TY - JOUR
T1 - Long-term efficacy and effectiveness of a behavioural and community-based exercise intervention (Urban Training) to increase physical activity in patients with COPD
T2 - A randomised controlled trial
AU - Arbillaga-Etxarri, Ane
AU - Gimeno-Santos, Elena
AU - Barberan-Garcia, Anael
AU - Balcells, Eva
AU - Benet, Marta
AU - Borrell, Eulàlia
AU - Celorrio, Nuria
AU - Delgado, Anna
AU - Jané, Carme
AU - Marin, Alicia
AU - Martín-Cantera, Carlos
AU - Monteagudo, Mónica
AU - Montellà, Nuria
AU - Muñoz, Laura
AU - Ortega, Pilar
AU - Rodríguez, Diego A.
AU - Rodríguez-Roisin, Robert
AU - Simonet, Pere
AU - Torán-Monserrat, Pere
AU - Torrent-Pallicer, Jaume
AU - Vall-Casas, Pere
AU - Vilaró, Jordi
AU - Garcia-Aymerich, Judith
N1 - Funding Information:
Support statement: The study was funded by grants from Fondo de Investigación Sanitaria, Instituto de Salud Carlos III (ISCIII, PI11/01283 and PI14/0419), integrated into Plan Estatal I+D+I 2013–2016 and co-funded by ISCIII-Subdirección General de Evaluación y Fomento de la Investigación and Fondo Europeo de Desarrollo Regional (FEDER); Sociedad Española de Neumología y Cirugía Torácica (SEPAR, 147/2011 and 201/2011), Societat Catalana de Pneumologia (Ajuts al millor projecte en fisioteràpia respiratòria 2013). ISGlobal is a member of the CERCA Programme, Generalitat de Catalunya. Anael Barberan-Garcia had personal funding from AGAUR 2014-SGR-661, Catalan Government. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Funding information for this article has been deposited with the Crossref Funder Registry.
Publisher Copyright:
Copyright ©ERS 2018.
PY - 2018
Y1 - 2018
N2 - There is a need to increase and maintain physical activity in patients with chronic obstructive pulmonary disease (COPD). We assessed 12-month efficacy and effectiveness of the Urban Training intervention on physical activity in COPD patients. This randomised controlled trial (NCT01897298) allocated 407 COPD patients from primary and hospital settings 1:1 to usual care (n=205) or Urban Training (n=202). Urban Training consisted of a baseline motivational interview, advice to walk on urban trails designed for COPD patients in outdoor public spaces and other optional components for feedback, motivation, information and support (pedometer, calendar, physical activity brochure, website, phone text messages, walking groups and a phone number). The primary outcome was 12-month change in steps·day−1 measured by accelerometer. Efficacy analysis (with per-protocol analysis set, n=233 classified as adherent to the assigned intervention) showed adjusted (95% CI) 12-month difference +957 (184–1731) steps·day−1 between Urban Training and usual care. Effectiveness analysis (with intention-to-treat analysis set, n=280 patients completing the study at 12 months including unwilling and self-reported non-adherent patients) showed no differences between groups. Leg muscle pain during walks was more frequently reported in Urban Training than usual care, without differences in any of the other adverse events. Urban Training, combining behavioural strategies with unsupervised outdoor walking, was efficacious in increasing physical activity after 12 months in COPD patients, with few safety concerns. However, it was ineffective in the full population including unwilling and self-reported non-adherent patients.
AB - There is a need to increase and maintain physical activity in patients with chronic obstructive pulmonary disease (COPD). We assessed 12-month efficacy and effectiveness of the Urban Training intervention on physical activity in COPD patients. This randomised controlled trial (NCT01897298) allocated 407 COPD patients from primary and hospital settings 1:1 to usual care (n=205) or Urban Training (n=202). Urban Training consisted of a baseline motivational interview, advice to walk on urban trails designed for COPD patients in outdoor public spaces and other optional components for feedback, motivation, information and support (pedometer, calendar, physical activity brochure, website, phone text messages, walking groups and a phone number). The primary outcome was 12-month change in steps·day−1 measured by accelerometer. Efficacy analysis (with per-protocol analysis set, n=233 classified as adherent to the assigned intervention) showed adjusted (95% CI) 12-month difference +957 (184–1731) steps·day−1 between Urban Training and usual care. Effectiveness analysis (with intention-to-treat analysis set, n=280 patients completing the study at 12 months including unwilling and self-reported non-adherent patients) showed no differences between groups. Leg muscle pain during walks was more frequently reported in Urban Training than usual care, without differences in any of the other adverse events. Urban Training, combining behavioural strategies with unsupervised outdoor walking, was efficacious in increasing physical activity after 12 months in COPD patients, with few safety concerns. However, it was ineffective in the full population including unwilling and self-reported non-adherent patients.
UR - http://www.scopus.com/inward/record.url?scp=85055203335&partnerID=8YFLogxK
U2 - 10.1183/13993003.00063-2018
DO - 10.1183/13993003.00063-2018
M3 - Article
C2 - 30166322
AN - SCOPUS:85055203335
SN - 0903-1936
VL - 52
JO - European Respiratory Journal
JF - European Respiratory Journal
IS - 4
M1 - 1800063
ER -