Chronic Obstructive Pulmonary Disease (COPD) Clinical Trial
Official title:
PhysicaL actIvity interVention vErsus puLmonarY Rehabilitation in COPD: The LIVELY COPD Project.
The primary aim of this study is to assess the feasibility of conducting a trial to
investigate the effectiveness of a physical activity intervention (physical activity
consultation and a pedometer-based walking programme) versus pulmonary rehabilitation in
improving physical activity in COPD.
Objectives are:
(i) to assess the feasibility (patient recruitment, adherence, drop-outs and adverse events)
of delivering a physical activity intervention in the COPD patient population versus
pulmonary rehabilitation; (ii) to explore users perceptions relating to satisfaction and
benefits of a physical activity intervention versus pulmonary rehabilitation; (iii) to
investigate between and within group change in physical activity, exercise capacity, quality
of life, self-efficacy and changes in the transtheoretical model with the physical activity
intervention versus pulmonary rehabilitation; and (iv) to examine the cost of delivering a
physical activity intervention versus pulmonary rehabilitation for patients with COPD.
The hypothesis for this study is that it will be feasible to conduct a trial that will
investigate the effectiveness of a physical activity intervention (physical activity
consultation and a pedometer-based walking programme) compared to pulmonary rehabilitation
for improving physical activity in COPD. The study will provide important information about
interventions designed to promote and maintain physical activity, improve patient outcomes
and increase patients' choice relating to exercise and physical activity interventions. It
will provide a rationale and data for an adequately powered clinical trial evaluating the
effects of a physical activity intervention.
A survey of pulmonary rehabilitation programmes mirrored the results of other UK studies and
highlighted that there are not enough programmes available; currently in the UK less than
1.5% of patients with COPD receive pulmonary rehabilitation per year. Only a proportion of
patients are targeted i.e. those with moderate to severe disease. The majority of programmes
are outpatient-based and are supervised by clinicians. This structured and supervised format
of pulmonary rehabilitation does not meet the needs of all patients with high numbers of
dropouts and non-adherence; yet alternative options for increasing physical activity for
patients with COPD currently do not seem to be offered.
A home-based pedometer-driven walking intervention offers an alternative method of delivering
physical activity training that could be provided to larger numbers of patients, at a lower
cost and with flexibility around life commitments. It would also provide patients with more
choice when deciding whether to participate in exercise or physical activity.
To date no study has compared a home-based walking intervention to structured, supervised
pulmonary rehabilitation or the patient preferences or cost of the two programmes. For this
reason, there is a need to compare a home-based-walking intervention to the standard method
of providing patients with physical activity training, i.e. pulmonary rehabilitation.
Therefore this study is essential as it will assess the feasibility of conducting a trial to
investigate the efficacy of a physical activity intervention (physical activity consultation
and a pedometer-based walking programme) versus pulmonary rehabilitation in improving
physical activity in COPD.
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