Evaluation einer appbasierten Reha-Nachsorge (AReNa) mit Schwerpunkt Bewegungsförderung nach COPD-Rehabilitation: Ergebnisse einer Pilotstudie

Zusammenfassung

Ziel der Studie

Die Evaluation einer appbasierten Nachsorge für Personen mit chronisch obstruktiver Lungenerkrankung (COPD).

Methodik

COPD-Rehabilitand:innen absolvierten eine dreiwöchige stationäre pneumologische Rehabilitation mit anschließender zwölfwöchiger appbasierter Nachsorge, entwickelt auf Basis des Modells der Bewegungsbezogenen Gesundheitskompetenz. Hauptkomponenten der Nachsorge waren (1) individuelle Pläne für Kraft- und Ausdauertraining, (2) Fitnesstracker zum Selbstmonitoring, (3) Online-Lernmodule, sowie (4) 1:1-Betreuung durch Sport- bzw. Physiotherapeut:innen der Rehabilitationsklinik. Per Fragebogen wurden unter anderem folgende Outcomes erhoben: COPD-Assessmenttest, Lebensqualität, Depressivität, Angst, Fatigue, COPD-Leitsymptome, Schmerz, Sport- und Freizeitaktivität, Bewegungsbezogene Gesundheitskompetenz, Erfahrungen der Rehabilitand:innen mit der Nachsorge. Messzeitpunkte waren Beginn und Ende der Rehabilitation sowie Ende der Nachsorge. Veränderungen der Outcomes während der Rehabilitation und Nachsorge wurden explorativ untersucht (Wilcoxon-Vorzeichen-Rang-Test, α<0,05). Die Erfahrungen mit der Nachsorge wurden deskriptiv analysiert.

Ergebnisse

Von 42 Personen mit COPD lagen zu allen Messzeitpunkten Daten vor (Alter: M=57,5; SD=5,6; BMI: M=29,1; SD=6,5; GOLD-Stadium 1/2/3/4: 2,4%/50,0%/38,1%/9,5%). Alle Outcomes außer Freizeitaktivität und Angst bezüglich Partnerschaft verbesserten sich im Verlauf der Rehabilitation signifikant und verblieben fast alle auch am Ende der Nachsorge auf dem Level des Reha-Ende. Belastungsatemnot (d=−0,45) sowie die Subkompetenzen der Bewegungsbezogenen Gesundheitskompetenz (Bewegungskompetenz: d=−0,69; Steuerungskompetenz: d=−0,68; Selbstregulationskompetenz: d=−0,80) verbesserten sich zusätzlich während der Nachsorge. Sportliche Aktivität (d=−1,28) und Sputummenge (d=−0,64) verbesserten sich während der Reha, waren jedoch während der Nachsorge wieder rückläufig (sportliche Aktivität: d=−0,52; Sputummenge: d=−0,55). Absolut liegt die sportliche Aktivität nach der Nachsorge jedoch noch deutlich über der zu Reha-Beginn (d=−0,65). Die Benutzerfreundlichkeit der App und die Atmosphäre während der Nachsorge waren hoch.

Schlussfolgerung

Die Reha-Effekte konnten während der App-basierten Reha-Nachsorge bei den meisten Outcomes gehalten oder gesteigert werden. Die durchgeführte Studie liefert somit erste Hinweise für die Effektivität der entwickelten appbasierten Reha-Nachsorge.

Abstract

Purpose

To evaluate an app-based follow-up care program for individuals with chronic obstructive pulmonary disease (COPD) post-rehabilitation.

Methods

After a 3-week inpatient pulmonary rehabilitation, a 12-week app-based follow-up care program was conducted. The app-based program was based on the model of physical activity-related health competence. The core components were: (1) personalized endurance and resistance training plans, (2) activity monitors for self-monitoring, (3) e-learning modules, and (4) 1:1 coaching by sports therapists and physiotherapists of the rehabilitation clinic. The following outcomes were assessed with questionnaires at the start and the end of rehabilitation as well as after follow-up care: COPD Assessment Test, quality of life, depression, anxiety, fatigue, key symptoms of COPD, pain, sport-/exercise-related activities, leisure-time/transportation physical activity, physical activity-related health competence, and experiences with the follow-up care. An exploratory analysis examined changes in outcomes during rehabilitation and follow-up care (Wilcoxon signed-rank tests, α<0.05). Experiences with the follow-up care were analyzed descriptively.

Results

42 participants (age: M=57.5; SD=5.6; BMI: M=29.1; SD=6.5; GOLD stage 1/2/3/4: 2.4%/50.0%/38.1%/9.5%) provided data at all measurement time points. Except for leisure-time/transportation physical activity and partnership-related anxiety, the outcomes improved significantly during rehabilitation. Exercise-induced dyspnea (d=−0.45) as well as the sub-competencies of physical activity-related health competence (movement competence: d=−0.69; control competence: d=−0.68; self-regulation competence: d=−0.80) showed further improvements during follow-up care. Sport- and exercise-related activity (d=−1.28) and sputum quantity (d=−0.64) improved during rehabilitation, but deteriorated during follow-up care (sport-/exercise related activity: d=−0.52; sputum quantity: d=−0.55). However, the values of sport- and exercise-related activity after follow-up care were higher than at the beginning of rehabilitation (d=−0.65). App-usability and the atmosphere during aftercare were high.

Conclusion

The effects of pulmonary rehabilitation were maintained or further improved in most outcomes over the course of the app-based intervention. These findings provide initial indications of the efficacy of the developed app-based follow-up care program.

Schlüsselwörter

COPD - Pneumologische Rehabilitation - mHealth - Reha-Nachsorge - Körperliche Aktivität - Training

Keywords

COPD - pulmonary rehabilitation - mHealth - rehabilitation aftercare - physical activity - exercise

Publication History

Article published online:
09 January 2026

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