Evaluation of the mobile pulmonary rehabilitation (m-PR) platform on exercise capacity and health status in people with chronic lung disease

The intervention is the mobile pulmonary rehabilitation (m-PR) program which will consist of an eight week pulmonary rehabilitation intervention conducted in the home of the participant supported by the use of a mobile application. Following the initial assessment of the participant, the m-PR app will be uploaded onto the participants own device (Smartphone). An education session on use of the m-PR app will be provided to the participant together with a hard copy instruction manual. A COPD Action Plan will be discussed with the participant as part of m-PR. The participants will then be asked to commence the eight week m-PR program at home and will be contacted once per week either via phone or videoconferencing facilities as part of m-PR. The m-PR platform will contain the following specific components: 1. Daily symptom diary: Daily symptoms (breathlessness, cough, sputum colour, sputum volume, wheeze) will be recorded on the m-PR platform by participants. Symptoms will be scored and graphed over time for discussion between participants and physiotherapist. 2. Exercise Prescription: Following the exercise assessment at the PR centre, m-PR will contain an individually prescribed (by the physiotherapist) exercise program (8 weeks x 3 times per week) supported by exercise videos. The exercise sessions will include aerobic exercise, using a modality accessible to the participant, which is usually walking (or use of stationary cycle or treadmill if available) and strength training using functional activities and equipment that are readily accessible in the home environment (e.g. sit to stand, squats, stepping, arm exercises). Participants will be instructed to indicate when each exercise is completed with the data (date, time, duration, sets and repetitions of each exercise) recorded on the m-PR platform. Progression of exercise training will be considered on a weekly basis by the physiotherapist and will be individualized to each participant but may involve an increase in duration or intensity of aerobic training and/or an increase in sets or repetitions for strength training. This will be updated in the exercise training section of the platform. Motivating text messages from a pool of standard messages will be sent as reminders to facilitate training compliance. 3. Educational videos: Personalised education sessions, consisting of videos, will be scheduled and automatically delivered to the m-PR platform each week based on topics that the physiotherapist has identified as relevant to that participant. These videos have been designed specifically for this study. Motivating text messages about the educational content can also be sent including reminders to watch the videos if necessary. Data on participant use of the educational videos (date, time, duration) will be recorded on the m-PR app. 4. Electronic COPD action plan: Entry of prescribed inhaled medicines will automatically populate the electronic Lung Foundation Australia COPD action plan on the m-PR platform. Participants will use m-PR to review the action plan and record their actions taken. Data on the use of the COPD action plan (i.e. if opened in m-PR by participants) will be recorded on m-PR. 5. Physical activity plan: The plan for physical activity prescribed by the physiotherapist will be uploaded to m-PR. Participants may use an activity monitor or the motion sensors built into the smartphone to automatically monitor physical activity (step number, duration). Text messages will be sent to the mobile phone to encourage physical activity. 6. Inhaler technique videos: Instructional videos for inhaler technique from the Lung Foundation Australia website will be integrated in the m-PR platform for regular use. Data on the use of the inhaler technique videos (date, time, duration) will be recorded. 7. CAT questionnaire: participants will be asked to complete the CAT once a week via the m-PR app. The CAT scores will be used to track the participants well being during the m-PR program on a weekly basis. The physiotherapist involved in managing the participants will access information through a "clinician portal". This is where the physiotherapists upload the required components of the program to be shown on the participant interface. Information on intervention adherence will also be available from the portal. The portal is a secure system, with all information kept fully confidential. Data will only be accessible by the physiotherapist and research team.