et al. The main Antioxidant-rich beverages why Boost exercise capacity sub-analysis capacjty the Avocado Salad Ideas studies which used walking as exercise vapacity failed to demonstrate a statistically significant efficacy vs. A total of 17 participants were enrolled, among them 12 COPD participants completed the week study. Maltais F, Hamilton A, Marciniuk D, Hernandez P, Sciurba FC, Richter K, Kesten S, O'Donnell D.

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Based on design requirements, the conceptual model for intervention and content of the system were developed. Figure 3 shows an overview of the conceptual model.

Patients were first evaluated to identify their initial physical capacity and disease severity. Then personalized exercise prescriptions were provided and patients would perform these exercises. Exercise-related data will be received by the rule engine, which provides decision support for HCPs.

The rule engine will also provide patients with different types of feedback to motivate and authorize them to achieve their goals. Exercise data and early warning information will also be sent to HCPs who will adjust their prescriptions according to patient conditions.

Iterative system development resulted in a functional mobile app for patients to 1 receive daily tasks of exercise prescription; 2 undertaken actions stepwise following the instructions and information provided; 3 record and upload exercise data; 4 self-manage and monitor symptoms; 5 receive followed-up visit and communication.

The server provides Application Programming Interface API for both terminals for data interaction. Moreover, it works as a rule engine to provide decision support according to the conceptual model mentioned before. Overall, participants reported that this app had a positive effect on promoting exercise at home, and that they would be willing to continue using the app over an extended period.

It plays an important role, yes, it is very good. Now, I started indoor training. Maybe it will be better to train for a long time. In addition, they expected to gain more health-related knowledge through this app. And the content of exercise training may need to be richer. Knowledge of nutritional diet and health care can also be increased.

The majority had a high school education and above. The results of both the primary outcome and the secondary outcomes are shown in Table 6.

The mMRC grades reduced overall with grade 3 disappearing and showed a significant difference. Originally grade 1 accounted for the majority, but after rehabilitation it was mostly reduced to grade zero Table 7.

In addition, step counts, CRQ and HAD showed no statistically significant difference in this study but non-inferiority. The overall compliance of this study was defined as the compliance averaged across all patients and it reached At the end of assessment test, the compliance remained at The boxplot Fig.

Evaluation of technology acceptance by patients occurred at the end of the experiment. Users answered the questionnaire and Fig. The average score for the participants was During the interview session, only one participant reported difficulty in using the study-involved technology at the beginning of the intervention.

For example, this year-old man participant stated he needed some time to understand the data from the pedometer. All of the participants would participate again.

I will. Unfortunately, there are not so many patients with COPD around me. Another analysis evaluated the techniques and functions applied in this system through the average score given by the patients.

When finalizing the rehabilitation program, the patient could rate these techniques with a score of 1—5 points. Table 8 presents that the walking exercise section was the one that received the highest score average, 4.

In second place was the breathing exercise section that obtained 4. This study developed a home-based PR mHealth system for COPD patients, the core of which is its exercise prescription contains the standardized guidelines for PR and can adapt to patients' conditions such as exercise capacities and breathlessness and fatigue during physical work.

The use of BCW in the intervention developing process offereda systematic method for designing a theory-driven intervention. In addition, our pilot study in Yinchuan demonstrated the benefits of applying mHealth technology and BCT to Home-based PR for COPD patients.

The designed exercise program provided a design scheme suitable for home environment and transmitted through mobile app. To satisty different volume need, we made the three attributes that make up the volume adjustable within a certain range.

Customization of patients' exercise plan can be implemented to a certain extent. The iterative system design process made the system continuously improved based on user needs.

During the iterative process, the research team made decisions to add some changes to the conceptual model of the intervention that were not thought of beforehand, such as including the exercise methods of traditional Chinese sports medicine e.

Of note, in the final version of system, we added rhythm audio to the walk training module to monitor its intensity walking speed.

Patients walked following the cueing rhythm of the audio prompt and the rhythm would be modified according to the results of the Borg scale filled out by patients after training. Among respiratory function parameters, 6MWT scores showed significant improvement in two pilot studies.

Few pulmonary rehabilitation programs based on mHealth achieved no significant improvement at 6MWT or were not mentioned at all. For example, Kwon et al.

indicated that their participants had mild or moderate disease severity GOLD 1 or 2 and their 6MWT ranged — might cause this result [ 17 ]. The outcome of step counts examined the potential feasibility of using an app to encourage patients with COPD to increase, or at least maintain their physical activity levels.

Meanwhile, CAT, mMRC and CCQ showed meaningful improvement in our trail while CRQ did not. However, correlations between CCQ and CRQ were found and study showed that both the CCQ and CRQ are equally reliable and valid [ 41 ]. Reda et al. indicated that CRQ was a good indicator for the medium term but its responsiveness declines in the longer term and CCQ is the recommended alternative when the follow-up exceeds 26 weeks [ 42 ].

This might explain why CCQ is significant in our study but CRQ is not, as some patients participating in the assessment test had already received intervention in the preliminary test before with a longer trial period lasting for 11 months in total. We did not find significantly improved HAD outcomes at post-intervention but non-inferiority.

This may be due to the relatively healthy mental state and small sample size. Thus, the mental state of the participants is generally improved and HAD scores show a tendency of reduction but without significant change.

Feasibility and usability findings showed that participants overall were highly engaged and reported accepting the intervention. In our study, participants keep training on average for Besides, participants had positive perceptions about technology and mHealth.

Considering the result of the questionnaire, they were willing to use software for self-management and rehabilitation training out of trust to doctors and willingness to control their own disease conditions, even though they may not be tech-savvy people.

We showed that it is feasible to deliver a mHealth-BCT-based intervention to patients with COPD in a real-life setting over several months to promote their physical activity and capacity. Few recent studies reported promising clinical results using mHealth to conduct home-based PR in older patients.

As mentioned before, Kwon et al. developed a comprehensive rehabilitation management platform as an intervention to improve physical activity and HRQL but found no meaningful improvement in 6MWT [ 17 ]. Bentley et al. reported that theory-based intervention via an app was well accepted and perceived as easy to use [ 23 ].

Their study focused on helping patients maintain physical activity after undertaking PR, which is somewhat different from the purpose of our study. In another study, Burkow et al. intervened patients using an app with functionality for a virtual peer group and visual rewards but reported limited clinical outcomes [ 22 ].

Compared with these interventions, the clinical benefits obtained by the assistance of app in this study may be attributed to several factors. First, the walking speed was exactly controlled by the tempo of audio to achieve the intended level of endurance training at home. Specific speed value was determined by the current exercise capacity of patients, which was measured by the integrated assessment of 6MWT, Borg and history compliance of previous walk tasks.

In this process, the system plays an important auxiliary role in realizing different configurations of exercise prescriptions. Secondly, using smart phones, the daily record of exercise data was well monitored.

The change in exercise data may draw attention to patients themselves and HCPs who observe the data on the website, and early medical intervention may be implemented to prevent acute exacerbation of COPD control. Thirdly, the long-term adherence and compliance to exercise training is the critical factor in sustaining the clinical benefit in the home setting PR program.

Using internet or smartphone apps technology, a feasible and acceptable method for the monitoring of adherence can be provided, even for elderly COPD patients.

In our study, timely supervision and management from HCPs are additional factors that contribute to the maintenance of compliance and clinical benefits. Besides, present pilot studies were small, and only the first step was towards exploring feasibility of these interventions.

Coupled with the impact of Corona Virus Disease COVID , only preliminary and limited data on clinical outcomes are available.

The statistical analyses must be interpreted with great caution given the small sample size. Further work includes conducting a randomized controlled trial with lager number of patients. In conclusion, we showed that the home-based PR mHealth system incorporating BCTs is a feasible and acceptable intervention for COPD patients, and COPD patients can benefit from the intervention.

The form of intervention delivered by mHealth improved the availability of PR for COPD patients. The clinical outcomes demonstrated the benefits of applying the system for COPD patients. The design process of the system offered a systematic method for designing a mHealth-based, theory-guided PR program.

Moreover, the proposed system played an important auxiliary role in offering exercise prescription according to the characteristics of patients. Global Initiative for Chronic Obstructive Lung Disease GOLD.

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Reliability and validity of the clinical COPD questionniare and chronic respiratory questionnaire. Download references. This study was supported by the National Key Research and Development Programs of China No.

This work was also supported by the Alibaba Cloud. College of Biomedical Engineering and Instrument Science, Ministry of Education Key Laboratory of Biomedical Engineering, Zhejiang University, Hangzhou, China. Alibaba-Zhejiang University Joint Research Center of Future Digital Healthcare, Hangzhou, China.

Department of Pulmonary and Critical Care Medicine, General Hospital of Ningxia Medical University, Yinchuan, , Ningxia, China. You can also search for this author in PubMed Google Scholar. ND, LS and WJ conceptualized the home-based rehabilitation mHealth system and designed the study.

LS designed the mHealth system. LS, and WJ developed the app. YH, SW and BW recruited the patients. YH intervened patients and collected data. ND, LS and WJ analyzed the evaluation data and drafted the manuscript.

JC, and HD made critical revisions to the paper for important intellectual content. All authors read and approved the final manuscript. Correspondence to Juan Chen. Two pilot studies conducted in this study were approved by the Ethics Committee for the Conduct of Human Research at General Hospital of Ningxia Medical University Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This file gives the content of the questionnaire used for the measurement of functional usability. Examples of the questions used during the interview. This file lists 9 questions used during the interview conducted in the two pilot studies.

BCT Taxonomy v1 : 93 hierarchically-clustered techniques. Open Access This article is licensed under a Creative Commons Attribution 4. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material.

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Reprints and permissions. Deng, N. et al. A home-based pulmonary rehabilitation mHealth system to enhance the exercise capacity of patients with COPD: development and evaluation. He has been featured as an expert in the Washington Post , The New York Times , Los Angeles Times , Runner's World and Self.

He holds a master's degree in exercise science and health promotion, and several advanced certifications and specializations with NSCA and NASM. Sign up to receive relevant, science-based health and fitness information and other resources.

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Wall Justin Price Billie Frances Amanda Vogel. This means that a larger person with more muscle mass will consume more oxygen at the same intensity than a smaller individual.

Increasing aerobic capacity can help improve the flow of oxygenated blood to muscle tissue, which, in turn, can improve mitochondrial density. Mitochondria are the organelles of a muscle cell that use oxygen to help produce adenosine triphosphate ATP , which is the actual fuel that supplies muscle contractions.

High-intensity interval training HIIT is not only effective for burning calories, but it can also help improve aerobic capacity. At higher intensities, the body will use ATP from anaerobic sources, but will rely on aerobic metabolism during the lower-intensity recovery intervals to help replace the energy spent during the high-intensity work periods.

The downside is that while HIIT is effective, too much of it could cause overtraining. For best results, limit your clients to no more than three HIIT workouts per week.

Low-intensity steady state LISS training, also known as long slow distance LSD training, is the ability to maintain a steady work-rate over an extended period of time. LISS relies on aerobic energy pathways for energy and can supply fuel muscle activity for extended durations like endurance races.

Compared to HIIT, LISS is a lower-stress way to improve aerobic capacity, but it is not as effective for burning calories for a specific comparison between HIIT and LISS, click here.

The upside, however, is that LIIS can be performed almost every day , especially for those who can walk or ride a bike to work. Cross training, popularized in the late s by two-sport sensation Bo Jackson , refers to doing different activities or modes of exercise on different days to achieve a specific fitness goal.

Performing a LISS run on one day followed by a HIIT cycling class followed by a circuit-training workout on the third day is an excellent example of how to periodize a workout to improve overall aerobic capacity.

DEXA scan for metabolic rate measurement Assistance and Food Exervise Resources. Regular physical activity is one of the most important Eexercise you can do for your health. Being physically Boost exercise capacity can Avocado Salad Ideas your brain healthhelp capaciy weightreduce the risk of diseasestrengthen bones and musclesand improve your ability to do everyday activities. Adults who sit less and do any amount of moderate-to-vigorous physical activity gain some health benefits. Only a few lifestyle choices have as large an impact on your health as physical activity. Everyone can experience the health benefits of physical activity — age, abilities, ethnicity, shape, or size do not matter. Some benefits of physical activity on brain health [PDF BMC Medical Informatics and Decision Making volume CapaciytArticle number: Cite capackty article. Metrics details. Patients cwpacity chronic obstructive exerfise Avocado Salad Ideas COPD experience deficits in Probiotics and Bowel Movements capacity and physical activity as Bost disease progresses. Pulmonary rehabilitation PR can enhance exercise capacity of patients and it is crucial for patients to maintain a lifestyle which is long-term physically active. This study aimed to develop a home-based rehabilitation mHealth system incorporating behavior change techniques BCTs for COPD patients, and evaluate its technology acceptance and feasibility. Guided by the medical research council MRC framework the process of this study was divided into four steps.