Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide. Pulmonary rehabilitation (PR) is an integral nonpharmacological component of chronic disease management, but global participation in PR is low (<3%). Pulmonary telerehabilitation (TPR) delivered via video or mobile applications can overcome barriers of travel, distance, and cost and may increase access to home-based PR.

To comprehensively evaluate the effects of a WeChat mini-program-based PTR program on exercise capacity, health-related quality of life, lung function, psychological status, sleep quality, and adherence in patients with stable COPD.

From October 2022 to October 2024, 82 stable COPD patients attending the Respiratory Department of the Affiliated Hospital of Inner Mongolia Medical University were enrolled in this randomized study. Patients were assigned by random number table to either: the intervention group (home-based PTR through a WeChat mini-program, n=42) or the control group (outpatient face-to-face PR, n=40). Both groups received rehabilitation three times weekly for 12 weeks. Assessments were performed at baseline (T1), week 8 (T2), and week 12 (T3). Primary and secondary outcomes included: 6-minute walk distance (6MWD) for exercise capacity; modified Medical Research Council dyspnea scale (mMRC); St. George's Respiratory Questionnaire (SGRQ) for health-related quality of life; Hospital Anxiety and Depression Scale (HADS); Pittsburgh Sleep Quality Index (PSQI); and spirometry measured at T1 and T3. Adherence and safety were evaluated after 12 weeks.

Exercise capacity: there was a significant group × time interaction for 6MWD (P_interaction<0.05); the main effect of time was significant (P_time<0.05), while the main effect of group was not significant (P_group>0.05). Dyspnea (mMRC): no significant group × time interaction, and no significant main effects of group or time on mMRC scores (P>0.05). Quality of life (SGRQ): no significant interaction between group and time for SGRQ symptom, activity, impact domains, or total score (P_interaction>0.05); group main effects were not significant (P_group>0.05), whereas time main effects were significant (P_time<0.001). Psychological status: both groups showed significant reductions in HADS anxiety and depression scores over the study period (P<0.05). Sleep quality and lung function: no significant group×time interactions or main effects of group were observed for PSQI scores (P>0.05). The main effect of time was significant for the total PSQI score (P_time<0.05), but not for the other subscale scores (P_time>0.05). Comparisons of spirometric indices [forced expiratory volume in 1 second (FEV₁), forced vital capacity (FVC), forced expiratory volume in 1 second as a percentage of the predicted value (FEV₁%pred), FEV₁/FVC] between groups at T1 and T3 showed no significant differences (P>0.05); within-group comparisons between T1 and T3 were also not significant (P>0.05). Adherence: the intervention group demonstrated significantly better adherence than the outpatient control group (χ²=5.00, P<0.05).

A WeChat mini-program-based PTR program is at least comparable to outpatient face-to-face PR in improving exercise capacity, health-related quality of life, and psychological status in stable COPD patients, and it achieves higher patient adherence. It represents a feasible alternative to conventional outpatient PR.