Physical Activity in People with COPD: the feasibility of a RCT to compare a physical activity intervention versus pulmonary rehabilitation, and the fidelity of the physical activity intervention

Abstract

Background: People with COPD engage in lower levels of physical activity (PA) compared to healthy people. PA interventions(PAI) for people with COPD are not offered in the current healthcare system.

Aim: To assess the feasibility of conducting a trial to explore the effectiveness a PAI versus pulmonary rehabilitation (PR) in improving physical activity in patients with COPD (the LIVELY COPD project); and to assess the treatment fidelity of the LIVELY PAI.

Methods: A mixed methods randomised controlled feasibility trial was undertaken and the treatment fidelity of the PAI was assessed. COPD patients referred to PR in two health and social care trusts were screened; n=50 were recruited and randomised. The PAI consisted of a 12 week pedometer driven walking intervention, participants had weekly contact with a physiotherapist/nurse and set step goals. Outcome measures were collected at baseline, post intervention and follow up. Qualitative interviews were conducted at post intervention. Based on a review of the literature, the Borrelli 2011 checklist was used to assess the fidelity of the PAI.

Results: N=50 participants were recruited (PAI n=23, PR n=27). There were less dropouts in the PAI (26%) compared to PR (52%). Participants in the PAI increased their average daily step count in line with the minimal clinically important difference for step count in COPD, this was not observed in PR. The results of the qualitative component demonstrated that the participants experienced a range of health benefits. Participants in both groups encountered barriers to participation; the PAI had a stronger emphasis on facilitators. The LIVELY PAI was delivered with good fidelity and the use of the Borrelli 2011 checklists provide a feasible platform for assessming fidelity of a PAI.

Conclusion: These findings support the feasibility of the LIVELY COPD project and there was important learning which could help ensure the success of a future trial. Testing the feasibility of a trial with a mixed methods design was a valuable process and the qualitative data enriched our results. Assessing the fidelity of the LIVELY PAI increased our understanding of the intervention. Future research is needed to test the intervention in a fully powered randomised controlled trial.

Date of Award	Mar 2018
Original language	English
Sponsors	NI Chest Heart & Stroke Association
Supervisor	Suzanne Mc Donough (Supervisor), Brenda O'Neill (Supervisor) & Jonathan Bradley (Supervisor)