Journal of Rehabilitation Research & Development (JRRD)

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Volume 47 Number 5, 2010
   Pages 485 — 496

Abstract — Use of pedometer and Internet-mediated walking program in patients with chronic obstructive pulmonary disease

Marilyn L. Moy, MD, MSc;1-4* Adrienne W. Janney, MSI;5 Huong Q. Nguyen, PhD, RN;6 Kirby R. Matthess, BS;2,4 Miriam Cohen, MSN;7 Eric Garshick, MD, MOH;2,4,8 Caroline R. Richardson, MD5,9

1Rehabilitation Research and Development Service, Veterans Health Administration, Department of Veteran Affairs (VA), Washington, DC; 2Pulmonary and Critical Care Medicine Section, VA Boston Healthcare System, Boston, MA; 3Division of Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA; 4Harvard Medical School, Boston, MA; 5Department of Family Medicine, University of Michigan Medical School; 6University of Washington, Seattle, WA; 7VA, New York Harbor, Brooklyn, NY; 8Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Boston, MA; 9Ann Arbor VA Medical Center, Ann Arbor, MI

Abstract — We evaluated an Internet-mediated, pedometer-based program to promote walking in chronic obstructive pulmonary disease (COPD). First, we assessed the accuracy of the Omron HJ-720ITC pedometer (OMRON Healthcare, Inc; Bannockburn, Illinois) in 51 persons with COPD. The Bland-Altman plot showed a median difference of 3 steps (5th and 95th quintiles, -8.0 and 145.0, respectively). We calculated percent difference = ([manual - Omron step counts]/manual step counts) ?? 100. Variability in percent difference occurred at the lowest usual walking speeds. At speeds <0.94 m/s, the mean +/- standard deviation percent difference was 14 +/- 26%. Nevertheless, the Omron captured >80% of the manual step counts in 20 of the 23 persons with walking speed <0.94 m/s. Second, we examined step counts in 24 persons with COPD who used the Omron and an Internet-mediated, 16-week walking program. At baseline, participants with COPD walked an average of 3429 +/- 1502 steps per day. Sixteen participants completed the program with an average increase in daily step count of 988 +/- 1048 steps (p = 0.002). The Omron is accurate in persons with COPD with usual walking speeds > 0.94 m/s. Accuracy is more variable at lower speeds, but the Omron captures more than 80% of manual step counts in most persons. In this preliminary study, an Internet-mediated walking program using the Omron significantly increased step counts in COPD.

Key words: accuracy, ambulation, COPD, exercise capacity, HRQL, Internet, intervention, pedometer, physical activity, pulmonary rehabilitation, walking.


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