- ICH GCP
- US-Register für klinische Studien
- Klinische Studie NCT07575841
Pulmonary Rehabilitation Frequency in COPD Patients
Comparative Efficacy of a Supervised Pulmonary Rehabilitation Program Performed 3 Days/Week Versus 1 Day/Week in Patients With Chronic Obstructive Pulmonary Disease (COPD): a Randomized Clinical Trial
Chronic obstructive pulmonary disease (COPD) is a common condition that can cause breathlessness and reduced physical capacity. Pulmonary rehabilitation (PR) is an effective treatment, but traditional programs often require patients to attend sessions several times per week, which may limit participation.
This study aims to compare the effectiveness of two supervised pulmonary rehabilitation programs: one performed 3 days per week and another performed 1 day per week, both over an 8-week period and including additional home-based exercises.
The main objective is to determine whether the lower-frequency program is not inferior to the higher-frequency program in improving functional capacity, measured by the six-minute walk test. Secondary outcomes include dyspnea, quality of life, muscle strength, physical activity, adherence, exacerbations, and safety.
The results of this study may help optimize pulmonary rehabilitation programs and improve accessibility for patients with COPD.
Studienübersicht
Status
Bedingungen
Intervention / Behandlung
Detaillierte Beschreibung
This is a randomized, parallel-group clinical trial designed to evaluate the non-inferiority of a supervised pulmonary rehabilitation (PR) program performed once weekly compared with a program performed three times weekly in patients with stable chronic obstructive pulmonary disease (COPD).
Participants will be recruited from a tertiary care hospital and randomly assigned to one of two intervention groups: (1) supervised PR three days per week or (2) supervised PR one day per week. Both interventions will be conducted over 8 weeks and will include structured exercise training and educational components, complemented by a home-based program.
The primary outcome is functional capacity assessed by the six-minute walk test. Secondary outcomes include dyspnea, health-related quality of life, peripheral muscle strength, physical activity levels, adherence to the intervention, incidence of exacerbations, and safety.
Statistical analyses will be conducted according to both intention-to-treat and per-protocol principles. A non-inferiority framework will be applied, and appropriate mixed-effects models will be used to assess differences between groups over time.
Studientyp
Einschreibung (Geschätzt)
Phase
- Unzutreffend
Teilnahmekriterien
Zulassungskriterien
Studienberechtigtes Alter
- Kind
- Erwachsene
- Älterer Erwachsener
Akzeptiert gesunde Freiwillige
Beschreibung
IInclusion criteria
- Diagnosis of COPD confirmed by spirometry (FEV₁/FVC <0.70)
- Modified Medical Research Council (mMRC) dyspnoea scale ≥2
- Ability to actively participate and perform physical exercise
- Signed informed consent
Exclusion criteria
- Unstable cardiac or musculoskeletal comorbidity contraindicating or limiting exercise
- Moderate to severe cognitive impairment or inability to understand instructions
- Recent participation (<6 months) in a complete pulmonary rehabilitation programme
- Inability to attend the centre 1-3 days/week according to group allocation
- Current participation in any structured pulmonary rehabilitation programme or supervised rehabilitation intervention in another centre.
- Active oncological treatment
Studienplan
Wie ist die Studie aufgebaut?
Designdetails
- Hauptzweck: Behandlung
- Zuteilung: Zufällig
- Interventionsmodell: Parallele Zuordnung
- Maskierung: Single
Waffen und Interventionen
Teilnehmergruppe / Arm |
Intervention / Behandlung |
|---|---|
|
Experimental: Pulmonary Rehabilitation 3 Days/Week
Participants receive supervised pulmonary rehabilitation three times per week for 8 weeks, including exercise training and educational components, complemented by a home-based program.
|
Supervised pulmonary rehabilitation program including exercise training and educational components, complemented by a home-based program.
|
|
Experimental: Pulmonary Rehabilitation 1 Day/Week
Participants receive supervised pulmonary rehabilitation once per week for 8 weeks, including exercise training and educational components, complemented by a home-based program.
|
Supervised pulmonary rehabilitation program including exercise training and educational components, complemented by a home-based program.
|
Was misst die Studie?
Primäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
|
Functional capacity assessed by the six-minute walk test (6MWT)
Zeitfenster: Change from baseline to 8 weeks (end of intervention)
|
Functional capacity will be measured using the six-minute walk test (6MWT), expressed as distance walked in meters.
|
Change from baseline to 8 weeks (end of intervention)
|
Sekundäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
|
Maximal inspiratory pressure (MIP)
Zeitfenster: Change from baseline to 8, 12, and 24 weeks
|
Respiratory muscle strength assessed by maximal inspiratory pressure (MIP), expressed in cmH₂O.
|
Change from baseline to 8, 12, and 24 weeks
|
|
Maximal expiratory pressure (MEP)
Zeitfenster: Change from baseline to 8, 12, and 24 weeks
|
Respiratory muscle strength assessed by maximal expiratory pressure (MEP), expressed in cmH₂O.
|
Change from baseline to 8, 12, and 24 weeks
|
|
Quadriceps muscle strength
Zeitfenster: Change from baseline to 8, 12, and 24 weeks
|
Peripheral muscle strength assessed by quadriceps dynamometry, expressed in Newtons.
|
Change from baseline to 8, 12, and 24 weeks
|
|
Five-times sit-to-stand test (5STS)
Zeitfenster: Change from baseline to 8, 12, and 24 weeks
|
Functional lower limb performance assessed by the time required to complete five sit-to-stand repetitions, expressed in seconds.
|
Change from baseline to 8, 12, and 24 weeks
|
|
One-minute sit-to-stand test (1-min STS)
Zeitfenster: Change from baseline to 8, 12, and 24 weeks
|
Functional capacity assessed by the number of repetitions completed in one minute.
|
Change from baseline to 8, 12, and 24 weeks
|
|
Dyspnea assessed by the modified Medical Research Council (mMRC) scale
Zeitfenster: Change from baseline to 8, 12, and 24 weeks
|
Dyspnea severity measured using the mMRC scale (range 0-4, higher scores indicate worse dyspnea).
|
Change from baseline to 8, 12, and 24 weeks
|
|
COPD Assessment Test (CAT)
Zeitfenster: Change from baseline to 8, 12, and 24 weeks
|
Health status assessed using the CAT questionnaire (range 0-40, higher scores indicate worse health status).
|
Change from baseline to 8, 12, and 24 weeks
|
|
Short Form-36 Health Survey (SF-36)
Zeitfenster: Change from baseline to 8, 12, and 24 weeks
|
Health-related quality of life assessed using the SF-36 questionnaire across multiple domains.
|
Change from baseline to 8, 12, and 24 weeks
|
|
Hospital Anxiety and Depression Scale (HADS)
Zeitfenster: Change from baseline to 8, 12, and 24 weeks
|
Psychological status assessed using the HADS questionnaire (range 0-21 per subscale, higher scores indicate worse symptoms).
|
Change from baseline to 8, 12, and 24 weeks
|
|
Physical activity assessed by the International Physical Activity Questionnaire (IPAQ)
Zeitfenster: At 8 and 24 weeks
|
Physical activity levels assessed using the IPAQ questionnaire.
|
At 8 and 24 weeks
|
|
Adherence to pulmonary rehabilitation program
Zeitfenster: During the 8-week intervention period
|
Adherence defined as the percentage of attended supervised sessions.
|
During the 8-week intervention period
|
|
COPD exacerbations
Zeitfenster: Up to 24 weeks
|
Number of COPD exacerbations during follow-up.
|
Up to 24 weeks
|
|
Emergency department visits and hospital admissions
Zeitfenster: Up to 24 weeks
|
Number of COPD-related emergency visits and hospital admissions.
|
Up to 24 weeks
|
|
Adverse events
Zeitfenster: During the 8-week intervention and follow-up up to 24 weeks
|
Incidence of adverse events, including fatigue, dyspnea, pain, dizziness, and falls.
|
During the 8-week intervention and follow-up up to 24 weeks
|
Mitarbeiter und Ermittler
Publikationen und hilfreiche Links
Allgemeine Veröffentlichungen
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- Nikolovski A, Gamgoum L, Deol A, Quilichini S, Kazemir E, Rhodenizer J, Oliveira A, Brooks D, Alsubheen S. Psychometric properties of the Hospital Anxiety and Depression Scale (HADS) in individuals with stable chronic obstructive pulmonary disease (COPD): a systematic review. Disabil Rehabil. 2024 Apr;46(7):1230-1238. doi: 10.1080/09638288.2023.2182918. Epub 2023 Mar 2.
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- Gephine S, Bergeron S, Tremblay Labrecque PF, Mucci P, Saey D, Maltais F. Cardiorespiratory Response during the 1-min Sit-to-Stand Test in Chronic Obstructive Pulmonary Disease. Med Sci Sports Exerc. 2020 Jul;52(7):1441-1448. doi: 10.1249/MSS.0000000000002276.
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- Sentanin AC, de Facio CA, da Silva MMC, Sousa FC, Arcuri JF, Mendes RG, Di Lorenzo VAP. Reliability of Quadriceps Femoris Muscle Strength Assessment Using a Portable Dynamometer and Protocol Tolerance in Patients With Chronic Obstructive Pulmonary Disease. Phys Ther. 2021 Sep 1;101(9):pzab107. doi: 10.1093/ptj/pzab107.
- Jenkins TO, Edwards GD, Patel S, Canavan J, Kon SSC, Barker RE, Jones SE, Walsh JA, Ingram KA, Maddocks M, Polkey MI, Nolan CM, Man W. Minimal important difference of quadriceps maximal voluntary contraction (QMVC) in COPD: a prospective cohort study. Thorax. 2026 Jan 27:thorax-2025-223799. doi: 10.1136/thorax-2025-223799. Online ahead of print.
- Xie J, Zhu Y, Wang Y, Mo Y, Shi X, Liang WM, Ren FF, Bai Z, Nie F. Effects of pulmonary rehabilitation combined with inspiratory muscle training on lung function and exercise capacity in older patients with COPD: a systematic review and meta-analysis. Front Med (Lausanne). 2025 Jul 9;12:1621375. doi: 10.3389/fmed.2025.1621375. eCollection 2025.
- Lista-Paz A, Langer D, Barral-Fernandez M, Quintela-Del-Rio A, Gimeno-Santos E, Arbillaga-Etxarri A, Torres-Castro R, Vilaro Casamitjana J, Varas de la Fuente AB, Serrano Veguillas C, Bravo Cortes P, Martin Cortijo C, Garcia Delgado E, Herrero-Cortina B, Valera JL, Fregonezi GAF, Gonzalez Montanez C, Martin-Valero R, Francin-Gallego M, Sanesteban Hermida Y, Gimenez Moolhuyzen E, Alvarez Rivas J, Rios-Cortes AT, Souto-Camba S, Gonzalez-Doniz L. Maximal Respiratory Pressure Reference Equations in Healthy Adults and Cut-off Points for Defining Respiratory Muscle Weakness. Arch Bronconeumol. 2023 Dec;59(12):813-820. doi: 10.1016/j.arbres.2023.08.016. Epub 2023 Sep 29. English, Spanish.
- Holland AE, Hill CJ, Rasekaba T, Lee A, Naughton MT, McDonald CF. Updating the minimal important difference for six-minute walk distance in patients with chronic obstructive pulmonary disease. Arch Phys Med Rehabil. 2010 Feb;91(2):221-5. doi: 10.1016/j.apmr.2009.10.017.
- Gimeno-Santos E, Vilaro J, Arbilllaga-Etxarri A, Herrero-Cortina B, Ramon MA, Corbero AB, Fernandez-Dominguez JC, Zarate-Tejero C, Barberan-Garcia A, Del Corral T, Jimenez-Reguera B, Lopez A, Lopez-Fernandez D, Treves PM, Martinez-Alejos R, Munoz G, Rios-Cortes A, Ruiz-Lopez K, San Miguel-Pagola M, Sanchez-Cayado N, Valeiro B, Valenza MC, Valenza G, Varas AB, Cordoba S, Vega A, Linares M, Madrid EM, Souto S, Vendrell M, Garcia-Aymerich J. Development and Comparison of Reference Equations for the Six-Minute Walk Test in Spanish Healthy Adults Aged 45-85 Years. Arch Bronconeumol. 2025 Aug;61(8):459-466. doi: 10.1016/j.arbres.2025.01.005. Epub 2025 Jan 17. English, Spanish.
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Studienaufzeichnungsdaten
Haupttermine studieren
Studienbeginn (Geschätzt)
Primärer Abschluss (Geschätzt)
Studienabschluss (Geschätzt)
Studienanmeldedaten
Zuerst eingereicht
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst gepostet (Tatsächlich)
Studienaufzeichnungsaktualisierungen
Letztes Update gepostet (Tatsächlich)
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Zuletzt verifiziert
Mehr Informationen
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Schlüsselwörter
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