Table 1.
Characteristics of Studies That Evaluated the Effects of Internet Mediated Rehabilitation in COPD Patients
| Study | Study Type | N | Sex | Age | Duration/Frequency | Technology | Exercise Program | Data Collection | Monitoring/Feedback | Outcomes Primary/Secondary |
|---|---|---|---|---|---|---|---|---|---|---|
| Galdiz (2020)16 | Multicentre RCT (1:1) | 94 | M,W | 63 | 48 weeks 3/week |
Smartphone, delivering data to web-based platform | Aerobic training - 30 min of leg cycle ergometry. Strength training - 30 min of weight lifting. | Uploaded by patient after every session | Mobile application with exercise diary, pulse oximeter | 6MWT, HRQoL (SF-36, CRQ)/BODE |
| Chaplin (2017)17 | RCT (1:1) | 103 | M,W | 66 | 8 weeks 7/week |
Interactive web-based PR programme | Aerobic training - walking at 85% intensity of baseline ESWT. Strength training - upper and lower extremity resistance training. | Recorded by patient after each training | Online application - questionnaires, self-reporting, exercise diary | ISWT, ESWT, HADS, CAT, PRAISE, BCKQ, HRQoL (Euro QOL, CRQ) |
| Demeyer (2017)18 | Multicentre RCT (1:1) | 343 | M,W | 67 | 12 weeks 4–7/week |
Smartphone application, step counter with daily activity goal, text messages | Aerobic training - walking/steps per day. If participant meet the goals, next week daily goal increase by 500 steps. | NR | Step counter. Automated coaching in application - activity goal, graphical representation of performance. Weekly text message with activity proposal. Telephone contact in case of non-compliance. | Physical activity (steps per day)/6MWT, isometric quadriceps force, CAT, CCQ, mMRC |
| Vasilopoulou (2016)19 | RCT (1:1:1) | 150 | M,W | 67 (64) | 48 weeks 3/week |
Tablet application - individualized training plan. Spirometer. Pedometer. Data stored on the web-based platform | Aerobic training – Individual walking drills Strength training - Arm and leg exercise |
Uploaded by patient on specific days every week | Pedometer, Spirometer, Oximeter, Questionnaires, Training log. Phone or video call once a week | Lung function, 6MWT, Peak Work Rate, HRQoL (SGRQ, CAT, mMRC) |
| Vorrink (2016)20 | Multicentre RCT (1:1) | 157 | M,W | 63 | 24 weeks 7/week |
Smartphone application for patients, website for physiotherapists | Aerobic training - walking - 1) steps per day 2) 30min of intensive walking per day; Intensity: baseline + 20% | Automatically | Accelerometer embedded in smartphone. Application showing physical activity in quantitative and qualitative form | Steps per day/6MWT, HRQoL (CRQ), BMI |
| Moy (2015)21 | RCT (2:1) | 239 | M,W | 67 | 16 weeks 5–7/week |
Website with individualized goal setting, iterative feedback, educational and motivational content, online community forum | Aerobic training - Walking/daily step-count. | Uploaded by patient at least once a week | Pedometer | HRQoL (SGRQ)/daily step count |
| Moy (2016)22 | RCT (2:1) | 239 | M,W | 67 | 32 weeks 5–7/week |
Website with individualized goal setting, iterative feedback, motivational content, online community forum | Aerobic training - Walking/daily step-count. | Uploaded by patient at least once a week | Pedometer | HRQoL (SGRQ)/daily step count |
| Wang (2014)23 | RCT (1:1) | 30 | M | 72 | 24 weeks 4–6/week |
Mobile application - music with preset walking tempo, website for collecting data | Aerobic training - Walking at constant speed with individualised tempo. Intensity: 80% of maximal capacity predicted from ISWT |
Automatically | Mobile application - time of walking at preset speed. Phonecall when patient missed one day of training | ISWT, muscle strength |
| Tabak (2014)15 | RCT (1:1) | 34 | M,W | 65 | 4 weeks 4–7/week |
Smartphone application, 3D accelerometer for activity registration. Web portal with a symptom diary for self-treatment of exacerbations | Aerobic training - Walking/daily step-count. | Data from accelerometer automatically, diary filled by patient | Pedometer, symptom diary. Automatic feedback messages - summary of activity behaviour and advice how to improve or maintain it. | Number of steps per day/CCQ, MRC, MFI-20 |
| Liu (2008)24 | RCT (1:1) | 60 | M | 72 | 48 weeks 7/week |
Mobile application - music with preset walking tempo, questionnaires for respiratory symptoms | Aerobic training - Endurance walking at constant speed with individualised tempo. | Automatically | Website - monitoring frequency of performance and the duration of the endurance walking. Phonecall when patient missed one day of training | ISWT, Spirometry, Short Form-12 |
Abbreviations: 6MWT, 6 minute walking test; CCQ, Clinical COPD Questionnaire; CRQ, Chronic Respiratory Questionnaire; mMRC, modified British Medical Research Council; CAT, COPD Assessment Test; HADS, Hospital Anxiety and Depression Scale; HRQoL, Health Related Quality of Life; SGRQ, St. George’s Respiratory Questionnaire; CG, control group; IG, intervention group; PR, PR; ISWT, Incremental Shuttle Walking Test; ESWT, Endurance Shuttle Walking test; PRAISE, PR Adapted Index of Self-Efficacy; BCKQ, Bristol COPD Knowledge Questionnaire; VAS, Visual Analogue Score; MFI-20, Multidimensional Fatigue Inventory; NR, not reported.