Access Article. It is published by JMIR Publications under the Creative Commons Attribution 4.0 International Licence (CC BY). Full details of this licence are available at: http://creativecommons.org/licenses/by/4.0/
Sponsor: The research was part funded by Loughborough University funding for the Centre for Doctoral Training in Chronic Diseases. The trial was funded by research facilitation funds from Loughborough University.
Version: Published
DOI: 10.2196/mhealth.9398
URI: https://dspace.lboro.ac.uk/2134/32595
Publisher Link: https://doi.org/10.2196/mhealth.9398
ISSN: 2291-5222
Appears in Collections:Published Articles (Sport, Exercise and Health Sciences)
Published Articles (Social Sciences)

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