Development of Respercise® a Digital Application for Standardizing Home Exercise in COPD Clinical Trials.

Yonchuk, John G; Mohan, Divya; LeBrasseur, Nathan K; George, Ashley R; Singh, Sally; Tal-Singer, Ruth

Background Pulmonary Rehabilitation (PR) is an important therapy for patients with COPD, yet uptake remains low. Intervention strategies which recapitulate the benefits of PR are therefore needed, and digital, home-based therapies present opportunity in this space. Digital therapies also potentially offer an opportunity to standardize PR in clinical trials for new COPD therapies. Aims and Methods We aimed to create a digital application (App), Respercise®, consisting of up to 4 strengthening exercises in conjunction with Therbands and a daily physical activity program with individualized step goals, and to test its feasibility in a clinical trial. App usability was surveyed qualitatively before development iterations and deployment in a 13-week interventional clinical trial. All participants who completed the study were invited for an exit interview and performed the 5 sit-to-stand test amongst other measures. Results Feedback from clinical trial participants was positive; 97% of respondents liked the App. 88% of participants reported that it was easy to fit the exercises into their daily routine, and there was over 90% adherence for entering daily step counts. Notably, on day 90 both females and males using Respercise® alone demonstrated a 2.22- and 2.27-seconds improvement in time for 5 repetition sit-to-stand test respectively, above the 1.7 second threshold that is considered clinically meaningful in COPD. Conclusions Respercise® can be successfully deployed in clinical trials, offering the opportunity for standardization of exercise in clinical trials and with further development could have wider reach as a home-based intervention for individuals with COPD.