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Cheng SWM, McKeough ZJ, McNamara RJ, Alison JA. Pulmonary Rehabilitation Using Minimal Equipment for People With Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis. Phys Ther 2023; 103:pzad013. [PMID: 37140475 PMCID: PMC10158642 DOI: 10.1093/ptj/pzad013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 10/10/2022] [Accepted: 12/28/2022] [Indexed: 05/05/2023]
Abstract
OBJECTIVE Pulmonary rehabilitation programs that use minimal equipment for exercise training, rather than gymnasium equipment, would enable delivery of pulmonary rehabilitation to a greater number of people with chronic obstructive pulmonary disease (COPD). The effectiveness of minimal equipment programs in people with COPD is unclear. This systematic review and meta-analysis aimed to determine the effects of pulmonary rehabilitation using minimal equipment for aerobic and/or resistance training in people with COPD. METHODS Literature databases were searched up to September 2022 for randomized controlled trials (RCTs) comparing the effect of minimal equipment programs with usual care or with exercise equipment-based programs for exercise capacity, health-related quality of life (HRQoL), and strength. RESULTS Nineteen RCTs were included in the review and 14 RCTs were included in the meta-analyses, which reported low to moderate certainty of evidence. Compared with usual care, minimal equipment programs increased 6-minute walk distance (6MWD) by 85 m (95% CI = 37 to 132 m). No difference in 6MWD was observed between minimal equipment and exercise equipment-based programs (14 m, 95% CI = -27 to 56 m). Minimal equipment programs were more effective than usual care for improving HRQoL (standardized mean difference = 0.99, 95% CI = 0.31 to 1.67) and were not different from exercise equipment-based programs for improving upper limb strength (6 N, 95% CI = -2 to 13 N) or lower limb strength (20 N, 95% CI = -30 to 71 N). CONCLUSION In people with COPD, pulmonary rehabilitation programs using minimal equipment elicit clinically significant improvements in 6MWD and HRQoL and are comparable with exercise equipment-based programs for improving 6MWD and strength. IMPACT Pulmonary rehabilitation programs using minimal equipment may be a suitable alternative in settings where access to gymnasium equipment is limited. Delivery of pulmonary rehabilitation programs using minimal equipment may improve access to pulmonary rehabilitation worldwide, particularly in rural and remote areas and in developing countries.
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Affiliation(s)
- Sonia Wing Mei Cheng
- Discipline of Physiotherapy, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Zoe J McKeough
- Discipline of Physiotherapy, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Renae J McNamara
- Department of Physiotherapy, Prince of Wales Hospital, South Eastern Sydney Local Health District, Sydney, Australia
- Woolcock Emphysema Centre, Woolcock Institute of Medical Research, Sydney, Australia
| | - Jennifer A Alison
- Discipline of Physiotherapy, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- Allied Health Professorial Unit, Sydney Local Health District, Sydney, Australia
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Cheng SWM, Alison J, Stamatakis E, Dennis S, McNamara R, Spencer L, McKeough Z. Six-week behaviour change intervention to reduce sedentary behaviour in people with chronic obstructive pulmonary disease: a randomised controlled trial. Thorax 2021; 77:231-238. [PMID: 34226203 DOI: 10.1136/thoraxjnl-2020-214885] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 06/02/2021] [Indexed: 11/03/2022]
Abstract
INTRODUCTION This study aimed to determine whether a 6-week behaviour change intervention was more effective than a sham intervention for reducing sedentary behaviour (SB) in people with chronic obstructive pulmonary disease (COPD). METHODS People with stable COPD on the waitlist for entry into pulmonary rehabilitation were recruited to this multicentre trial with randomisation (independent, concealed allocation) to either an intervention group or sham group, assessor blinding and intention-to-treat (ITT) analysis. The behaviour change intervention consisted of once weekly sessions for 6 weeks with a physiotherapist to reduce SB through education, guided goals setting and real-time feedback on SB. The sham intervention consisted of once weekly phone calls for 6 weeks to monitor health status. SB was measured continuously over 7 days using thigh-worn accelerometry (activPAL3 micro). The primary outcome was time spent in SB. Participants with at least 4 days of ≥10 hours waking wear time were included in the ITT analysis and those who reported achieving ≥70% of goals to reduce SB or who completed all sham calls were included in a per-protocol analysis. RESULTS 70 participants were recruited and 65 completed the study (mean±SD age 74±9 years, mean FEV1 55%±19% predicted, 49% male). At 6 weeks, no between-group differences in time spent in SB were observed in the ITT analysis (mean difference 5 min/day, 95% CI -38 to 48) or per-protocol analysis (-16 min/day, 95% CI -80 to 48). DISCUSSION A 6-week behaviour change intervention did not reduce time in SB compared with a sham intervention in people with stable moderate-to-severe COPD prior to pulmonary rehabilitation.
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Affiliation(s)
- Sonia Wing Mei Cheng
- Discipline of Physiotherapy, The University of Sydney, Sydney, New South Wales, Australia .,Department of Physiotherapy, Macquarie University Hospital, Sydney, New South Wales, Australia
| | - Jennifer Alison
- Discipline of Physiotherapy, The University of Sydney, Sydney, New South Wales, Australia.,Allied Health Professorial Unit, Sydney Local Health District, Sydney, New South Wales, Australia
| | - Emmanuel Stamatakis
- Charles Perkins Centre, School of Public Health, Prevention Research Collaboration, The University of Sydney, Sydney, New South Wales, Australia
| | - Sarah Dennis
- Discipline of Physiotherapy, The University of Sydney, Sydney, New South Wales, Australia.,Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia
| | - Renae McNamara
- Department of Physiotherapy, Prince of Wales Hospital and Community Health Services, Randwick, New South Wales, Australia.,Woolcock Emphysema Centre, Woolcock Institute of Medical Research, Sydney, New South Wales, Australia
| | - Lissa Spencer
- Department of Physiotherapy, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - Zoe McKeough
- Discipline of Physiotherapy, The University of Sydney, Sydney, New South Wales, Australia
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Verhagen E, Oliveira F, Ahmed OH, Anderson N, Badenhorst M, Bekker S, Belavy DL, Blake T, Cao C, Carrard J, Chen L, Cheng SWM, Edouard P, Harwood A, Hendricks S, Hespanhol L, Kearney R, Keohane D, Magnani R, Mah D, Mavros Y, McLeary N, Memon AR, Moholdt T, Morais Azevedo A, Nauta J, Nicol G, Noorbhai H, Ogbonmwan I, Owen PJ, Panagodage Perera N, Reiman M, Resende R, Robinson DG, Rojas-Valverde D, Sewry N, Statuta S, van Nassau F, West L, Wheeler PC, Xiao T, Pandya T. Let us introduce ourselves, #WeAreBOSEM. BMJ Open Sport Exerc Med 2021; 7:e001171. [PMID: 34262787 PMCID: PMC8246350 DOI: 10.1136/bmjsem-2021-001171] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/24/2021] [Indexed: 11/20/2022] Open
Affiliation(s)
- Evert Verhagen
- Amsterdam Collaboration on Health & Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam UMC, University Medical Centers - Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Fabio Oliveira
- Department of Rehabilitation, Faculty of Medicine, Laval University, Quebec, Quebec, Canada
| | - Osman Hassan Ahmed
- Physiotherapy Department, University Hospitals Dorset NHS Foundation Trust, Poole, UK.,School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, UK
| | - Nash Anderson
- Tuggeranong Chiropractic Centre, Fadden, Australian Capital Territory, Australia
| | - Marelise Badenhorst
- ISEM, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | | | | | - Tracy Blake
- University Health Network, Toronto, Ontario, Canada
| | - Chao Cao
- Washington University School of Medicine in Saint Louis, Saint Louis, Missouri, USA
| | - Justin Carrard
- Division of Sports and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland.,ALTIUS Swiss Sportmed Center AG, Rheinfelden, Switzerland
| | - Lingxiao Chen
- Institute of Bone and Joint Research, The University of Sydney, Saint Leonards, New South Wales, Australia
| | - Sonia Wing Mei Cheng
- Discipline of Physiotherapy, University of Sydney, Sydney, New South Wales, Australia
| | - Pascal Edouard
- Centre Hospitalier Universitaire de Saint-Etienne, Saint-Etienne, Rhône-Alpes, France
| | - Amy Harwood
- Centre for Sport and Exercise Life Sciences, Faculty of Health and Life Sciences, Coventry University, Coventry, UK
| | - Sharief Hendricks
- Division of Exercise Science and Sports Medicine, Department of Human Biology, University of Cape Town, Rondebosch, South Africa.,Carnegie Applied Rugby Research (CARR) centre, Institute for Sport, Physical Activity and Leisure, Leeds Beckett University, Leeds, UK
| | - Luiz Hespanhol
- Amsterdam Collaboration on Health & Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam UMC, University Medical Centers - Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Masters and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil
| | | | - David Keohane
- Department of Medicine, Clinical Sciences Cork University Hospital, University College Cork, Cork, Ireland
| | - Rina Magnani
- Physiotherapy, State University of Goias, Goiânia, Brazil
| | - Dominic Mah
- Orthopaedics, Prince of Wales Hospital and Community Health Services, Sydney, New South Wales, Australia.,Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Yorgi Mavros
- University of Sydney, Sydney, New South Wales, Australia
| | - Nikki McLeary
- Sport & Health Sciences, University of Exeter, Exeter, UK
| | - Aamir Raoof Memon
- Institute of Physiotherapy and Rehabilitation Science, Peoples University of Medical and Health Sciences for Women, Nawabshah, Pakistan
| | - Trine Moholdt
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway.,Women's Clinic, St.Olav's University Hospital, Trondheim, Norway
| | | | - Joske Nauta
- Amsterdam Collaboration on Health & Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam UMC, University Medical Centers - Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Greig Nicol
- Orthopaedics, Woodend Hospital, Aberdeen, UK
| | - Habib Noorbhai
- Department of Sport and Movement Studies, Faculty of Health Sciences, University of Johannesburg, Auckland Park, South Africa
| | | | - Patrick J Owen
- Institute for Physical Activity and Nutrition, Deakin University, Burwood, Victoria, Australia
| | | | - Mike Reiman
- Duke University, Durham, North Carolina, USA
| | - Renan Resende
- Department of Physical Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Diana Gai Robinson
- Australasian College of Sport and Exercise Physicians (ACSEP), Melbourne, Victoria, Australia
| | - Daniel Rojas-Valverde
- Campus Benjamín Núñez, Escuela Ciencias del Movimiento, Humano y Calidad de Vida, Universidad Nacional de Costa Rica, Heredia, Costa Rica
| | - Nicola Sewry
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Pretoria, Gauteng, South Africa
| | - Siobhan Statuta
- Family Medicine and Physical Medicine and Rehab, University of Virginia, Charlottesville, Virginia, USA
| | - Femke van Nassau
- Amsterdam Collaboration on Health & Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam UMC, University Medical Centers - Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Liam West
- Olympic Park Sports Medicine Centre, Melbourne, Victoria, Australia
| | - Patrick Crane Wheeler
- Department of Sport and Exercise Medicine, University Hospitals of Leicester NHS Trust, Leicester, UK.,SSEHS, Loughborough University, Loughborough, UK
| | - Tao Xiao
- College of Mathematics and Statistics, Shenzhen University, Shenzhen, Guangdong, China
| | - Tej Pandya
- Institute of Science and Technology, University of Manchester, Manchester, UK
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McKeough Z, Cheng SWM, Alison J, Jenkins C, Hamer M, Stamatakis E. Low leisure-based sitting time and being physically active were associated with reduced odds of death and diabetes in people with chronic obstructive pulmonary disease: a cohort study. J Physiother 2018; 64:114-120. [PMID: 29574168 DOI: 10.1016/j.jphys.2018.02.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 11/07/2017] [Accepted: 02/15/2018] [Indexed: 02/04/2023] Open
Abstract
QUESTIONS In people with chronic obstructive pulmonary disease (COPD), are activity phenotypes (based on physical activity and recreational screen time) associated with mortality and cardiometabolic risk factors? DESIGN Cohort study. PARTICIPANTS People with COPD aged≥40years and who were current or ex-smokers were identified from the 2003 Scottish Health Survey. OUTCOME MEASURES Data were collected regarding demographics, anthropometric measurements, medical history, physical activity, sedentary behaviour, health outcomes, and mortality. ANALYSIS Participants were categorised into one of the following activity phenotypes: 'couch potatoes' were those who were insufficiently active with high leisure-based sitting time and/or no domestic physical activity; 'light movers' were insufficiently active with some domestic physical activity; 'sedentary exercisers' were sufficiently active with high leisure-based sitting time; and 'busy bees' were sufficiently active with low leisure-based sitting time. 'Sufficiently active' was defined as adhering to physical activity (PA) recommendations of≥7.5 metabolic equivalent (MET) hours/week. 'Low leisure-based sitting time' was defined as≤200minutes of recreational screen time/day. RESULTS The 584 participants had a mean age of 64 years (SD 12) and 52% were male. Over 5.5 years (SD 1.3) of follow-up, there were 81 all-cause deaths from 433 COPD participants with available data. Compared to the 'couch potatoes', there was a reduced risk of all-cause mortality in the 'busy bees' (Hazard Ratio 0.26, 95% CI 0.11 to 0.65) with a trend towards a reduction in mortality risk in the other phenotypes. The odds of diabetes were lower in the 'busy bees' compared to the 'couch potatoes' (OR 0.14, 95% CI 0.03 to 0.67). CONCLUSIONS Adhering to physical activity guidelines and keeping leisure-based sitting time low had a mortality benefit and lowered the odds of diabetes in people with COPD. [McKeough Z, Cheng SWM, Alison J, Jenkins C, Hamer M, Stamatakis E (2018) Low leisure-based sitting time and being physically active were associated with reduced odds of death and diabetes in people with chronic obstructive pulmonary disease: a cohort study. Journal of Physiotherapy 64: 114-120].
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Affiliation(s)
- Zoe McKeough
- Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney
| | - Sonia Wing Mei Cheng
- Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney
| | - Jennifer Alison
- Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney; Allied Health Professorial Unit, Sydney Local Health District
| | - Christine Jenkins
- Department of Thoracic Medicine, Concord Hospital, Sydney, Australia
| | - Mark Hamer
- University of Loughborough, United Kingdom
| | - Emmanuel Stamatakis
- School of Public Health, Charles Perkins Centre, The University of Sydney, Sydney, Australia
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Cheng SWM, McKeough Z, Alison J, Dennis S, Hamer M, Stamatakis E. Associations of total and type-specific physical activity with mortality in chronic obstructive pulmonary disease: a population-based cohort study. BMC Public Health 2018; 18:268. [PMID: 29454345 PMCID: PMC5816365 DOI: 10.1186/s12889-018-5167-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Accepted: 02/08/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Regular physical activity is recommended for all people with chronic obstructive pulmonary disease (COPD), but the dose of physical activity required to gain mortality benefit in this population is not yet known. This aim of this study was to examine the associations of total and type-specific physical activity with mortality risk in people with COPD. METHODS People with COPD aged ≥40 years were identified from the 1997 Health Survey for England and the 1998 and 2003 Scottish Health Survey cohorts. Self-reported total physical activity, moderate-vigorous intensity physical activity (MVPA), walking, domestic physical activity, and sport/exercise were assessed at baseline. Cox proportional hazards models were used to examine the associations between physical activity and mortality risk. RESULTS Two thousand three hundred ninety-eight participants with COPD were included in the analysis and followed up for a mean 8.5 (SD 3.9) years. For both total physical activity and MVPA, we observed dose-response associations with all-cause and cardiovascular disease (CVD) mortality risk, and with respiratory mortality risk to a lesser extent. Compared to those who reported no physical activity, participants who met the physical activity guidelines demonstrated the greatest reductions in all-cause (HR 0.56, 95% CI 0.45-0.69), CVD (HR 0.48, 95% CI 0.32-0.71) and respiratory mortality risk (HR 0.40, 95% CI 0.24-0.67). Participants who reported a level of physical activity of at least half the dosage recommended by the guidelines also had a reduced risk of all-cause (HR 0.75, 95% CI 0.56-1.00) and CVD mortality (HR 0.48, 95% CI 0.26-0.88). Dose-response associations with mortality risk were demonstrated for walking and sport/exercise, but not domestic physical activity. CONCLUSIONS We found a dose-response association between physical activity and all-cause and CVD mortality risk in people with COPD, with protective effects appearing at levels considerably lower than the general physical activity recommendations. People with COPD may benefit from engagement in low levels of physical activity, particularly walking and structured exercise.
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Affiliation(s)
| | - Zoe McKeough
- Discipline of Physiotherapy, The University of Sydney, Sydney, Australia
| | - Jennifer Alison
- Discipline of Physiotherapy, The University of Sydney, Sydney, Australia
| | - Sarah Dennis
- Discipline of Physiotherapy, The University of Sydney, Sydney, Australia.,Ingham Institute for Applied Medical Research, Sydney, Australia
| | - Mark Hamer
- University of Loughborough, Loughborough, UK
| | - Emmanuel Stamatakis
- Charles Perkins Centre, School of Public Health, Prevention Research Collaboration, The University of Sydney, Sydney, Australia
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Cheng SWM, Alison J, Dennis S, Stamatakis E, Spencer L, McNamara R, Sims S, McKeough Z. A behaviour change intervention to reduce sedentary time in people with chronic obstructive pulmonary disease: protocol for a randomised controlled trial. J Physiother 2017; 63:182. [PMID: 28526329 DOI: 10.1016/j.jphys.2017.04.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2017] [Revised: 03/20/2017] [Accepted: 04/10/2017] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Replacing sedentary behaviour with light intensity physical activity (ie, activities classified as less than three metabolic equivalents, such as slow-paced walking) may be a more realistic strategy for reducing cardiometabolic risk in people with chronic obstructive pulmonary disease than only aiming to increase levels of moderate-vigorous intensity physical activity. Behaviour change interventions to reduce sedentary behaviour in people with chronic obstructive pulmonary disease have not yet been developed or tested. RESEARCH QUESTIONS Is a 6-week behaviour change intervention effective and feasible in reducing sedentary time in people with chronic obstructive pulmonary disease? DESIGN This study will be a multi-centre, randomised, controlled trial with concealed allocation, assessor blinding, and intention-to-treat analysis, comparing a 6-week behaviour change intervention aimed at reducing sedentary time with a sham intervention in people with chronic obstructive pulmonary disease. PARTICIPANTS AND SETTING Seventy participants will be recruited from the waiting lists for pulmonary rehabilitation programs at Royal Prince Alfred Hospital and Prince of Wales Hospital, Sydney, Australia. INTERVENTION The behaviour change intervention aims to reduce sedentary time through a process of guided goal setting with participants to achieve two target behaviours: (1) replace sitting and lying down with light-intensity physical activity where possible, and (2) stand up and move for 2minutes after 30minutes of continuous sedentary time. Three face-to-face sessions and three phone sessions will be held with a physiotherapist over the 6-week intervention period. The 'capability', 'opportunity', 'motivation' and 'behaviour' (COM-B) model will be applied to each participant to determine which components of behaviour (capability, opportunity or motivation) need to change in order to reduce sedentary time. Based on this 'behavioural diagnosis', the Behaviour Change Wheel will be used to systematically select appropriate behaviour change techniques to assist participants in achieving their weekly goals. Behaviour change techniques will include providing information about the health consequences of sedentary behaviour, self-monitoring and review of weekly goals, problem-solving of barriers to achieving weekly goals, and providing feedback on sedentary time using the Jawbone UP3 activity monitor. CONTROL The sham intervention will consist of weekly phone calls for 6 weeks, to enquire whether the participants' health status has changed over the intervention period (eg, hospitalised for an acute exacerbation). No instructions regarding physical activity or exercise will be given. MEASUREMENTS Outcomes will be assessed at baseline, at the end of the 6-week intervention period, and at the 3-month follow-up. Primary outcome measures will be: (1) total sedentary time, including the pattern of accumulation of sedentary time, assessed by the activPAL3 activity monitor, and (2) feasibility of the intervention assessed by uptake and retention of participants, participant compliance, self-reported achievement of weekly goals, and adverse events. Secondary outcome measures will include functional exercise capacity, health-related quality of life, domain-specific and behaviour-specific sedentary time, patient activation, and anxiety and depression. Semi-structured interviews will be conducted with participants who receive the behaviour change intervention to explore acceptability and satisfaction with the different components of the intervention. ANALYSIS Analysis of covariance (ANCOVA) will be used to calculate between-group comparisons of total sedentary time and the number of bouts of sedentary time>30minutes after adjusting baseline values. Uncertainty about the size of the mean between-group differences will be quantified with 95% CI. Within-group comparisons will be examined using paired t-tests and described as mean differences with 95% CIs. Secondary outcome measures will be analysed similarly. The feasibility measures will be analysed descriptively. Semi-structured interviews will be conducted until data saturation is achieved and there are no new emerging themes. De-identified interview transcripts will be coded independently by two researchers and analysed alongside data collection using the COM-B model as a thematic framework. DISCUSSION/SIGNIFICANCE If behaviour change interventions are found to be an effective and feasible method for reducing sedentary time, such interventions may be used to reduce cardiometabolic risk in people with chronic obstructive pulmonary disease. An approach that emphasises participation in light-intensity physical activity may increase the confidence and willingness of people with chronic obstructive pulmonary disease to engage in more intense physical activity, and may serve as an intermediate goal to increase uptake of pulmonary rehabilitation.
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Affiliation(s)
| | | | - Sarah Dennis
- Discipline of Physiotherapy, The University of Sydney
| | - Emmanuel Stamatakis
- Charles Perkins Centre, School of Public Health, Prevention Research Collaboration, The University of Sydney
| | - Lissa Spencer
- Department of Physiotherapy, Royal Prince Alfred Hospital, Sydney Local Health District
| | - Renae McNamara
- Department of Physiotherapy, Prince of Wales Hospital, South Eastern Sydney Local Health District
| | - Susan Sims
- Grow Mind and Body Coaching, The Sydney Children's Hospital Network (Randwick and Westmead), Sydney, Australia
| | - Zoe McKeough
- Discipline of Physiotherapy, The University of Sydney
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