maintaining the BMI level, there was a fat free mass turnover, which may indicate a hidden muscle catabolism. Therefore, early management to prevent muscle mass loss would improve patient's daily physical activity and quality of health. -2013-204457.188 Aim To determine whether AO flow rate requirements can be predicted in patients with chronic lung diseas. Background The process for AO assessment as per current UK guidance can be extremely time consuming, necessitating multiple walking tests with significant rest periods between walks. We set out to explore whether a model could accurately predict the AO flow rate required to abolish/minimise desaturation, thus simplifying the process. Method Retrospectivedatawere analysed for all patients who attended AO clinic from April 2009 to January 2013. AO needs were assessed as per current UK guidance. For those who met the criteria for AO (n = 100), resting Sp02, desaturation on the endurance shuttle walk test (ESWT) and AO flow rate required to minimise this desaturation were recorded, along with age and diagnosis. Results Multiple regression analysis was undertaken to test how well the variables included in the data could predict the likely level of AO required. A range of models were constructed and tested against the actual AO flow rate that had been required. The model which accounted for the greatest proportion of the variance (r = 0.671, F = 79.40, p < 0.05) included only one variable, the level of oxygen desaturation on room air post ESWT. Adding additional variable to the model, such as age and resting SpO2 did not add significantly to the predictive power of the model. Conclusion Using this model, 91% of patients were predicted correctly with an error of +/-1L of the actual flow rate. It would therefore, 9 times out of 10, give a flow rate that was either correct ( +/-1L). Use of this model will reduce the number of walking tests required when performing AO assessment, saving both time and valuable healthcare resources. Aim To describe and compare the repeatability and responsiveness of the Incremental Shuttle Walk Test (ISWT) and incremental cardiopulmonary exercise test between COPD and Chronic Heart Failure (CHF). Hypothesis The null hypothesis, no difference in the measurement properties of ISWT and ICE between two chronic diseases. Methods Patients with symptomatic COPD and CHF (MRC 2 or NHYA II and above, respectively) were recruited. All patients underwent seven weeks of PR (1). At baseline, participants performed a familiarisation ISWT, two ISWTs and two incremental, There was a significant increase mean [SE] of 20 [4] m between the familiarisation ISWT and ISWT1 (p < 0.001). There was no difference between either, ISWT1 and ISWT2, 2 (4) m (p = 0.10), or peak oxygen uptake (VO 2 pk) for ICE1 and ICE2, 20 [10] ml·min -1 (p = 0.16). There was no effect of disease, p = 0.11 and p = 0.47, respectively. REFERENCES P39 A COMPARISON OF THE REPEATABILITY AND RESPONSIVENESS OF FIELD AND LABORATORY INCREMENTAL EXERCISE TESTS BETWEEN COPD AND CHRONIC HE...

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Introduction and ObjectivesChronic Obstructive Pulmonary Disease (COPD) is characterised by expiratory flow limitation contributing to dyspnoea and impacting on exercise capacity and quality of life. Inspiratory muscle training is commonly used to improve inspiratory muscle strength and endurance, exercise capacity and quality of life. The High Frequency Airway Oscillating (HFAO) device uses flow resistance to provide combined inspiratory and expiratory muscle training. It is hypothesised that the use of a HFAO device may improve the strength of the respiratory muscles resulting in reduced sensation of dyspnoea. This study was designed to explore the feasibility of HFAO in COPD.MethodsPatients with symptomatic COPD were included (MRC of ≥3). This was a single arm feasibility study using a HFAO device. All participants used the device for 5 min, 3 times per day, for eight-weeks. The primary outcomes were recruitment, attrition and compliance. Self-reported daily diaries identified participants as adherent if they completed ≥75% of device use. Secondary outcome measures included maximal inspiratory and expiratory pressures (Pimax/Pemax), Incremental and Endurance Shuttle Walking Tests (ISWT/ESWT) and health related quality of life questionnaires. Data was analysed by a Wilcoxon Signed Rank test and considered statistically significant if p<0.05.Results23 participants with COPD were recruited (65% male, mean [SD] age 65[5] years, FEV1%predicted 44[16], FEV1/FVC ratio 0.46 [0.13]), median [IQR] MRC 4 [3–5], of which 20 participants completed the intervention. 62% of potential participants were recruited and there was an attrition rate of 13%. 90% of participants were considered adherent to device use. A significant improvement in MRC score (median change −1 [IQR 3–3]) was observed (p≥0.01). Significant improvements were seen in Pimax and Pemax (table 1). Pre and post intervention exercise performance and quality of life are shown in Table 1.Abstract P72 Table 1n= 20PrePostP value MRC4 [3–5]3 [3–3]>0.01PImax (cm H2O)59 [34–74]63 [42–85]0.04PEmax (cm H2O)102 [62–125]110 [97–137]>0.01ISWT (m)200 [140–260]240 [170–270]0.68ESWT (secs)170.5 [131–247]203 [142–274]0.51CRQ dyspnoea2.6 [2–3]2.5 [2–4]0.32LCQ total15.71 [13–19]21.5 [16–26]0.14HADS Anxiety6 [3–10]6 [3–11]0.24HADS Depression6 [4–10]5 [4–7]0.19LCADL total32 [28–45]29 [23–39]0.26CAT Total24[18–29]21.5 [16–26]0.14CAT Sputum3[2–4]3 [2–4]0.76Median [IQR] and p-value.MRC, Medical Research Council dyspnoea score, PImax, Maximal Inspiratory Pressure; PEmax, Maximal Expiratory Pressure; ISWT, Incremental Shuttle Walking Test; ESWT, Endurance Shuttle Walking Test; CRQ, Chronic Respiratory Questionnaire; LCQ, Leicester Cough Questionnaire; HADS, Hospital Anxiety and Depression Score; LCADL, London Activity of Daily Living, CAT COPD Assessment Test.ConclusionsThis shows promising Results in the use of HFAO to reduce dyspnoea within COPD. Recruitment and attrition was appropriate and compliance rates were considered suitable and therefore it is feasible to proceed to a randomi...

Introduction and ObjectivesHospitalisation for an exacerbation of chronic respiratory disease has a major impact on physical activity (PA). However, criteria to derive reliable inpatient PA data do not exist and current recommendations are unlikely to account for variations in length of hospital stay (LOHS) and the hospital environment. The aims were to identify the minimum wear time and number of days required to obtain reliable inpatient PA data; to use these criteria to determine how PA changes during recovery as an inpatient; and to compare PA across patients stratified by LOHS.Methods259 individuals hospitalised with an exacerbation of chronic respiratory disease were recruited as part of an early rehabilitation trial previously reported (Greening et al, BMJ 2014). Participants (mean (SD) age 70.0±9.7 years, 58.3% female) wore a physical activity monitor (SenseWear) during their stay. Daily step count and walking time during waking hours was analysed. Inpatient PA was assessed across a range of minimum wear time criteria (≥1–12 hours). Repeated measures analysis of covariance was used to compare between days and between times of day. Single-day intraclass correlation coefficients (ICCs) were calculated across the range of wear time criteria. The minimum number of days required to obtain an ICC ≥0.80 was estimated using the Spearman-Brown prophecy formula.Abstract S82 Figure 1Step count per hour as a proportion of total daily step count across an average 24 hour period. Data are reported as mean (95% CI).ResultsA minimum wear time of 11 hours (≥1 valid day) allowed 80% of the sample to be retained. All minimum wear time thresholds produced an ICC ≥0.80, resulting in 1 day of wear required to produce representative inpatient PA. Mornings and afternoons were more active than evenings and overnight (32.1% and 32.0% vs. 25.2% and 10.7% of steps/day, respectively, p<0.001) (figure 1). No changes in PA were observed during the hospital stay; ranging 585–707 steps/day and 72–83 min/day of walking. After controlling for wear time, patients admitted for 2–3 days took more steps on average than patients staying 7–14 days (997±125 vs. 597±91, p=0.036).ConclusionsOne full day (24 hours) of monitoring is required at the individual-level to obtain representative inpatient PA. A minimum wear time criteria of ≥11 waking hours is recommended for sample-level data. Wear time and LOHS should be accounted for in analyses.