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UBC Theses and Dissertations

LungFIT : validating a smartphone application for pulmonary rehabilitation Chan, Christen


Introduction: Chronic Obstructive Pulmonary Disease (COPD) symptoms of dyspnea, exercise intolerance, and reduced health related quality of life are best treated with pulmonary rehabilitation (PR). Despite benefits, transportation, availability of PR programs, and social support barriers limit PR access. Telerehabilitation (TR) may provide the solution by utilizing pulse oximetry to monitor patient oxygen saturation (SpO₂) and heart rate (HR), along with measures of exercise intensity to ensure patient safety during home-based, unsupervised rehabilitation exercise. Study Purpose: To test the validity and reliability of a smartphone system called LungFIT in measuring heart rate, oxygen saturation, and distance in a healthy population. The LungFIT’s functionality was also assessed. Methods: Functionality of the LungFIT was assessed by a time-to-complete test and the adapted Mobile Phone Usability Questionnaire (MPUQ). SpO₂ and HR measurements by 3 different LungFIT probes (Nonin, Masimo, and LionsGate Technologies) were evaluated during 5-minute cycle ergometry (50 watts at 60-70 revolutions/minute) and treadmill walking tests (3km/hr). Both tests were repeated 3 times. Distance measurements were assessed by outdoor walking tests of a 1 city block course. Results: SpO₂ measurements were valid with mean biases ranging between -0.93% and 0.88% and limits of agreement no greater than ±3.78% over the 3 LungFIT probes. The Masimo probe had the smallest mean biases ranging from 0.18% to 0.74% and mean limits of agreement ranging from ±1.94% (±0.93% 95% confidence interval) to ±2.79% (±1.34% 95% confidence interval). All probes had moderate to good SpO₂ measurement reliability (ICCs between 0.65-0.87) with the Masimo probe performing the best (all ICCs ≥ 0.82). During exercise, HR measurements were invalid (mean limits of agreement > 10.00 beats/min), but reliable (ICCs between 0.87-0.97). Time-to-complete assessments found no software issues, but revealed 4 instances of navigation or setup issues. The MPUQ showed ease of use despite lack of interface appeal. Conclusion: During exercise, the 3 LungFIT probes were reliable in measuring SpO₂ and HR, but only valid in measuring SpO₂. Overall, the Masimo probe was the most valid and reliable of the 3 probes tested. Future LungFIT prototypes will improve user interface and accuracy of distance measurements.

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