Development of respercise® a digital application for standardizing home exercise in COPD clinical trials

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. Conclusion: 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.