A web-based, pedometer-mediated intervention significantly increased average daily step count and resulted in significant transitions from underactive to active physical activity levels over 12 weeks in persons with COPD.
Key Findings
Results
Intervention participants increased average daily steps significantly more than controls over 12 weeks.
Intervention participants increased average daily steps by 1,410 steps/day more than controls (p=0.005).
Baseline daily steps were 4,222±1,929 in the intervention group and 4,851±2,637 in the control group.
Analysis used linear mixed-effects models (PROC MIXED, SAS v9.4) adjusting for group, time, group*time, FEV1% predicted, enrollment season, and study modality.
Sample included 57 intervention and 52 control participants.
Results
The intervention group showed greater transitions from underactive to active physical activity intensity compared to controls.
Between-group difference in transitions from underactive to active intensity was statistically significant (p=0.025).
20 participants (41%) in the intervention group moved to active status (within-group: p=0.001).
Aerobic intensity was assessed by the Rapid Assessment of Physical Activity (RAPA) Questionnaire, which uses self-reported moderate or vigorous PA to categorize responders as underactive or active.
Participants were instructed to achieve step-count goals with as many steps of moderate-intensity as possible, guided by a modified Borg rating of 4–5 for dyspnea.
Methods
The study enrolled a predominantly male, older veteran population with mild-to-moderate COPD who had never enrolled in pulmonary rehabilitation.
Participants were 97% male with a mean age of 73±7 years.
Baseline FEV1 was 73±23% predicted, indicating on average mild-to-moderate airflow obstruction.
All participants had never enrolled in pulmonary rehabilitation (PR) prior to the study.
Total sample size was 109 participants (57 intervention, 52 control), randomized 1:1.
Methods
The intervention was a multi-component web-based program using a commercially available wearable device to objectively monitor walking.
The intervention included individualized step-count goals, iterative feedback, educational content, and an online community forum.
The Fitbit Inspire Heart Rate was used to objectively monitor daily step counts.
The primary outcome was change in PA measured as average daily step count at 12 weeks.
The study was conducted across in-person, virtual, and hybrid modalities, and modality was included as a covariate in analyses.
Discussion
The authors propose this intervention as a potential option for community-based ground-based walking training with objective measurement of exercise intensity.
Technology-mediated community-based walking increased both PA amount and intensity.
The findings support further evaluation of this intervention as 'a potential option for ground-based walking training with objective measurement of exercise intensity.'
Ground-based walking training is described as an aerobic exercise used in supervised pulmonary rehabilitation.
The authors note it is unclear whether community-based walking intensity can be targeted as aerobic exercise, framing this trial as addressing that gap.
What This Means
This research suggests that people with COPD (chronic obstructive pulmonary disease) who have never attended formal pulmonary rehabilitation can meaningfully increase both the amount and intensity of their daily walking through a web-based program. The program provided participants with personalized step-count goals, regular feedback, educational materials, and access to an online community forum, while a Fitbit device tracked their steps. Participants were also encouraged to walk at a moderate effort level, gauged by how breathless they felt. Over 12 weeks, those in the intervention group walked about 1,410 more steps per day than those in the control group, and 41% shifted from being classified as 'underactive' to 'active' in terms of exercise intensity.
This matters because pulmonary rehabilitation — the standard structured exercise program for COPD — is underutilized, and many patients never access it. This study suggests that a remotely delivered, technology-assisted walking program could serve as a practical alternative or complement, helping patients increase not just how much they walk but how vigorously they walk. The use of a widely available consumer wearable device (Fitbit) and a web-based platform also suggests the approach could be scalable and accessible outside of traditional clinical settings.
The study population was almost entirely older male veterans, which may limit how broadly the findings apply to other groups with COPD. Nevertheless, the results provide evidence that structured, goal-directed walking programs delivered online can produce clinically meaningful improvements in physical activity in this population, and the authors call for further research to evaluate this approach more broadly.
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Bamonti P, Desiato J, Kadri R, Gagnon D, Moy M. (2026). A Web-Based, Pedometer-Mediated Intervention Increases Amount and Intensity of Physical Activity in COPD: A Randomized Controlled Trial.. International journal of chronic obstructive pulmonary disease. https://doi.org/10.2147/COPD.S611540