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COPD ExacerbationNCT05233137

Enhancing Muscle Function After Exacerbations of COPD to Limit Its Impact on Physical Activity Decline

A study testing PA coaching and Exercise training in people with COPD Exacerbation, 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

Patients with COPD lose muscle strength during acute exacerbations of COPD (AECOPD) which interferes improving the recovery of physical activity (PA) after an AECOPD. Resistance training can reverse this process. Read more about this study

Who is it for?
Ages 40 years and older
Conditions the study is for
COPD Exacerbation
What is being tested?
PA coaching and Exercise training
Could I receive a placebo?
No, everyone receives an active treatment
How many people
86 participants
Where
2 sitesBelgium
Study dates
8 Feb 2022to 14 Jan 2025
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

  • Clinical diagnosis of COPD
  • Smoking history (> or = 10 pack years)
  • Experiencing a moderate (i.e. treated with short acting bronchodilatators plus antibiotics and/or oral corticosteroids or emergency room visit and reported impact on activities of daily living) exacerbation

Who cannot join

  • More than 21 days after stopping the treatment for the AECOPD
  • Presence of orthopaedic problems or other contra-indications not allowing to perform PA
  • Participation in or planned to start a multidisciplinary pulmonary rehabilitation program
  • Already participating in an intensive training program in the first 12 weeks in primary care with the aim of enhancing physical performance (maintenance programs are allowed)
  • Unable to learn to work with a smartphone and Fitbit, as judged by the investigator
  • Underwent major lung surgery (e.g. lung transplantation) or active on the lung transplantation list
  • Lung volume reduction within 6 months before inclusion
  • Having the current diagnosis of lung cancer or receiving active treatment for oncology

Trial locations and contacts

2 sites in 1 country.

Belgium2 sites
  • UZ Gent

    Ghent

  • University Hospitals Leuven

    Leuven

Other trials in Belgium

About this study

Patients with COPD lose muscle strength during acute exacerbations of COPD (AECOPD) which interferes improving the recovery of physical activity (PA) after an AECOPD. Resistance training can reverse this process. An exercise training program with the focus on resistance training is essential in minimizing the long-term effects of AECOPD as it may help to accelerate the gain in PA in the weeks after an acute event. Therefore, it is important that such programs are embedded at the right moment (i.e. immediately after an AECOPD) and in a setting accessible to the patient (i.e. primary care). The efficacy and effectiveness of implementing such training programs will be assessed in the present study.

Read the detailed description

The present study aims to:

  1. Investigate whether an 8 week exercise training program provided in primary or community care enhances lower limb muscle strength in patients following an AECOPD;
  2. Investigate whether such programs assist patients after an AECOPD to re-engage with a coaching intervention geared to long-term PA maintenance or improvement.

The secondary aim is to investigate how (repeated) AECOPD contribute to structural alterations in the skeletal muscle and how an exercise training program and PA can influence the deterioration in muscle fiber morphology and signals related to muscle atrophy.

Patients that experience a moderate or severe AECOPD will be recruited in the present multicentre randomised controlled trial (RCT).

Patients in this study will have at least 3 clinical visits:

  • Post AECOPD treatment: screening and randomisation visit (V1)
  • 8 weeks after randomisation (V2a and V2b*)
  • 52 weeks after randomisation (V3a and V3b*)
  • If patients agree to have a muscle biopsy taken, a V2b and V3b will be added, so this does not interfere with other measurements. These visits will take place 1-2 weeks after V2a and V3a, respectively.

After the screening and randomisation visit (V1), the patient will be randomised in either the intervention group (PA coaching and exercise training) or the control group (PA coaching).

Patients in the intervention group will receive a first physiotherapy session during this first visit provided by the trained researchers (with a degree in physiotherapy) to get acquainted with the exercises. Information about the PA coaching will be given to all the patients. The intervention will be started after this visit and is provided by a physiotherapist in primary or community care.

Being tested
PA coaching, Exercise training

What participants receive

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

  • PA coachingBehavioural

    PA coaching: Patients receive a step counter together with a coaching application (m-PAC, AppsOnly, KU Leuven) installed on a smartphone. The step counter and coaching application are connected via Bluetooth. The coaching application has the goal of PA promotion as well as detecting any new AECOPD.

  • Exercise trainingOther

    Each session will include at least the following components:

    • Resistance training of the lower limbs: Exercises for 6 muscle groups using minimal (e.g. ankle weights or elastic resistance bands) or no (body weight) equipment are foreseen. Each exercise will be performed in 3 series of 8 repetitions.
    • Functional training: Sit to stand exercise and stair climbing. During the first 2 weeks of the exercise training program, at least 3 strength exercises and 1 functional exercise will be performed each session.

    Starting from the 3rd week of the exercise training program, whole body exercise training (interval training for walking, cycling, stair climbing and high knees) will be added. From this moment on, at least 1-2 whole body exercises and 2-3 strength and functional exercises will be performed during each physiotherapy session. By doing this, each session will consist of a minimum of 4 exercises in total.

Study groups in NCT05233137
Study groupRoleWhat they receive
PA coaching and exercise trainingExperimentalPatients in this group will receive physical activity telecoaching as well as an exercise training program provided by a physiotherapist in primary care
Receives: Behavioral: PA coaching; Other: Exercise training
PA coachingActive comparatorPatients in this group will receive physical activity telecoaching
Receives: Behavioral: PA coaching

What is being measured

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

  1. Daily number of steps at 52 weeks

    Change in daily mean step count 52 weeks 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: 52 weeks

  2. Isometric quadriceps force

    Isometric quadriceps strength of the right leg will be measured using the strain gauge device (Sauter Controls NV, Zellik, Belgium) with the hip and knee in 90° flexion. Four repetitions will be performed using standardized encouragement with the first attempt not being maximal and not counting as a possible best result. The best of the last three measurements will be used.

    Measured: 8 weeks

Secondary outcomes (27)
  1. Functional exercise capacity

    Change in six-minutes walk distance between baseline and 52 weeks 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: 8 and 52 weeks

  2. Isometric quadriceps force

    Isometric quadriceps strength of the right leg will be measured using the strain gauge device (Sauter Controls NV, Zellik, Belgium) with the hip and knee in 90° flexion. Four repetitions will be performed using standardized encouragement with the first attempt not being maximal and not counting as a possible best result. The best of the last three measurements will be used.

    Measured: 52 weeks

  3. Functional performance

    This will be evaluated using the SPPB. This test assesses lower extremity function and mobility. It consists of 3 subtests that are scored and points are added up:

    • 4-meter gait speed: To evaluate the patient's functional gait speed. The test is repeated twice. The best time of the 2 attempts is used for the rating. Cut-off: <0.3 m/s or ≥0.3 m/s.
    • 5 times sit to stand: This test quantifies the functional lower extremity strength. In this test, patients are asked to complete 5 cycles sit-to-stand as fast as possible from a 45 cm height chair. The participant may practice 1 repetition prior commencing the test. The time needed to perform 5 repetitions is noted. Cut-offs: ≤11.19 seconds (4 points); A higher score indicates a better functional performance.

    Measured: 8 weeks and 52 weeks

  4. Health related quality of life

    Change in health related quality of life wil be measured by the Chronic Respiratory Disease Questionnaire (CRDQ-SAS) (dyspnea domain):

    This disease specific questionnaire measures both physical and emotional aspects of the chronic respiratory disease. The questionnaire contains 20 items, spread over 4 domains (dyspnea, fatigue, emotional function and mastery). The MCID is reflected by a change in score of 0.5 on a 7-point scale for each of the CRDQ domains (28). Only the dyspnea domain will be used for this study. The self-administered standardized (CRDQ-SAS) version will be used. A higher score indicates a higher health related quality of life.

    Measured: 8 weeks and 52 weeks

  5. Health status

    Change in health status will be measured using the COPD Assessment Test (CAT):

    This validated 8-item questionnaire assesses the impact of the disease on a patient's health status. Scores range from 0 (good health status) to 40 (worse health status). The minimal clinical important difference (MCID) is a change of 2 points (19).

    Measured: 8 weeks and 52 weeks

  6. Patient experience of PA

    Change in patient experience of physical activity will be measured using the Patient Reported Outcome (PRO) -active (C-PPAC) questionnaire: a simple, valid and reliable 12-item questionnaire assessing PA from a patient's perspective reflecting on the past 7 days. The questionnaire investigates the experienced amount of and difficulty of PA as perceived by the patient. The 2 domain scores as well as the total score will be retrieved as outcomes. The clinical visit version will be used. A paper version of the questionnaire will be given along with the monitor. 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: 8 weeks and 52 weeks

  7. Change in high-density lipoprotein (HDL)

    By taking a fasting blood sample of the patient

    Measured: 8 weeks and 52 weeks

  8. Change in low-density lipoprotein (LDL)

    By taking a fasting blood sample of the patient

    Measured: 8 weeks and 52 weeks

  9. Change in total cholesterol

    By taking a fasting blood sample of the patient

    Measured: 8 weeks and 52 weeks

  10. Change in triglycerides

    By taking a fasting blood sample of the patient and triglycerides) and blood pressure

    Measured: 8 weeks and 52 weeks

  11. Change in blood pressure

    By taking the systolic and diastolic blood pressure of the patient at rest

    Measured: 8 weeks and 52 weeks

  12. Change in weight

    By taking the weight of the patient

    Measured: 8 weeks and 52 weeks

  13. Change in waist and hip circumference

    The waist and hip circumference will be measured and risk factors fasting blood sample (glucose level, insulin Hba1c)

    Measured: 8 weeks and 52 weeks

  14. Change in insulin

    By taking a fasting blood sample of the patient

    Measured: 8 weeks and 52 weeks

  15. Change in glucose level

    By taking a fasting blood sample of the patient

    Measured: 8 weeks and 52 weeks

  16. Change in Hba1c

    By taking a fasting blood sample of the patient

    Measured: 8 weeks and 52 weeks

  17. Day to day Physical Activity

    Change in day to day data of PA will be assessed by a wearable. The patient receives a step counter (Fitbit) that can be worn on the wrist. The device provides direct feedback, expressed as the number of steps taken per day. The patient is asked to wear the step counter every day during the intervention and is invited to frequently verify the number of steps per day against the agreed goals.

    Measured: 52 weeks

  18. Number of AECOPD

    Number of AECOPD following the index AECOPD

    Measured: 52 weeks

  19. Change in fiber type proportion of the m. vastus lateralis of the quadriceps muscle

    By analysing muscle microbiopsies of the quadriceps muscle immunostaining of the myosin heavy chain, only for patients giving their specific consent.

    Measured: 8 weeks (+1-2 weeks) and 52 weeks (+1-2 weeks)

  20. Change in cross-sectional area of the m. vastus lateralis of the quadriceps muscle

    By analysing muscle microbiopsies of the quadriceps muscle immunostaining of the myosin heavy chain, only for patients giving their specific consent.

    Measured: 8 weeks (+1-2 weeks) and 52 weeks (+1-2 weeks)

  21. Change in capillarisation of the m. vastus lateralis of the quadriceps muscle

    By analysing muscle microbiopsies of the quadriceps muscle, only for patients giving their specific consent.

    Measured: 8 weeks (+1-2 weeks) and 52 weeks (+1-2 weeks)

  22. Change in the amount of satellite cells of the m. vastus lateralis of the quadriceps muscle

    By analysing muscle microbiopsies with Pax7 immunostaining of the quadriceps muscle, only for patients giving their specific consent.

    Measured: 8 weeks (+1-2 weeks) and 52 weeks (+1-2 weeks)

  23. Change in gene expression of the m. vastus lateralis of the quadriceps muscle

    By analysing muscle microbiopsies with RT2 profiler PCR array skeletal muscle, Qiagen of the quadriceps muscle, only for patients giving their specific consent.

    Measured: 8 weeks (+1-2 weeks) and 52 weeks (+1-2 weeks)

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

    Change in minutes per day spent in at least moderate intense activities between baseline, 8 weeks and 52 weeks 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: 8 weeks and 52 weeks

  25. Mean walking time per day

    Change in mean daily walking time between baseline, 8 weeks and 52 weeks 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: 8 weeks and 52 weeks

  26. Mean sedentary time per day

    Change in mean sedentary time between baseline, 8 weeks and 52 weeks 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: 8 weeks and 52 weeks

  27. Daily number of steps at 8 weeks

    Change in daily mean step count between baseline and 8 weeks 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: 8 weeks

Timeline

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

  1. First posted10 Feb 2022
  2. Study start8 Feb 2022
  3. Primary completion14 Jan 2025
  4. Study completion14 Jan 2025

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
Prevention
Allocation
Randomised
Intervention model
Parallel groups
Model description
1:1 allocation
Masking
None (open label)
Enrolment
86 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05233137
Sponsor's protocol ID
S65813
Status last verified
Jun 2025
First submitted
11 Jan 2022
Last updated
19 Jun 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided: Aggregated data can be shared upon request.

Publications

  • Wuyts M, Hermans F, Breuls S, Everaerts S, Derom E, Janssens W, Demeyer H, Troosters T. Development and feasibility of an exercise training program in primary care for patients with COPD experiencing an acute exacerbation. Physiotherapy. 2024 Jun;123:81-90. doi: 10.1016/j.physio.2023.09.003. Epub 2023 Oct 5.

    PubMed 38295552

Questions about this trial

What is this clinical trial studying?

A study testing PA coaching and Exercise training in people with COPD Exacerbation, 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 3 inclusion and 8 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 Jun 2025. 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. 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 52 weeks (time frame: 52 weeks). The study lists 2 primary outcomes in all. 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 NCT05233137, 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 Jun 2025; AzTrials last refreshed its copy on 1 Nov 2026.

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