RT Journal Article
SR Electronic
T1 Long-term efficacy and effectiveness of a behavioural and community-based exercise intervention (Urban Training™) to increase physical activity in patients with COPD. A randomised controlled trial
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 1800063
DO 10.1183/13993003.00063-2018
A1 Arbillaga-Etxarri, Ane
A1 Gimeno-Santos, Elena
A1 Barberan-Garcia, Anael
A1 Balcells, Eva
A1 Benet, Marta
A1 Borrell, Eulàlia
A1 Celorrio, Nuria
A1 Delgado, Anna
A1 Jané, Carme
A1 Marin, Alicia
A1 Martín-Cantera, Carlos
A1 Monteagudo, Mónica
A1 Montellà, Nuria
A1 Muñoz, Laura
A1 Ortega, Pilar
A1 Rodríguez, Diego A
A1 Rodríguez-Roisin, Robert
A1 Simonet, Pere
A1 Torán-Monserrat, Pere
A1 Torrent-Pallicer, Jaume
A1 Vall-Casas, Pere
A1 Vilaró, Jordi
A1 Garcia-Aymerich, Judith
YR 2018
UL http://erj.ersjournals.com/content/early/2018/08/09/13993003.00063-2018.abstract
AB There is a need to increase and maintain physical activity in patients with chronic obstructive pulmonary disease (COPD). We assessed the 12 months 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). Primary outcome: 12 months change in steps/day measured by accelerometer.Efficacy analysis (with per protocol analysis set, n=233 classified as adherent to the assigned intervention) showed +957 [184 to 1731] steps/day adjusted [95% CI] 12 months difference 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.FootnotesThis manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.Conflict of interest: Dr. ARBILLAGA-ETXARRI has nothing to disclose.Conflict of interest: Dr. GIMENO-SANTOS has nothing to disclose.Conflict of interest: Dr. BARBERAN-GARCIA has nothing to disclose.Conflict of interest: Dr. BALCELLS has nothing to disclose.Conflict of interest: Dr. BENET has nothing to disclose.Conflict of interest: Dr. BORRELL has nothing to disclose.Conflict of interest: Dr. CELORRIO has nothing to disclose.Conflict of interest: Dr. DELGADO has nothing to disclose.Conflict of interest: Dr. JANÉ has nothing to disclose.Conflict of interest: Dr. MARIN has nothing to disclose.Conflict of interest: Dr. MARTÍN-CANTERA has nothing to disclose.Conflict of interest: Dr. MONTEAGUDO has nothing to disclose.Conflict of interest: Dr. MONTELLÀ has nothing to disclose.Conflict of interest: Dr. MUÑOZ ORTIZ has nothing to disclose.Conflict of interest: Dr. ORTEGA has nothing to disclose.Conflict of interest: Dr. RODRÍGUEZ has nothing to disclose.Conflict of interest: Dr. RODRIGUEZ-ROISIN reports grants from Almirall and Menarini, personal fees from Boehringer Ingelheim, personal fees from Novartis, personal fees from Pearl Therapeutics, personal fees from Takeda, and personal fees from TEVA during the conduct of the study, all related to COPD.Conflict of interest: Dr. SIMONET reports personal fees from Menarini, personal fees from Gebro, personal fees from Teva, personal fees from Boehringer, personal fees from Rovi, personal fees from Astra-zeneca, personal fees from GSK, outside the submitted work.Conflict of interest: Dr. TORÁN-MONTSERRAT has nothing to disclose.Conflict of interest: Dr. TORRENT-PALLICER has nothing to disclose.Conflict of interest: Dr. VALL-CASAS has nothing to disclose.Conflict of interest: Dr. VILARÓ has nothing to disclose.Conflict of interest: Dr. GARCIA-AYMERICH reports other from AstraZeneca, other from Esteve, other from Chiesi, outside the submitted work.