Motivation of participants of the HOMEX-1 RCT to conduct long-term home-based exercise following pulmonary rehabilitation

Background: Many COPD patients who conduct pulmonary rehabilitation (PR) fail to maintain exercise training in the long-term. Aims: To assess the motivation of COPD patients to conduct a home-based exercise training program during 1 year prior to participate in the HOMEX-1 trial. Methods: Study participants were COPD patients recruited from 4 Swiss PR clinics who participated in the HOMEX-1 RCT to assess the effectiveness of the exercise program vs. usual care. Assessments included patient-reported outcomes (PROs; health-related quality of life, symptoms) and exercise capacity (6 minute walk test [6MWT], 1-min sit-to-stand test [1STS]). We assessed the participants’ motivation to conduct the program during 1 year on a scale from 1-10 (lowest-highest motivation) and analyzed its associations (dichotomized) with clinical variables and PROs by t-tests. Results: 121 participants (51.2% male) with mean±SD age of 66.6±8.1 years, FEV1%pred of 39.0±15.3, 6-minute walk test distance of 384±126m and 1-min sit-to-stand test (1STS) repetitions of 17.1±7.4 were included. Mean motivation to conduct the exercise program was 8.4±1.5; 52% reported a motivation >8 and 48% of £8. Patients with a higher motivation showed better 1STS performance (18.8±7.8 vs. 15.4±6.3, p=0.014) and reported less fatigue (5.3±0.9 vs. 4.8±1.0, p=0.021) and disease-specific symptoms (CAT; 13.4±5.8 vs. 16.2±6.3, p=0.007). No differences between groups with higher and lower motivation were found in lung function, number of comorbidities, 6MWT, other PROs. Conclusion: The participants’ motivation to conduct the exercise training program at HOMEX-1 trial onset was high, with no clear pattern of associations.