Chronic Obstructive Pulmonary Disease Clinical Trial
Official title:
Long Term Evaluation of Activity Levels Post Pulmonary Rehabilitation: 1 Year Follow-up
Sustained improvement after pulmonary rehabilitation in activity levels as measured by an
activity armband.
Pulmonary rehabilitation is utilized to improve exercise capacity, quality of life and
prognosis for patients who suffer from chronic obstructive pulmonary disease. There is also
strong evidence that supports the use of pulmonary rehabilitation to decrease hospital
admissions thereby reducing cost of care. Recent studies suggest that the significant
benefits achieved through rehabilitation fade with time and that in order to improve
activities of daily living; for example, average daily number of steps, programmes of longer
duration are required.
The primary aim of this study is to identify objective sustained improved in activity levels
using the SenseWear activity armband after a short-term pulmonary rehabilitation programme.
Secondary aims are to determine antibiotic and steroid use pre and post rehabilitation.
Chronic obstructive pulmonary disease (COPD) is characterised by airflow limitation and by
both systemic and airway inflammation. Together these features lead to decreased physical
activity which in turn worsens the patient's dyspnoea. In patients with COPD, physical
activity levels are low compared to healthy controls and indeed lower than in patients with
other chronic conditions such as arthritis and diabetes. For patients with COPD, decreased
physical activity and breathlessness are significant predictors of mortality and morbidity.
By reversing deconditioning pulmonary rehabilitation using supervised and home exercise
programs leads to increased exercise capacity and health quality of life scores. In order
for the benefits of pulmonary rehabilitation to be sustained in the long-term it is
essential that there is a change in the patient's physical activity in their home life.
While practice guidelines recommend that there is transference of exercise to the home
setting it is unknown if this happens in reality. Addressing whether there is an increase in
physical activity at home after pulmonary rehabilitation is the focus of this study.
Physical activity can be measured in a number of ways, including direct observation, patient
diaries and questionnaires, but one of the most successful are the performance based motion
sensors such as pedometers and accelerometers. One such performance based motion sensor is
the SenseWear accelerometer. The SenseWear has previously been used in patients with COPD,
has been shown to be a reliable measure of physical activity performed in this population,
other than those using rolators and it is objectively more accurate than questionnaires and
diaries. The hypothesis of this study was that pulmonary rehabilitation leads to a sustained
improvement in physical activity in patients with COPD. Physical activity was measured by
the daily averaged activity recorded with a SenseWear armband at several time points in the
year after a course of pulmonary rehabilitation.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Prevention
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