Development of a Virtual Home-Based Cycling Intervention for Individuals With Chronic Obstructive Pulmonary Disease: Qualitative Study

Abstract

Background: Chronic obstructive pulmonary disease (COPD) is a leading cause of mortality, and exercise has been shown to reduce both. Health conditions, environmental factors, and logistical challenges are often barriers for participation in pulmonary rehabilitation (PR). Given the barriers many individuals with COPD face when attending health care centers for PR, virtual home-based cycling exercise could be an option.

Objective: This study aimed to explore the development of a home-based cycling exercise intervention for individuals with COPD, focusing on aspects such as bicycle selection, app functionality, and pilot testing. Furthermore, it aimed to explore participants' and nonparticipants' attitudes toward the intervention.

Methods: Using a phenomenological-hermeneutic approach, data were gathered from 15 semistructured interviews, including test pilots, participants, and nonparticipants. A thematic analysis was used to analyze the data.

Results: Thematic analysis identified 8 key themes: bicycle selection, individual guidance needs, geographical and video quality, online connectivity, comfort and accessibility of home-based cycling, flexibility, energy levels, and practical limitations. Findings highlighted a preference for pedal bicycles with adjustable intensity, the importance of flexibility in scheduling, and the autonomy provided by a home-based setup. While participants appreciated the virtual journey on videos, barriers such as lack of energy, stress, and limited space were reported by nonparticipants.

Conclusions: Recommendations include enhancing app features and addressing individual needs to improve adherence. The study underscores the potential of tailored home-based exercise interventions in overcoming traditional PR challenges.

International registered report identifier (irrid): RR2-10.1136/bmjresp-2024-002573.

Keywords: COPD; chronic obstructive pulmonary disease; development; home-based exercise intervention; pulmonary rehabilitation; virtual cycling exercise.