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

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

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).

Citation

Armstrong, M., Hume, E., McNeillie, L., Chambers, F., Wakenshaw, L., Burns, G., Marshall, K. H., & Vogiatzis, I. (2021). Behavioural modification interventions alongside pulmonary rehabilitation improve COPD patients’ experiences of physical activity. Respiratory Medicine, 180, Article 106353. https://doi.org/10.1016/j.rmed.2021.106353

• Journal Article Type: Article
• Acceptance Date: Feb 25, 2021
• Online Publication Date: Mar 9, 2021
• Publication Date: 2021-04
• Deposit Date: Sep 4, 2024
• Journal: Respiratory Medicine
• Print ISSN: 0954-6111
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 180
• Article Number: 106353
• DOI: https://doi.org/10.1016/j.rmed.2021.106353
• Public URL: https://durham-repository.worktribe.com/output/2785688