Effects of individualized step targets on physical activity in COPD. A randomized study

Purpose: Improving physical activity (PA) is important in patients with chronic obstructive pulmonary disease (COPD). Goal setting can be a possible intervention, but its effect cannot be maintained for six months. We evaluated the effects of providing an individualized target step count, reflecting the disease condition of each patient, on PA and other factors, such as myokines, after six months in patients with COPD.

Patients and methods: We performed a randomized parallel group, open-label study (INTAR-Step study) between the target provision (intervention) group and the usual care (control) group and investigated differences in the proportion of subjects who achieved the target as a primary endpoint and differences in changes in PA parameters and myokines as secondary endpoints. This study was registered with UMIN-CTR (UMIN000046390, January 13, 2022).

Results: A total of 73 patients were analyzed (intervention, n=38; control, n=35). The proportion of participants in the intervention group who achieved their target step count did not show a significant increase relative to the control group (p=0.157). However, the change in step count, and change in duration of activity at ≥3.0 metabolic equivalents were significantly increased in the intervention group. The Changes in the Growth differentiation factor-15 (GDF-15), fatty acid-binding protein-3, and Irisin levels also increased in the intervention group. Furthermore, GDF-15 levels were significantly higher in patients with increased step counts than in those with decreased step counts.

Conclusion: Providing individualized step targets did not increase the proportion of subjects who achieved their targets, but it increased their step counts after six months. GDF-15 may be involved in the increase in the step count.

Methods
Recruitment was performed at five institutes, namely Osaka Metropolitan University, Saga University, Yamaguchi University, Wakayama Medical University, and NHO Wakayama Hospital, from June 2022 to January 2023. Written informed consent was obtained from all participants. This study was approved by the ethics committee of NHO Wakayama Hospital (approval number: 03-06; approval date: October 26, 2021) and registered with UMIN-CTR (UMIN000046390, January 13, 2022).