The Effect of a Technology-Mediated Integrated Walking and Tai Chi Intervention on Physical Function in Veterans With COPD and Chronic Musculoskeletal Pain

Persons with COPD benefit from being physically active, but they are often limited by chronic musculoskeletal pain. This project will determine whether a non-pharmacologic, integrated, technology-mediated walking and Tai Chi mindfulness intervention can improve physical function in Veterans with COPD and chronic musculoskeletal pain. The proposed research addresses VA Rehabilitation R&D Service's high priority area of improving health-related quality of life by reducing disease burden and maximizing function in Veterans with chronic disease.

Inclusion Criteria:Male and female participants, aged 40 and olderClinical diagnosis of COPD defined as history of cigarette consumption of > 10 pack-years, and either a ratio of forced expiratory volume in one second (FEV1) to forced vital capacity (FVC) < 0.70 or chest computerized tomography (CT) evidence of emphysema*Numeric Rating Scale pain score > 3 for > 3 monthsSelf-reported ability to walk a minimum of one block, bend at the hip, and transfer weight from one leg to anotherAbility to complete 800 feet walk with Fitbit Inspire-2 recording > 90% accuracy to detect steps compared to manual counts*Have access to a computer or smartphone with Internet connection or willing to come to study site to use study computersHave access to videoconferencing audio and video capabilitiesCompetent to provide informed consent and willingness to make return study visitsDifferent criteria are used if baseline study visit is a virtual one.Exclusion Criteria:COPD exacerbation in the previous 1 monthClinical signs of unstable cardiovascular disease (active coronary artery disease, congestive heart failure, uncontrolled atrial fibrillation, or uncontrolled hypertension)Oxygen saturation < 85% recorded on baseline 4-meter walk*High fall risk (unable to perform 5 chair stand tests)Inability to ambulateInability to complete questionnairesInability to collect at least 7 of 10 days of baseline step countsActive substance abuseParticipation in a regular exercise (i.e., MOVE! or Gerofit) or Tai Chi program in the previous 3 monthsConcurrent participation in another interventional research studyReceipt of hospice or end-of-life palliative careActive medical intervention that would cause a meaningful increase in pain such as surgery, chemotherapy, or radiation therapyDifferent criteria are used if baseline study visit is a virtual one.