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      International Journal of COPD (submit here)

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      Is Open Access

      Long-Term Effects of Pedometer-Based Physical Activity Coaching in Severe COPD: A Randomized Controlled Trial

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          Abstract

          Background and Objective

          Limited evidence on long-term effects of physical activity programs in COPD is available. The aim of the study was to investigate the effects of a three-month program combining physical activity counselling and pedometer-based feedback in addition to usual care, followed by a nine-month unsupervised observation period as compared to usual care in participants with severe to very severe COPD.

          Methods

          Participants were randomized to either a control group receiving usual care or an intervention group receiving motivational support, an activity diary with an individual step count goal (ie, an increase of ≥15% from baseline) and a pedometer in addition to usual care. The intervention ended after three months and an unsupervised observational period followed until twelve months. Primary outcome was daily step count after one year.

          Results

          Seventy-four participants were included, 61 (82%) completed the study. Linear regression modelling, adjusted for baseline step count, showed no significant difference in change in step count after 12 months between the groups (Β = 547.33, 95% CI = −243.55/1338.20).

          Conclusion

          A three-month program combining physical activity counselling and pedometer-based feedback in addition to usual care does not attenuate the declining course of physical activity in participants with severe and very severe COPD during a long term follow-up of one year as compared to usual care. This result was primarily determined by the low intervention response rates to the combined program.

          Clinical Trial Registration

          www.ClinicalTrials.gov , NCT03114241.

          Most cited references26

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          Standardisation of spirometry.

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            Pulmonary rehabilitation for chronic obstructive pulmonary disease.

            Widespread application of pulmonary rehabilitation (also known as respiratory rehabilitation) in chronic obstructive pulmonary disease (COPD) should be preceded by demonstrable improvements in function (health-related quality of life, functional and maximal exercise capacity) attributable to the programmes. This review updates the review reported in 2006.
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              Development and first validation of the COPD Assessment Test.

              There is need for a validated short, simple instrument to quantify chronic obstructive pulmonary disease (COPD) impact in routine practice to aid health status assessment and communication between patient and physician. Current health-related quality of life questionnaires provide valid assessment of COPD, but are complex, which limits routine use. The aim of the present study was to develop a short validated patient-completed questionnaire, the COPD Assessment Test (CAT), assessing the impact of COPD on health status. 21 candidate items identified through qualitative research with COPD patients were used in three prospective international studies (Europe and the USA, n = 1,503). Psychometric and Rasch analyses identified eight items fitting a unidimensional model to form the CAT. Items were tested for differential functioning between countries. Internal consistency was excellent: Cronbach's alpha = 0.88. Test re-test in stable patients (n = 53) was very good (intra-class correlation coefficient 0.8). In the sample from the USA, the correlation with the COPD-specific version of the St George's Respiratory Questionnaire was r = 0.80. The difference between stable (n = 229) and exacerbation patients (n = 67) was five units of the 40-point scale (12%; p<0.0001). The CAT is a short, simple questionnaire for assessing and monitoring COPD. It has good measurement properties, is sensitive to differences in state and should provide a valid, reliable and standardised measure of COPD health status with worldwide relevance.
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                Author and article information

                Journal
                Int J Chron Obstruct Pulmon Dis
                Int J Chron Obstruct Pulmon Dis
                copd
                copd
                International Journal of Chronic Obstructive Pulmonary Disease
                Dove
                1176-9106
                1178-2005
                06 November 2020
                2020
                : 15
                : 2837-2846
                Affiliations
                [1 ]Department of Pulmonology, University Hospital Zurich , Zurich, Switzerland
                [2 ]Institute of Primary Care, University of Zurich , Zurich, Switzerland
                Author notes
                Correspondence: Christian F ClarenbachDepartment of Pulmonology, University Hospital Zurich , Raemistrasse 100, Zurich8091, SwitzerlandTel +41 44 255 17 12 Email christian.clarenbach@usz.ch
                Author information
                http://orcid.org/0000-0001-6674-5193
                http://orcid.org/0000-0003-1758-4586
                http://orcid.org/0000-0003-4422-7250
                http://orcid.org/0000-0003-2158-2321
                Article
                279293
                10.2147/COPD.S279293
                7655791
                33192057
                20787282-b0cc-4bdc-b37c-0428c4f96c0c
                © 2020 Kohlbrenner et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                : 28 August 2020
                : 14 October 2020
                Page count
                Figures: 4, Tables: 12, References: 27, Pages: 10
                Funding
                Funded by: Lunge Zurich;
                This work was supported by Lunge Zurich.
                Categories
                Original Research

                Respiratory medicine
                physical activity,copd,counselling program,randomized controlled trial,long-term follow-up

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