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

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).