The feasibility of recruiting patients with early COPD to a pilot trial assessing the effects of a physical activity intervention

Abstract

Aim: To determine the feasibility of recruiting patients with early chronic obstructive pulmonary disease (COPD) to the Health Enhancing Activity in Lung THerapy (HEALTH) exercise and education programme. Methods:Patients with early COPD were identified from general practices. Those meeting the study inclusion criteria were administered tiotropium throughout the study period. Participants were randomised to either an eight-week health enhancing and physical activity (HEPA) programme, or to a control group (usual care). Behavioural, physiological and psychosocial outcome measures were reported preand post-intervention.Results: Out of 27 practices approached, 16 (59.3%) agreed to participate. Of 215 potentially eligible patients contacted, 60 (27.9%) replied. Twenty (33.3%) were randomised to either HEPA intervention (n=10) or usual care (n=10). Fourteen patients attended a postintervention assessment. Conclusion:This study provides valuable information on the feasibility of conducting such a trial involving a physical activity intervention.

Exercise training alone or with the addition of activity counseling improves physical activity levels in COPD: a systematic review and meta-analysis of randomized controlled trials

“…PA counseling was delivered either in a center-based setting (n=9),25–27,29,30,32–34,39 through phone calls (n=3)31,36,37 or by internet-mediated approaches (n=3) 35,38,40. Studies compared interventions to usual care (n=16),15–17,19,20,24,31,32,37,39,41,42,45–48,51,53 PR programs (n=8)25,27–30,33,43,50,52 or another active intervention (n=13) 14,18,21–23,26,34–36,38,40,44,49. Characteristics of included studies are summarized in Table 2.…”

“…Objective measures included accelerometers (n=18, 50%),16,17,20–23,27,29,33,36,37,41,44–49,51 pedometers (n=8, 22%)18,25,30,32,34,35,38,50 and an activity monitor (n=1) 31. PA was also measured subjectively using validated tools such as Seven-Day PA Recall Questionnaire (n=1),19 PA Scale for the Elderly (PASE) questionnaire (n=1),15 Community Healthy Activities Model Program for Seniors (CHAMPS) questionnaire (n=1)26 and the International PA Questionnaire (IPAQ; n=3) 24,39,53. Nonvalidated tools to measure PA included exercise diary cards (n=1)52 and trial-designed activity questionnaires (n=3) 14,40,43…”

“…This systematic review found that when compared to usual care, ET including Nordic walking,17 supervised exercise19 and self-efficacy enhancing exercise20 produce large effects on PA levels in COPD. These effects were not sustained after a long-term exercise maintenance program 15,24.…”

“…37,39 Four months of ET produced moderate to large statistically significant effects on PA (n=3 studies, 0.84 [0.44–1.25]; Figure 2),17,19,20 whereas long-term maintenance exercise programs showed small nonsignificant effects on PA at 12 and 15 months post-intervention (n=2 studies, 0.15 [−0.17 to 0.47]; Figure 2). 15,24 None of the studies included in the meta-analyses had blinded the assessors or the therapists from study groups.…”

Stanford Seven-Day Physical Activity Recall questionnaire in COPD

“…To our knowledge, the PAR has been used once in a small study of patients with COPD [33]. There has been no previous attempt to validate the PAR in COPD patients, but data from other populations support its validity.…”