Abstract
BackgroundPhysical activity promotion in people with Chronic Obstructive Pulmonary Disease (COPD) is focus of research and public health. Patient-centred interventions like counselling are promising approaches to help patients reducing sedentary behaviour. Aim of the present study is to investigate if a physical activity counselling program during pulmonary rehabilitation increases physical activity level in daily life in people with COPD.MethodsA two-armed, single blind randomised controlled trial including 56 people with COPD will be conducted in an outpatient pulmonary rehabilitation. Patients will participate in a 12-week-rehabilitation program; individuals randomized to the interventional group will additionally participate in five counselling sessions with a physiotherapist, based on the principles of motivational interviewing. The participants’ physical activity level will be measured using an accelerometer (SenseWear Pro®) before, directly and 3 months after pulmonary rehabilitation. Semi-structured interviews will be conducted to learn more about barriers and facilitators regarding daily physical activity.DiscussionIf the strategy successfully improves the physical activity level in people with COPD, counselling might be implemented in pulmonary rehabilitation.Trial registrationClinical Trials.gov NCT02455206 (05/21/2015), Swiss National Trails Portal SNCTP000001426 (05/21/2015).
Highlights
Physical activity promotion in people with Chronic Obstructive Pulmonary Disease (COPD) is focus of research and public health
In order to address the recommendations of the American Thoracic Society (ATS) and the European Respiratory Society (ERS) more accurately, the current study aims to improve long-term self-management and adherence to exercise at home during PR by adding counselling based on motivational interviewing (MI)
Recruitment and randomization People with confirmed COPD according to the guidelines referred to the pulmonary division of Kantonspital Winterthur (KSW) between October 2015 and likely October 2018 will be asked to participate in the study
Summary
Design and ethics The study is a prospective two-arm single-blinded randomized controlled trial comparing a PA counselling group (PAcG) with a usual care control group (CG). Recruitment and randomization People with confirmed COPD according to the guidelines referred to the pulmonary division of KSW between October 2015 and likely October 2018 will be asked to participate in the study. Intervention Pneumofit Cardio-pulmonary exercise training will be performed according to published guidelines [19, 32,33,34]. The fidelity check evaluates the general session content, as well as random 20-min segments of the conversations which will be assessed by an external independent MI-expert according to the Motivational Interviewing Treatment Integrity (MITI 4) [36] criteria. Measurements Before beginning of PR program, baseline pulmonary function test and other routine assessments will be performed. A physiotherapist instructs patients about the duration of the test (1 min) and to perform as many repetitions as possible allowing for short breaks if needed but without using the arms for support. From within R, we will use the rjagspackage [60]
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