Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Jul 30, 2024
Date Accepted: Jun 11, 2025
Smartphone Application-guided Pulmonary Rehabilitation in Chronic Respiratory Diseases: a Randomized Controlled Trial
ABSTRACT
Background:
Pulmonary rehabilitation improves exercise capacity, dyspnea, quality of life, and survival in patients with chronic respiratory disease.
Objective:
We evaluated smartphone application-guided pulmonary rehabilitation for individuals with chronic respiratory diseases.
Methods:
This was a multicenter prospective, single-blind, randomized controlled trial conducted in 2022. Total 100 participants were recruited, with equal distribution (50:50) between the intervention group and the control group. The intervention group followed a 12-week application-guided rehabilitation program, while the control group received standard outpatient treatment. The primary outcome was the 6-minute walk test distance after the 12-week rehabilitation period. Secondary outcomes included symptom scores and healthcare utilization.
Results:
Among the 100 participants included, 88 completed the follow-up visit (41 in the intervention group and 47 in the control group). Their median age was 68.0 years, and 72 (81.8%) were men. Most participants (85, 96.6%) had chronic obstructive pulmonary disease. When comparing clinical outcomes between baseline and follow-up, the modified Medical Research Council dyspnea scale showed improvement (intention-to-treat set: median 1.0 [interquartile range (IQR) 1.0–2.0] to 1.0 [IQR 1.0–1.0], P = .002; per-protocol set: median 1.0 [IQR 1.0–1.8] to 1.0 [IQR 1.0–1.0], P = .046). Additionally, the hospital anxiety and depression scale scores decreased in the intervention group (intention-to-treat set: median 10.0 [IQR 7.0–14.3] to 10.0 [IQR 5.0–13.3], P = .004). Notably, participants experienced hospitalization or emergency room visits during the study period.
Conclusions:
Smartphone application-guided pulmonary rehabilitation improved symptoms of patients with chronic respiratory diseases, including dyspnea, anxiety, and depression. Clinical Trial: This study was registered in the ClinicalTrials.gov database (NCT05299385, https://clinicaltrials.gov/study/NCT05299385).
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