Home-based cycling for individuals with COPD: A qualitative study on engagement and barriers

<bold>Introduction:</bold> Regular exercise is crucial for individuals with chronic obstructive pulmonary disease (COPD), yet long-term adherence remains low. Home-based cycling interventions offer a flexible alternative although engagement is unknown. <bold>Aim:</bold> This study explored participants' experiences with a home-based cycling intervention post-rehabilitation following hospitalization for acute exacerbation of COPD. We sought to identify motivators, barriers, and the perceived impact on physical, social, and emotional well-being. <bold>Methods:</bold> A qualitative study was conducted using semi-structured interviews with eleven persons with COPD who participated in a randomized controlled trial: a one-year home-based cycling intervention (COPDtoParis). Thematic analysis was applied to identify themes. <bold>Results:</bold> Engaged participants valued flexibility, adaptability, and autonomy, when integrating cycling into their daily routines. Intrinsic motivation and personal goals, such as maintaining independence and strength, played a key role in sustaining participation. The bikes’ familiarity and accessibility promoted consistent use and was reported to be more motivating than other exercise forms. Most participants found the cycling videos engaging but online interaction amongst participants were rarely used. Barriers for engagement included technical issues, discomfort, need of more support, and life stressors. <bold>Conclusions:</bold> This study found that flexibility, personal goals, and immersive content motivated participants to engage long-term in home-based cycling, positively impacting their physical, social, and emotional well-being. However, technical issues, need for more support, and life stressors served as barriers for others.