{
  "abstract": "Background Mobile health (mHealth) is a novel model of care that may overcome barriers to pulmonary rehabilitation (PR) access. This study determined if mHealth PR was equivalent to centre-based PR (CB-PR) in improving exercise capacity and health status in people with chronic obstructive pulmonary disease (COPD).Method Single-blinded, multicentre, randomised controlled equivalence trial using an intention-to-treat analysis. Participants completed 8 weeks of either mHealth PR, using the mobile PR (m-PR) application and supported by telephone calls, or CB-PR. Co-primary outcomes, measured at baseline and end-intervention, were change in 6 minute walk distance (6MWD) and COPD assessment test (CAT) score, with an equivalence margin of 30 m and 2 points, respectively.Results 90 participants were randomised (mean (SD), m-PR n = 44: age 75 (7) years; forced expiratory volume in one second (FEV 1) 58 (15) % predicted; CB-PR n = 46: age 75 (6) years; FEV1 55 (14) % predicted) with 38 m-PR participants and 42 CB-PR participants completing at least one primary outcome. At end-intervention, there was no between-group difference in 6MWD (mean difference (MD) 13 m, 95% CI −6 to 31), indicating equivalence of m-PR to CB-PR. There was a significant between-group difference in CAT score (MD −4.9 points, 95% CI −7.2 to −2.6), with both limits of the CI exceeding the equivalence margin, indicating superiority of m-PR.Conclusion An mHealth PR programme resulted in equivalent improvements in exercise capacity and superior improvements in health status when compared with CB-PR in people with COPD. mHealth PR could be effective as a management option for people with COPD with adequate digital literacy.Trial registration number ACTRN12619001253190.",
  "authors": [
    {
      "affiliations": [
        "Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia",
        "Physiotherapy Department, Royal North Shore Hospital, Sydney, New South Wales, Australia",
        "Chronic Disease Community Rehabilitation Service, Northern Sydney Local Health District, Sydney, New South Wales, Australia"
      ],
      "name": "Sarah E Brown"
    },
    {
      "affiliations": [
        "Chronic Disease Community Rehabilitation Service, Northern Sydney Local Health District, Sydney, New South Wales, Australia",
        "Kolling Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia"
      ],
      "name": "Sally Wootton"
    },
    {
      "affiliations": [
        "Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia"
      ],
      "name": "Marita T Dale"
    },
    {
      "affiliations": [
        "Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia",
        "Allied Health, Sydney Local Health District, Sydney, New South Wales, Australia"
      ],
      "name": "Jennifer A Alison"
    },
    {
      "affiliations": [
        "Chronic Disease Community Rehabilitation Service, Northern Sydney Local Health District, Sydney, New South Wales, Australia",
        "Department of Respiratory and Sleep Medicine, Royal North Shore Hospital, Sydney, New South Wales, Australia",
        "Northern Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia"
      ],
      "name": "Andrew S L Chan"
    },
    {
      "affiliations": [
        "Australian eHealth Research Centre, CSIRO, Brisbane, Queensland, Australia"
      ],
      "name": "Marlien Varnfield"
    },
    {
      "affiliations": [
        "Department of Thoracic Medicine, The Prince Charles Hospital, Brisbane, Queensland, Australia",
        "Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia"
      ],
      "name": "Ian Yang"
    },
    {
      "affiliations": [
        "Charles Perkins Centre, Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia",
        "Implementation and Policy, Cardiovascular Initiative, The University of Sydney, Sydney, New South Wales, Australia",
        "Sydney Local Health District, Sydney, New South Wales, Australia"
      ],
      "name": "Michelle Cunich"
    },
    {
      "affiliations": [
        "Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia"
      ],
      "name": "Zoe J McKeough"
    }
  ],
  "title": "Mobile health pulmonary rehabilitation (m-PR): a randomised controlled equivalence trial",
  "uid": "51ddf8be-3f54-58c0-8cb6-589737f42dc9"
}