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COPDNCT04139200

Long-term Activity Coaching in Patients With COPD

A study testing Type 1 physical activity tele coaching intervention and Type 2 physical activity tele coaching intervention in people with COPD, run by KU Leuven at 2 sites in Belgium.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Chronic Obstructive Pulmonary Disease (COPD) is a leading cause of mortality and morbidity around the world. Studies revealed that patients with COPD are less active than age-matched healthy controls and activity level decreases with disease severity. Read more about this study

Who is it for?
Ages 40 years and older
Conditions the study is for
COPD
What is being tested?
Type 1 physical activity tele coaching intervention and Type 2 physical activity tele coaching intervention
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
150 participants
Where
2 sitesBelgium
Study dates
22 Jan 2020to 11 Dec 2023
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 40 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Patients diagnosed with COPD (GOLD criteria post bronchodilator FEV1/FVC < 0.70)
  • Patients under medical follow-up of a respiratory physician or general practitioner with no moderate (ambulatory treated) and/or severe (requiring a hospital admission) exacerbation in the past month
  • Older than 40 years old
  • Smoking history with more than 10 pack years

Who cannot join

  • The presence of orthopedic or other problems not allowing an increase in physical activity levels
  • Unable to learn to work with a new electronic device (e.g. smartphone), as judged by the investigator
  • Underwent lung transplantation or active on the lung transplantation list
  • Involved in or planned to start with a structured multidisciplinary rehabilitation program

Trial locations and contacts

2 sites in 1 country.

Belgium2 sites
  • UZ Gent

    Ghent

  • UZ Leuven

    Leuven, 3000

Other trials in Belgium

About this study

Official title: The Long-term Effects of a Tele Coaching Intervention in Patients With COPD: a Randomized Controlled Trial

Chronic Obstructive Pulmonary Disease (COPD) is a leading cause of mortality and morbidity around the world. Studies revealed that patients with COPD are less active than age-matched healthy controls and activity level decreases with disease severity. Higher levels of physical activity is related to important health-related outcomes, such as lower mortality rate and hospital admissions. Additionally, increasing physical activity is related with substantial health benefits. Patients with COPD have a higher risk of developing insulin resistance, hypertension, dyslipidemia, osteopenia, leading to chronic diseases such as coronary heart disease, type 2 diabetes and osteoporosis, which have been related to physical inactivity in the healthy population. Moreover, physical inactivity has been related to the occurrence of comorbidities in patients with COPD. Therefore, improving physical activity levels is a recommended treatment in the disease management in all patients with COPD and is implemented in the recent GOLD guidelines for all patients with COPD, regardless of the disease severity.

The research group investigated the effect of a 3-month semi-automatic tele-coaching intervention on physical activity levels in patients with COPD. The tele coaching intervention led to a significant improvement on physical activity in the intervention group. Although this trial showed positive results on physical activity, further research is needed, mainly to investigate the long-term (12 months) effectiveness of such interventions and the added value of a smartphone application on top of a simple step counter providing feedback. Additionally, since physical activity is related to the development of comorbidities, the investigators aim to explore the influence of improving physical activity levels on the occurrence of cardiovascular, metabolic and musculoskeletal comorbidities. Finally, this study will explore baseline characteristics (such as social support, self-efficacy, dynamic hyperinflation, etc.) that can predict success in this intervention.

Read the detailed description

The aims of the present study are:

  1. primary objective: To investigate the changes in physical activity after a 12-month tele coaching intervention (including individualized goal setting, feedback, motivational contacts with coach and a step counter providing direct feedback), compared to a sham group receiving a light coaching intervention (feedback from step counter and static goal setting, without additional motivation or contact with the coach).
  2. secondary objectives:
  3. Investigate the effect of a 12-month tele coaching intervention on exercise capacity, muscle force, quality of life, physical activity from a patient's perspective, dyspnea-related fear and comorbidities.
  4. Confirming previous findings on short-term effects (or lack of effect) of the tele coaching intervention on physical activity, exercise capacity and quality of life, assessed at 6 months.
  5. Identifying possible baseline characteristics that are determinants of the change in physical activity after the 12-month tele coaching intervention.
  6. Investigating the association between the pattern in vital signs (including physical activity, resting heart rate, heart rate variability, heart rate recovery, oxygen saturation, respiratory rate) as measured by a wearable and the onset of an exacerbation.
  7. To explore the relation between dynamic hyperinflation as measured during the six-minutes walk test, physical activity measured at baseline and change in physical activity as result of the intervention.
  8. Investigate the effect of an acute exacerbation on functional performance (only in Ghent).
  9. Investigate the association between a change in physical activity and autonomic function (only in Ghent).
  10. Validity and reliability of wearable devices to measure autonomic function, respiratory rate and oxygen saturation (only in Ghent).

Therefore, the study will include stable patients with COPD (post bronchodilator FEV1/FVC < 0.70) with no moderate or severe exacerbations in the past month, across all disease severities.

For patients in UZ Leuven and UZ Ghent, the study will consists of 4 clinical visits:

  • Visit 1 screening visit
  • Visit 2: randomization visit, scheduled 1-2 weeks after visit 1
  • Visit 3: short term follow-up visit, scheduled 6 months after visit 2
  • Visit 4: long-term follow-up visit, scheduled 12 months after visit 2

Only for patients in UZ Ghent: to investigate the effect of an acute COPD exacerbation on functional performance, an additional visit will take place when the patient experiences an exacerbation after the first 6 months of the study. This visit will take place as soon as possible and maximally 14 days after onset of the symptoms.

If the patient does not experience an exacerbation during the first year of the study, the patient will be followed-up until occurrence of the first exacerbation or up to 30 months (whichever occurs first) with intermediate visits at 18 months and 24 months.

All patients included in the study will be randomized in either the intervention group or sham group:

  • A multicomponent tele coaching intervention that consists of 1) education about the importance of physical activity and a one-to-one interview with the coach discussing the motivation and barriers to be active, 2) a step counter providing direct feedback, 3) application installed on a smartphone providing an adaptive goal and daily and weekly feedback and 4) contact with the coach if the patient is not compliant with the intervention, not increasing physical activity or when the patient reports a change in medication. The patient is asked to have a daily interaction with the smartphone application.
  • A sham intervention that consist of 1) education about the importance of physical activity and a personal (fixed) goal expressed in terms of steps. The patient is asked to try to reach this goal, 2) a step counter providing direct feedback, 3) application installed on a smartphone only displaying a graph with the activity of the present week and the personal (fixed) goal, 4) contact with the coach if the patient reports a change in medication. The patient is asked to have at least a weekly interaction with the application.
  • Only in UZ Ghent: in case of extended follow-up after 12 months, patients will receive the multicompenent tele coaching intervention after 12 months of inclusion in the study.
Conditions
COPD
Being tested
Type 1 physical activity tele coaching intervention, Type 2 physical activity tele coaching intervention
Keywords
Physical activity, Tele coaching
Medical subject headings
Pulmonary Disease, Chronic Obstructive, Motor Activity

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Type 1 physical activity tele coaching interventionBehavioural

    1. Education about the importance of PA. During a one-to-one interview with the coach motivation, self-efficacy, barriers, favorite activities and strategies to become more active are discussed. B) Step counter providing direct feedback. C) A smartphone with a project-tailored application. The application provides automated coaching by displaying an activity goal (number of steps) and feedback on a daily basis. The feedback comes with a graphical presentation. Patients' targets are automatically revised weekly. The aim is to progressively increase the PA during the 12 weeks period and maintain afterwards. D) Telephone contacts triggered in the case of non-compliance with wearing the step counter, failure to transmit data, failure to progress or change in medication. Coaches are alerted by a note at the coaches' backend to take contact with the patient if needed.
  • Type 2 physical activity tele coaching interventionBehavioural

    1. Education about the importance of PA. During a one-to-one interview with the investigator, patients will receive a personal goal (expressed in steps/day), based on their individual exercise capacity. B) A step counter providing direct feedback. C) A smartphone with a project-tailored application. The application receives the step data of the patient and asks on a weekly basis about the patient's change in medication. The application does provide a graph showing the steps the patient took and presents a general activity plan including their personal goal (which stays the same throughout the entire intervention period). D) Telephone contacts triggered in the case of change in medication. Coaches are alerted by a note at the coaches' backend to take contact with the patient if needed.
Study groups in NCT04139200
Study groupRoleWhat they receive
Type 1 tele coaching groupExperimentalCoaching with daily interaction with the coaching application, based on a adaptive physical activity goal
Receives: Behavioral: Type 1 physical activity tele coaching intervention
Type 2 tele coaching groupSham comparatorCoaching with fixed physical activity goal and limited interaction with the smartphone application
Receives: Behavioral: Type 2 physical activity tele coaching intervention

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Daily number of steps at 12 months

    Change in daily mean step count 12 months post randomization in the intervention group as compared to the control group. Physical activity will be objectively measured for 1 week using a tri-axial accelerometer validated for use in patients with COPD. At least 4 valid weekdays (> 8 hours of wearing time during waking hours) is necessary to label the physical activity measurement as valid.

    Measured: 12 months

Secondary outcomes (14)
  1. Daily number of steps at 6 months

    Change in daily mean step count 6 months post randomization in the intervention group as compared to the control group. Physical activity will be objectively measured for 1 week using a tri-axial accelerometer validated for use in patients with COPD. At least 4 valid weekdays (> 8 hours of wearing time during waking hours) is necessary to label the physical activity measurement as valid.

    Measured: 6 months

  2. Minutes per day spent in at least moderate intense activities

    Change in minutes per day spent in at least moderate intense activities 6 and 12 months post randomization in the intervention group as compared to the control group. Physical activity will be objectively measured for 1 week using a tri-axial accelerometer validated for use in patients with COPD. At least 4 valid weekdays (> 8 hours of wearing time during waking hours) is necessary to label the physical activity measurement as valid.

    Measured: 6 months and 12 months

  3. Mean walking time per day

    Change in mean daily walking time 6 and 12 months post randomization in the intervention group as compared to the control group. Physical activity will be objectively measured for 1 week using a tri-axial accelerometer validated for use in patients with COPD. At least 4 valid weekdays (> 8 hours of wearing time during waking hours) is necessary to label the physical activity measurement as valid.

    Measured: 6 months and 12 months

  4. Mean sedentary time per day

    Change in mean sedentary time 6 and 12 months post randomization in the intervention group as compared to the control group. Physical activity will be objectively measured for 1 week using a tri-axial accelerometer validated for use in patients with COPD. At least 4 valid weekdays (> 8 hours of wearing time during waking hours) is necessary to label the physical activity measurement as valid.

    Measured: 6 months and 12 months

  5. Exercise capacity

    Change in six-minutes walk distance 6 and 12 months post randomization in the intervention group as compared to the control group. The six-minutes walk test will be performed with standardized encouragement to assess patients' functional exercise capacity. The best of two measurements will be used.

    Measured: 6 months and 12 months

  6. Quadriceps force

    Change in quadriceps force 6 and 12 months post randomization in the intervention group as compared to the control group. The quadriceps isometric strength will be evaluated by a maximal voluntary contraction using the Biodex, a computerized dynamometer. Patients will be seated with a 90° hip and 60° knee flexion. The best of 4 measurements will be taken into analysis as the maximal force capacity of the lower limb.

    Measured: 6 months and 12 months

  7. Health status

    Change in health status 6 and 12 months post randomization in the intervention group as compared to the control group. Health status will be measured by COPD assessment test (CAT), a validated, 8-item questionnaire to assess the impact of the disease on a patient's health status. Scores range from 0 to 40, with a higher score indicating a worse health status. The minimal clinical important difference (MCID) is a change of 3 points.

    Measured: 6 and 12 months

  8. Health related quality of life: CRDQ-SAS

    Change in health related quality of life 6 and 12 months post randomization in the intervention group as compared to the control group. Health status will be measured by Chronic Respiratory Disease Questionnaire; self-administrated standardized version (CRDQ-SAS), measuring both physical and emotional aspects of chronic respiratory disease. The questionnaire contains 20 items, spread over 4 domains (dyspnea, fatigue, emotional function and mastery). The minimal clinical important difference is reflected by a change in score of 0.5 on a 7-point scale.

    Measured: 6 months and 12 months

  9. Physical activity from a patients' perspective

    Change in physical activity from a patients' perspective 6 and 12 months post randomization in the intervention group as compared to the control group. This will be measured by PROactive tool (clinical visit version), a validated 12-item questionnaire assessing physical activity from a patient's perspective reflecting the past 7 days. The questionnaire investigates the amount of and difficulty with physical activity as perceived by the patient. The 2 domain scores (i.e. amount and difficulty) as well as the total score will be retrieved as outcomes. Subscores and total score are from 0 to 100, with higher score meaning less problems with daily life activities as reported by the patient.

    Measured: 6 months and 12 months

  10. Dyspnea-related fear

    Change in dyspnea-related fear 6 and 12 months post randomization in the intervention group as compared to the control group. This will be measured by breathlessness beliefs questionnaire (BBQ), an 17-item questionnaire investigating the dyspnea-related anxiety in patients with respiratory diseases. Score ranges from 17 to 85. Higher values indicate worse dyspnea-related fear.

    Measured: 6 months and 12 months

  11. Symptoms of anxiety and depression

    Change in symptoms of anxiety and depression 12 months post randomization in the intervention group as compared to the control group. Symptoms of anxiety and depression will be measured by the Hospital Anxiety and Depression Scale (HADs). The HADs is a generic screening measure of symptoms of anxiety and depression. The HADS is a 14 item measure comprising 7 anxiety items and 7 depression items from which separate anxiety and depression sub-scale scores are calculated, ranging from 0 to 21 for both sub domains. A score of 8 or higher indicates a high possibility of anxiety / depression

    Measured: 12 months

  12. Functional performance

    To investigate the effect of an acute COPD exacerbation on functional performance, functional performance will be measured by the Short physical performance battery (SPPB), timed up and go test (TUG) and 1-minute sit-to-stand (1' STS) as soon as possible (and maximally 14 days) after onset of an exacerbation.

    Measured: Only in Ghent - as soon as possible and max 14 days after the occurrence of an COPD exacerbation

  13. Autonomic function

    Exploring the association between change in physical activity and autonomic function. To evaluate the autonommic fuction, the patient will wear a Polar chest band with corresponding watch for 7 consecutive days (day and night). Based on this measurement we will retrieve measures on: respiratory rate; resting heart rate (heart rate during the night); heart rate variability. Data will be processed using Kubios software.

    The Polar chest band with corresponding watch will also be worn while performing the 6-minute walking test as measures of HRV during exercise and heart rate recovery (HRR). Data will be processed using Kubios software.

    Measured: Only in Ghent - 6 months and 12 months; additionally at 18 months and 24 months in case of extended design

  14. Autonomic symptoms

    Exploring the association between change in physical activity and autonomic fuction, To evaluate autonomic symptoms, autonomic symptoms will be measured by the COMPASS 31 questionnaire. This questionnaire contains six domains: orthostatic intolerance, vasomotor, secrotomotor, gastrointestinal, urinary and pupillomotor function. Total score ranges from 0 to 100, with higher score indicating more autonomic dysfunction.

    Measured: Only in Ghent - 6 months and 12 months; additionally at 18 months and 24 months in case of extended design

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted25 Oct 2019
  2. Study start22 Jan 2020
  3. Primary completion11 Dec 2023
  4. Study completion11 Dec 2023

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
1:1 randomization
Masking
Single blind
Who is masked
Participant
Enrolment
150 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04139200
Sponsor's protocol ID
S62902
Status last verified
Jan 2024
First submitted
23 Oct 2019
Last updated
19 Jan 2024
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Publications

  • Blondeel A, Hermans F, Breuls S, Wuyts M, Everaerts S, De Maeyer N, Derom E, Janssens W, Demeyer H, Troosters T. A Long-Term Physical Activity Coaching Program for Patients with Chronic Obstructive Pulmonary Disease: A Randomized Controlled Trial. Am J Respir Crit Care Med. 2025 Dec;211(12):2330-2339. doi: 10.1164/rccm.202501-0170OC.

    PubMed 40700740

Questions about this trial

What is this clinical trial studying?

A study testing Type 1 physical activity tele coaching intervention and Type 2 physical activity tele coaching intervention in people with COPD, run by KU Leuven at 2 sites in Belgium.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 19 Jan 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 2 sites in Belgium. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Daily number of steps at 12 months (time frame: 12 months). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04139200, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 19 Jan 2024.

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