The aim of this study was to examine the use of pedometers as a tool to promote daily physical activity levels in patients with COPD.A systematic review meta-analysis of pedometer physical activity promotion in patients with COPD was conducted. Medline/PubMed, Cochrane Library, Web of Science and CINAHL were searched from inception to January 2019. The search strategy included the following keywords: physical activity promotion, pulmonary rehabilitation and daily physical activity. The eligibility criteria for selecting studies were randomised controlled trials reporting pedometer physical activity promotion in patients with COPD.Improvements in steps per day were found with pedometer physical activity promotion either standalone (n=12, mean 0.53 (95% CI 0.29–0.77); p=0.00001) or alongside pulmonary rehabilitation (n=7, 0.51 (0.13–0.88); p=0.006). A subgroup analysis reported significant differences in the promotion of physical activity based on baseline physical activity levels and the type of instrument used to assess levels of physical activity.Future trials should consider the way in which pedometers are used to promote physical activity to inform clinical practice in the setting of pulmonary rehabilitation.

During exercise, non-invasive ventilation (NIV) prolongs endurance in chronic obstructive pulmonary disease (COPD), but routine use is impractical. The VitaBreath device provides portable NIV (pNIV); however, it can only be used during recovery. We assessed the effect of pNIV compared to pursed lip breathing (PLB) on exercise tolerance. Twenty-four COPD patients were randomised to a high-intensity (HI: 2-min at 80% peak work rate (WRpeak) alternated with 2-min recovery; n = 13), or a moderate-intensity (MOD: 6-min at 60% WRpeak alternated with 2-min recovery; n = 11) protocol, and within these groups two tests were performed using pNIV and PLB during recovery in balanced order. Upon completion, patients were provided with pNIV; use over 12 weeks was assessed. Compared to PLB, pNIV increased exercise tolerance (HI: by 5.2 ± 6.0 min; MOD: by 5.8 ± 6.7 min) (p < 0.05). With pNIV, mean inspiratory capacity increased and breathlessness decreased by clinically meaningful margins during recovery compared to the end of exercise (HI: by 140 ± 110 mL and 1.2 ± 1.7; MOD: by 170 ± 80 mL and 1.0 ± 0.7). At 12 weeks, patients reported that pNIV reduced anxiety (median: 7.5/10 versus 4/10, p = 0.001) and recovery time from breathlessness (17/24 patients; p = 0.002); 23/24 used the device at least weekly. pNIV increased exercise tolerance by reducing dynamic hyperinflation and breathlessness in COPD patients.

The value of ‘data-enabled’, digital healthcare is evolving rapidly, as demonstrated in the COVID-19 pandemic, and its successful implementation remains complex and challenging. Harmonisation (within/between healthcare systems) of infrastructure and implementation strategies has the potential to promote safe, equitable and accessible digital healthcare, but guidance for implementation is lacking. Using respiratory technologies as an example, our scoping review process will capture and review the published research between 12^th December 2013 to 12^th December 2023. Following standard methodology (Arksey and O’Malley), we will search for studies published in ten databases: MEDLINE, EMBASE, CINAHL, PsycINFO, Cochrane Library, Web of Science, Scopus, IEEE Xplore, CABI Global Health, and WHO Medicus. Our search strategy will use the terms: digital health, respiratory conditions, and implementation. Using Covidence, screening of abstracts and full texts will be undertaken by two independent reviewers, with conflicts resolved by a third reviewer. Data will be extracted into a pilot-tested data extraction table for charting, summarising and reporting the results. We will conduct stakeholder meetings throughout to discuss the themes emerging from implementation studies and support interpretation of findings in the light of their experience within their own networks and organisations. The findings will inform the future work within the ERS CONNECT clinical research collaboration and contribute to policy statements to promote a harmonised framework for digital transformation of respiratory healthcare.

Introduction: We compared the effect of physical activity (PA) behavioural modification interventions alongside pulmonary rehabilitation (PR) to PR alone on COPD patients’ experiences of PA, exercise capacity and health status. The Clinical PROactive Physical Activity in COPD (C-PPAC) instrument combines subjective questions on the amount and difficulty of PA with objective PA measurements to assess patients’ experiences of PA. Methods: In this RCT, 48 patients with low baseline PA levels (means±SD: FEV1: 50±19%) were assigned 1:1 to receive PR alone, twice weekly for 8 weeks, or PA behavioural modification interventions (comprising motivational interviews, monitoring and feedback using a pedometer and goal setting) alongside PR (PR+PA). Assessments included the C-PPAC instrument, accelerometer daily steps, the CAT and the 6MWT. Results: We found significant improvements in favour of the PR+PA compared to PR alone in the C-PPAC total score, daily steps and CAT scores and similar improvements in 6MWT across both groups (table 1). Conclusions: PA behavioural modification interventions alongside PR are superior to PR alone in improving the experience of PA, daily steps and measures of health status in patients with COPD.

Chronic respiratory diseases such as Chronic Obstructive Pulmonary Disease, Asthma, Interstitial Lung Disease, Cystic Fibrosis, and Pulmonary Hypertension affect over 500 million people globally and pose significant challenges for diagnosis, management, and long-term care. Traditional approaches often rely on episodic clinical assessments and patient-reported symptoms, which fail to capture the dynamic nature of respiratory health. The integration of wearable technology offers a transformative solution, enabling continuous, real-time monitoring of physiological and behavioural parameters. This review explores the evolving role of wearable devices, including activity trackers, smartwatches, spirometers, and biosensors, in modernising chronic respiratory disease management. Evidence across disease domains demonstrates that wearables can enhance physical activity, predict exacerbations, support remote rehabilitation, and facilitate personalised care. In Chronic obstructive pulmonary disease, step counters and biometric sensors have shown improvements in activity levels and early exacerbation detection. Asthma care benefits from AI-driven platforms that integrate environmental and physiological data to optimise treatment. For Interstitial lung disease and Cystic fibrosis, home spirometry and sweat biomarker monitoring empower patients and improve disease tracking. In Pulmonary hypertension, wearables provide insights into activity and sleep patterns, complementing traditional assessments. Despite promising outcomes, barriers remain. Technical limitations, data reliability, digital literacy, privacy concerns, and integration into clinical workflows hinder widespread adoption. Economic and equity considerations further challenge scalability, particularly in low-resource settings. Looking forward, the convergence of multimodal sensing, AI analytics, and digital therapeutics will enable proactive, personalised, and equitable respiratory care. Addressing validation, interoperability, and ethical governance will be critical to realising the full potential of wearable technology in CRD management.