Changes in D-PPAC and C-PPAC scores after interventions and in relation to clinically relevant variables (responsiveness)
| D-PPAC | n | Amount score | Difficulty score | Total score | ||||||
| Change* | P† | SRMs | Change* | P† | SRMs | Change* | P† | SRMs | ||
| M (SD) | M (SD) | M (SD) | M (SD) | M (SD) | M (SD) | |||||
| Response to interventions | ||||||||||
| PHYSACTO (12 week) | ||||||||||
| SMBM+placebo (ref.) | 63 | 1.8 (12.3) | 0.2 (1.1) | 0.8 (9.2) | 0.1 (0.9) | 1.3 (7.9) | 0.2 (1.0) | |||
| SMBM +tiotropium | 58 | 2.3 (9.8) | >0.999 | 0.2 (0.9) | 6.2 (12.0) | 0.021 | 0.6 (1.2) | 4.3 (8.2) | 0.178 | 0.6 (1.2) |
| SMBM +tiotropium/olodaterol | 60 | 4.7 (10.7) | 0.798 | 0.4 (1.0) | 5.9 (10.8) | 0.037 | 0.6 (1.0) | 5.3 (7.5) | 0.02 | 0.7 (1.0) |
| SMBM+tiotropium/olodaterol+exercise training | 62 | 4.4 (9.6) | >0.999 | 0.4 (0.9) | 5.9 (8.3) | 0.034 | 0.6 (0.8) | 5.1 (6.2) | 0.026 | 0.7 (0.8) |
| MrPAPP (12 week) | ||||||||||
| Usual care (ref.) | 144 | −2.9 (9.0) | −0.3 (0.8) | 0.9 (9.4) | 0.1 (1) | −1.0 (6.4) | −0.1 (0.9) | |||
| Telecoaching for physical activity | 141 | 2.1 (11.8) | <0.001 | 0.2 (1.1) | −0.8 (10.1) | 0.123 | −0.1 (1) | 0.6 (7.7) | 0.055 | 0.1 (1) |
| ACTIVATE (8 week) | ||||||||||
| Placebo (ref.) | 95 | 2.8 (14.3) | 0.2 (1.2) | −0.3 (8.5) | −0.03 (0.9) | 1.2 (6.7) | 0.2 (1.0) | |||
| Aclidinium bromide/formoterol fumarate | 105 | 2.5 (8.5) | 0.844 | 0.2 (0.7) | 3.0 (9.5) | 0.01 | 0.3 (1.0) | 2.7 (6.7) | 0.123 | 0.4 (1.0) |
| Change in relation to self-reported global rating of change (12 week for PHYSACTO and MrPAPP) | ||||||||||
| Change in physical activity experience overall | ||||||||||
| Much worse, worse, slightly worse | 74 | −5.3 (9.2) | <0.001 | −0.5 (0.9) | −2.4 (9.5) | 0.009 | −0.2 (1.0) | −3.8 (6.4) | <0.001 | −0.5 (0.9) |
| No change, slightly better (ref.) | 244 | 0.4 (9.7) | – | 0.04 (0.9) | 1.6 (9.8) | – | 0.2 (1.0) | 1.0 (6.6) | – | 0.1 (0.9) |
| Better, much better | 197 | 4.8 (11.5) | <0.001 | 0.5 (1.1) | 4.7 (10.7) | 0.005 | 0.5 (1.1) | 4.8 (8.0) | <0.001 | 0.6 (1.1) |
| Change in difficulty with physical activity | ||||||||||
| Much more/more/a little more difficult | 82 | −5.6 (10.6) | <0.001 | −0.5 (1.0) | −3.7 (9.5) | <0.001 | −0.4 (1.0) | −4.7 (6.7) | <0.001 | −0.6 (0.9) |
| No change, a little easier (ref.) | 281 | 1.1 (9.5) | – | 0.1 (0.9) | 1.9 (9.5) | – | 0.2 (1.0) | 1.5 (6.3) | – | 0.2 (0.9) |
| More easy, much more easy | 154 | 5.4 (11.6) | <0.001 | 0.5 (1.1) | 6.0 (10.7) | <0.001 | 0.6 (1.1) | 5.7 (8.0) | <0.001 | 0.8 (1.1) |
| Change in amount of physical activity | ||||||||||
| Much less/less/a little less active | 97 | −6.0 (9.9) | <0.001 | −0.6 (0.9) | −2.1 (10.1) | 0.001 | −0.2 (1.0) | −4.1 (6.9) | <0.001 | −0.6 (1.0) |
| No change, slightly better (ref.) | 222 | 0.3 (9.3) | – | 0.03 (0.9) | 2.3 (9.5) | – | 0.2 (0.9) | 1.3 (6.3) | – | 0.2 (0.9) |
| More/much more active | 198 | 6.2 (10.8) | <0.001 | 0.6 (1.0) | 4.3 (10.8) | 0.127 | 0.4 (1.1) | 5.2 (7.5) | <0.001 | 0.7 (1.1) |
| Changes according to COPD exacerbations during follow-up (8 week for ACTIVATE; 12 week for PHYSACTO and MrPAPP) | ||||||||||
| Any COPD exacerbation | ||||||||||
| No (ref.) | 443 | 2.1 (11.0) | 0.2 (1.0) | 2.8 (10.2) | 0.3 (1.0) | 2.5 (7.5) | 0.3 (1.0) | |||
| Yes | 96 | −3.0 (8.6) | <0.001 | −0.3 (0.8) | −0.6 (9.6) | 0.002 | −0.0 (1.0) | −1.8 (6.6) | <0.001 | −0.3 (1.0) |
| C-PPAC | n | Amount score | Difficulty score | Total score | ||||||
| Change* | P† | SRMs | Change* | P† | SRMs | Change* | P† | SRMs | ||
| M (SD) | M (SD) | M (SD) | M (SD) | M (SD) | M (SD) | |||||
| Response to interventions | ||||||||||
| MRPAPP (12 week) | ||||||||||
| Usual care (ref.) | 114 | −4.3 (12.5) | −0.3 (1.0) | −1.7 (10.7) | −0.2 (1.1) | −3.0 (8.4) | −0.4 (1.0) | |||
| Telecoaching for physical activity | 112 | 2.9 (12.8) | <0.001 | 0.2 (1) | 0.2 (8.5) | 0.157 | 0.02 (0.9) | 1.5 (8.1) | <0.001 | 0.2 (1.0) |
| ATHENS (12 week) | ||||||||||
| Usual care (ref.) | 27 | −0.5 (13.3) | −0.0 (1.0) | −3.1 (10.4) | −0.3 (1.0) | −1.8 (8.5) | −0.2 (1.0) | |||
| Pulmonary rehabilitation | 25 | 5.9 (11.5) | 0.071 | 0.5 (0.9) | 5.3 (9.2) | 0.003 | 0.5 (0.9) | 5.6 (7.5) | 0.002 | 0.6 (0.8) |
| URBAN TRAINING‡ (12 m) | ||||||||||
| Usual care (ref.) | 74 | −0.2 (12.6) | −0.0 (1.0) | 0.4 (12.4) | 0.0 (1.0) | 0.2 (10.4) | 0.0 (1.0) | |||
| Urban training for physical activity | 29 | 4.6 (10.9) | 0.072 | 0.4 (0.9) | 4.8 (11.2) | 0.096 | 0.4 (0.9) | 4.7 (8.9) | 0.04 | 0.5 (0.9) |
| Change in relation to self-reported global rating of change (12 week for MRPAPP, 12 m for URBAN TRAINING‡) | ||||||||||
| Change in physical activity experience overall | ||||||||||
| Much worse, worse, slightly worse | 77 | −6.8 (12.7) | <0.001 | −0.5 (1.0) | −3.4 (13.5) | 0.016 | −0.4 (1.2) | −4.9 (10.1) | <0.001 | −0.6 (1.1) |
| No change, slightly better (ref.) | 165 | −0.4 (11.0) | – | −0.0 (0.9) | 0.6 (9.8) | – | 0.0 (0.9) | 0.0 (7.4) | – | −0.0 (0.8) |
| Better, much better | 84 | 5.8 (13.0) | <0.001 | 0.5 (1.0) | 2.3 (9.1) | 0.68 | 0.2 (0.9) | 4.1 (9.0) | 0.001 | 0.5 (1.0) |
| Change in difficulty with physical activity | ||||||||||
| Much more/more/a little more difficult | 84 | −6.3 (12.3) | <0.001 | −0.5 (1.0) | −4.4 (13.0) | <0.001 | −0.4 (1.2) | −5.1 (10.0) | <0.001 | −0.6 (1.1) |
| No change, a little easier (ref.) | 185 | 0.4 (11.5) | – | 0.0 (0.9) | 1.0 (9.5) | – | 0.1 (0.9) | 0.6 (7.6) | – | 0.1 (0.8) |
| More easy, much more easy | 58 | 5.9 (13.5) | 0.006 | 0.5 (1.0) | 3.9 (9.3) | 0.177 | 0.4 (0.8) | 5.0 (8.7) | 0.001 | 0.6 (0.9) |
| Change in amount of physical activity | ||||||||||
| Much less/less/a little less active | 91 | −6.7 (12.1) | <0.001 | −0.5 (1.0) | −2.4 (13.1) | 0.128 | −0.2 (1.2) | −4.3 (10.0) | <0.001 | −0.5 (1.1) |
| No change, slightly better (ref.) | 175 | 0.7 (11.8) | – | 0.1 (0.9) | 0.4 (10.0) | – | −0.0 (0.9) | 0.4 (8.2) | – | 0.0 (0.9) |
| More/much more active | 77 | 4.8 (12.5) | 0.039 | 0.4 (1.0) | 2.5 (9.0) | 0.441 | 0.2 (0.9) | 3.7 (7.8) | 0.017 | 0.4 (0.9) |
| Changes according to COPD exacerbations during follow-up (12 week for MRPAPP, 12 m for URBAN TRAINING‡) | ||||||||||
| Any COPD exacerbation | ||||||||||
| No (ref.) | 218 | 0.8 (12.8) | 0.1 (1.0) | 0.9 (9.8) | 0.1 (0.9) | 0.8 (8.4) | 0.1 (0.9) | |||
| Yes | 108 | −3.0 (12.5) | 0.008 | −0.2 (1.0) | −1.9 (12.4) | 0.022 | −0.2 (1.1) | −2.3 (10.2) | 0.003 | −0.3 (1.1) |
Parameters are in bold font when they met our assumptions (p value<0.05 and SRM≥0.5).
*Change calculated as 8 weeks score—baseline score in patients from ACTIVATE trial; 12 weeks score—baseline score in patients from PHYSACTO and MrPAPP trials; and 12 months—baseline in patients from Urban Training trial.
†P value of the score difference between groups, using multiple comparisons (Bonferroni method) after ANOVA test.
‡Using per protocol population.
ACTIVATE, Effect of Aclidinium/Formoterol on Lung Hyperinflation, Exercise Capacity and Physical Activity in Moderate to Severe COPD Patients; ANOVA, analysis of variance; ATHENS, Pulmonary Rehabilitation Program and PROactive Tool; COPD, chronic obstructive pulmonary disease; C-PPAC, Clinical visit version of PROactive Physical Activity in COPD instrument; D-PPAC, Daily version of PROactive Physical Activity in COPD instrument; MrPAPP, Impact of Telecoaching Program on Physical Activity in Patients With COPD; PHYSACTO, Effect of Inhaled Medication Together With Exercise and Activity Training on Exercise Capacity and Daily Activities in Patients With Chronic Lung Disease With Obstruction of Airways; SMBM, self-management behaviour-modification; SRM, standardised response mean; URBAN TRAINING, Effectiveness of an Intervention of Urban Training in Patients With COPD.