The Trajectory of Physical Activity Following Pulmonary Rehabilitation



Status:Recruiting
Conditions:Chronic Obstructive Pulmonary Disease
Therapuetic Areas:Pulmonary / Respiratory Diseases
Healthy:No
Age Range:40 - Any
Updated:1/5/2017
Start Date:April 2015
End Date:July 2017
Contact:Richard ZuWallack, MD
Phone:860-714-4055

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Pulmonary rehabilitation clearly increases exercise capacity, but its effect on physical
activity in the home and community settings is less clear. It may take a longer time for
this increase in physical activity to occur. It has been stated in an editorial that it
takes 3 months to train the muscles but 6 months to train the brain. The Investigators will
first evaluate the change in physical activity following pulmonary rehabilitation using
state-of-the-science motion detectors, then Investigators will follow the trajectory of
physical activity over the next several months.

This study will follow physical activity following pulmonary rehabilitation longitudinally
over 48 weeks. Investigators will use a state-of-the-art accelerometer, to analyze minutes
walking per day as the primary outcome, rather than vector magnitude units (VMU) or
estimated steps per day. Investigators will explore potential factors influencing this
important outcome, including baseline activity levels, demographic variables, changes in
exercise capacity, psychological variables, and self-efficacy scores. Finally, Investigators
will evaluate the rate of change (trajectory) in physical activity over approximately six
months after pulmonary rehabilitation. There are limited data suggesting it takes time for
the translation of increased exercise capacity into increased physical activity to occur.

Inclusion Criteria:

1. Adults (≥ 40 years) with a primary clinical diagnosis of COPD

2. A post-bronchodilator FEV1/FVC < 0.70 from spirometry performed within the preceding
12 months (no specific FEV1 percent-predicted requirement, although we anticipate the
FEV1 will average around 45% of predicted, based on previous studies of pulmonary
rehabilitation)

3. The patient was referred to pulmonary rehabilitation

4. The patient is clinically-stable: no exacerbation in preceding 4 weeks

5. Modified Medical Research Council (mMRC) dyspnea rating of at least 2 out of 5.

Exclusion Criteria:

1. Disease severity or co-morbidity that would make the patient be at-risk for
participation this study

2. A significant movement disorder, such as hemiplegia, etc.

3. Inability to read and comprehend the questionnaires, which will be in English

4. A history of poor wound healing or chronic skin conditions that might predispose to
local problems from wearing the DynaPort. (The DynaPort can be worn outside a thin
garment, such as a tee shirt, and is relatively thin, without protruding parts.
However, since the device may be worn overnight, and there is a remote risk of
pressure problems, this exclusion criterion was added).
We found this trial at
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West Haven, Connecticut 06516
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114 Woodland St
Hartford, Connecticut 06105
(860) 714-4000
Saint Francis Hospital and Medical Center Saint Francis Hospital and Medical Center has come a...
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New York, New York 10003
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Providence, Rhode Island 02908
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Wallingford, Connecticut 06492
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