Behavioural modification interventions alongside pulmonary rehabilitation improve COPD patients’ experiences of physical activity

Matthew Armstrong*, Emily Hume, Laura McNeillie, Francesca Chambers, Lynsey Wakenshaw, Graham Burns, Karen Heslop Marshall, Ioannis Vogiatzis

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)

Abstract

Aims and objectives
The Clinical PROactive Physical Activity in COPD (C-PPAC) instrument, combines a questionnaire assessing the domains of amount and difficulty of physical activity (PA) with activity monitor data (steps/day and vector magnitude units) to assess patients’ experiences of PA. The C-PPAC instrument is responsive to pharmacological and non-pharmacological interventions and to changes in clinically relevant variables. We compared the effect of PA behavioural modification interventions alongside pulmonary rehabilitation (PR) to PR alone on the C-PPAC scores in COPD patients with low baseline PA levels.

Methods
In this randomised controlled trial, 48 patients (means±SD: FEV1: 50±19%, baseline steps/day: 3450±2342) were assigned 1:1 to receive PR alone, twice weekly for 8 weeks, or PA behavioural modification interventions (comprising motivational interviews, monitoring and feedback using a pedometer and goal setting) alongside PR (PR+PA). The C-PPAC instrument was used to assess PA experience, including a perspective of the amount and difficulty of PA.

Results
There were clinically important improvements in favour of the PR+PA interventions compared to PR alone in: 1) the C-PPAC total score (mean [95% CI] difference: 8 [4 to 12] points, p=0.001), the difficulty (mean [95% CI] difference: 8 [3 to 13] points, p=0.002) and the amount (mean [95% CI] difference 8 [3 to 16] points, p=0.005) domains and 2) the CAT score (mean [95% CI] difference: -2.1 [-3.8 to -0.3] points, p=0.025).

Conclusion
PA behavioural modification interventions alongside PR improve the experiences of PA in patients with advanced COPD and low baseline PA levels. (NCT03749655).
Original languageEnglish
Article number106353
JournalRespiratory Medicine
Volume180
Early online date9 Mar 2021
DOIs
Publication statusPublished - 1 Apr 2021

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