Activity Monitor Use in COPD Patients Undergoing Rehabilitation
In patients with Chronic Obstructive Pulmonary Disease (COPD) lifestyles with lower physical activity levels have been shown to increase the risk of hospital admissions and shorten survival rates. An established process in increasing activity levels is to undergo pulmonary rehabilitation classes.
The investigators wish to identify whether the use of activity monitors,which will provide feedback on activity levels, will increase the physical activity levels of patients with COPD outside of the supervised pulmonary rehabilitation sessions.
|Chronic Obstructive Pulmonary Disease COPD Emphysema Chronic Bronchitis||Behavioral: Feedback|
|Study Design:||Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
|Official Title:||The Role of Activity Monitors in Improving Physical Activity in COPD Patients Participating in Pulmonary Rehabilitation|
- Daily physical activity measured as: A: number of minutes active during the day; B: number of steps* [ Time Frame: Through Study completion, upto 7 weeks total ]from the data recorded on the device
- Assessment of exercise capacity: 6 minute walk test (comparing the 2 groups and in comparison to baseline) [ Time Frame: At beginning and at 7 weeks, with repeat at 6 months ]
- Self reported exercise diary - duration of exercise [ Time Frame: Through Study completion, upto 7 weeks total ]
- Self reported exercise diary - BORG (perceived activity levels and effort scale) [ Time Frame: Through Study completion, upto 7 weeks total ]
- Assessment of symptom severity using Copd Assessment Test (comparing the 2 groups and in comparison to baseline) [ Time Frame: Through Study completion, upto 7 weeks total ]
- Assessment of symptom severity using Hospital Anxiety and Depression Scale (comparing the 2 groups and in comparison to baseline) [ Time Frame: Through Study completion, upto 7 weeks total ]
- Assessment of symptom severity using the Patient Activation Measure Score (comparing the 2 groups and in comparison to baseline) [ Time Frame: Through Study completion, upto 7 weeks total ]
- Assessment of symptom severity using the Chronic Respiratory Disease Questionaire Score (comparing the 2 groups and in comparison to baseline) [ Time Frame: Through Study completion, upto 7 weeks total ]
|Study Start Date:||August 2016|
|Estimated Study Completion Date:||August 2017|
|Estimated Primary Completion Date:||August 2017 (Final data collection date for primary outcome measure)|
Those randomised to the feedback arm will receive weekly feedback on their activity levels and tailored advice on how to improve activity levels.
Will receive feedback on the amount of activity that has been undertaken in the last week, will specialist advice on steps taken, active minutes each day, how much device has been worn and tailored advice on how to improve activity levels
No Intervention: Control
Control arm will wear the activity monitor as specified in the protocol but will not receive feedback on activity levels
The research proposal has been developed in conjunction with the Respiratory Physicians and Physiotherapy team who deliver the pulmonary Rehabilitation sessions.
The investigators want to address if providing patients with monitors to record activity levels and then giving feedback on activity level data enhances the effect of the standard pulmonary rehabilitation program. The investigators want to pay particular attention to the levels of activity outside the duration of the rehabilitation classes - to see if higher levels of activity are reached.
This aims to be a feasibility study done on a small scale where issues such as compliance with wearing the device can be monitored closely. Compliance will be reviewed during a one week trial of wearing the device prior to starting the rehabilitation sessions. It will also enable study participants to get into the routine of wearing the device, charging etc.
Analysis of the data will be data collected during weekdays, choosing the 4 weekdays where there is a minimum of 8hrs of wearing time during waking hours. If the device has been worn for less than 8 hours, then days with most wear-time of the device will be selected. This method was chosen as it is a robust and statistically validated method of assessing activity levels in patients with COPD.
All study participants will be asked to wear the activity monitor to minimise any bias in the collected data. Subjects will be randomised as to whether they receive feedback or not.
The choice of activity monitor to be used was considered. Requirements are that it should be wrist-worn and the data collected by the device able to been downloaded through the associated computer software/"app". Wrist worn devices were chosen so that compliance in wearing the device would be maximized - they are worn in the same way a normal wrist watch would be.
A model from the brand "Fitbit" was selected based on this criteria. This was justified by previous studies showing Fitbit has good validity and usability in measuring energy expenditure in COPD patients.
As all participants in the study will partake in the pulmonary rehabilitation sessions there will be no deviations from standard care with this project. Analysis of activity will be downloaded, once a week, from the devices during the sessions and subjects randomised to receive feedback will have a 10 minute session dedicated to this.
There is a risk that subjects will have an exacerbation of their condition/chest infection during the period of pulmonary rehab. If a subject is too unwell to attend a rehabilitation session they will receive their feedback on their next attendance. Any subjects that are hospitalised during the study will be withdrawn.
Please refer to this study by its ClinicalTrials.gov identifier: NCT02895152
|Contact: Patricia Kellyemail@example.com|
|Contact: Glenn Cardwell, MBChB, MRCPfirstname.lastname@example.org|
|Salford Royal NHS Foundation Trust||Recruiting|
|Salford, Greater Manchester, United Kingdom, M6 8HD|
|Contact: Natalie Garratt Natalie.Garratt@manchester.ac.uk|
|Principal Investigator: Nawar D Bakerly, MD, FRCP|
|Sub-Investigator: Glenn Cardwell, MBChB, MRCP|
|Principal Investigator:||Nawar D Bakerly, MD, FRCP||Salford Royal NHS Foundation Trust|