Cardiovascular Diseases Clinical Trial
Official title:
The Effectiveness of a Physical Activity Intervention Versus Pulmonary Rehabilitation on Cardiovascular Risk Markers for Individuals With Chronic Obstructive Pulmonary Disease: a Feasibility Study
The Aim of this study is to examine the feasibility of a future trial comparing the impact of
a physical activity intervention and a standard pulmonary rehabilitation programme upon
cardiovascular risk and symptoms in COPD. The study involved three groups which are physical
activity group, pulmonary rehabilitation group and usual care. The physical activity group
and the pulmonary rehabilitation group will complete six-weeks of intervention. The pulmonary
rehabilitation group will participate in a standard rehabilitation programme of supervised
exercise and education sessions. Physical activity group will be involved in a programme that
aims to increase their physical activity level with an increasing step count. Usual care
group will be monitored for six-weeks.
Before and after interventions measures will be taken including exercise capacity, body
composition, blood tests, arterial stiffness, questionnaires assessing health quality of
life, anxiety and depression, symptoms, cardiovascular disease risk.
The investigators will also have a sub-group study. The subgroup study will have two arms
interventions which are pulmonary rehabilitation group and physical activity group. The
investigators will recruit 10 participants for each group from the main groups' population
(no usual care group). Additional before and after measures will be taken for sub-group study
and that includes Magnetic resonance imaging (MRI) scanning for adipose visceral tissue and
postprandial lipaemic response test.
It is hypothesised that exercise and physical activity level can reduce cardiovascular
disease risk with COPD patients, but the relative impact of both interventions need to be
explored.
For those with COPD, both physical activity (PA) interventions and pulmonary rehabilitation
(PR) seem to be promising to potentially lower the risk of CVD. PA interventions seem to be
promising in improving outcomes of COPD but there is lack of evidence on how the
effectiveness of PA interventions compared with the gold standard intervention of PR.
However, the outcomes of both interventions have not been extensively investigated, nor have
they been directly compared. The immediate effects of pulmonary rehabilitation and PA
interventions on cardiovascular risk factors for individuals with COPD have not been
extensively investigated or compared.
Therefore, the purpose of this study is to examine the feasibility of conducting a trial to
compare the impact of pulmonary rehabilitation and physical activity interventions in a
number of important clinical outcomes including cardiovascular risk.
Investigation and data collection will be taking place within University Hospitals of
Leicester NHS trust sites. The investigators are aiming to recruit 50 COPD patients who are
eligible for a pulmonary rehabilitation programme to investigate the effect of physical
activity intervention compared to pulmonary rehabilitation with respect to cardiovascular
risks.
The study will measure various outcomes, immediately before, immediately after interventions.
These outcomes will include measures in aerobic fitness (walking test), strength tests,
physical activity level, quality of life, breathlessness questionnaires. In addition, blood
sampling and body measurements will be completed. The investigators will also measure
arterial stiffness with a non-invasive technique. Arterial stiffness is a hardening of the
artery wall.
In a subgroup study, 20 participants will have additional visits and measures. The
investigators will be doing magnetic resonance imaging (MRI), diagnostic pictures of the
inside of the body which is used for picturing the fat tissue around the abdomen. The
investigators will be also doing a postprandial lipaemic test which is testing the fat level
in the circulating blood after a high-fat meal. The investigators will do this test as before
and after the intervention to allow for comparison.
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