Cited by 43Chronic Obstructive Pulmonary Disease (COPD) ResearchHealth Systems, Economic Evaluations, Quality of LifePhysical Activity and Health

Validity and responsiveness of the daily- and clinical visit-PROactive physical activity in COPD (D-PPAC and C-PPAC) instruments

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Garcia-Aymerich, Judith, Puhan, Milo A, Corriol-Rohou, Solange, de Jong, Corina, Demeyer, Heleen, Dobbels, Fabienne, Erzen, Damijan, Frei, Anja +11 more·2021·Thorax

Abstract

Background: The Daily-PROactive and Clinical visit-PROactive Physical Activity (D-PPAC and C-PPAC) instruments in chronic obstructive pulmonary disease (COPD) combines questionnaire with activity monitor data to measure patients’ experience of physical activity. Their amount, difficulty and total scores range from 0 (worst) to 100 (best) but require further psychometric evaluation. Objective: To test reliability, validity and responsiveness, and to define minimal important difference (MID), of the D-PPAC and C-PPAC instruments, in a large population of patients with stable COPD from diverse severities, settings and countries. Methods: We used data from seven randomised controlled trials to evaluate D-PPAC and C-PPAC internal consistency and construct validity by sex, age groups, COPD severity, country and language as well as responsiveness to interventions, ability to detect change and MID. Results: We included 1324 patients (mean (SD) age 66 (8) years, forced expiratory volume in 1 s 55 (17)% predicted). Scores covered almost the full range from 0 to 100, showed strong internal consistency after stratification and correlated as a priori hypothesised with dyspnoea, health-related quality of life and exercise capacity. Difficulty scores improved after pharmacological treatment and pulmonary rehabilitation, while amount scores improved after behavioural physical activity interventions. All scores were responsive to changes in self-reported physical activity experience (both worsening and improvement) and to the occurrence of COPD exacerbations during follow-up. The MID was estimated to 6 for amount and difficulty scores and 4 for total score. Conclusions: The D-PPAC and C-PPAC instruments are reliable and valid across diverse COPD populations and responsive to pharmacological and non-pharmacological interventions and changes in clinically relevant variables.

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Crossref · 10.1136/thoraxjnl-2020-214554

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  • A recent study reported the effect of physical activity behavioural modification interventions or pulmonary rehabilitation alone on patients' experiences of physical activity using the C-PPAC instrument, indicating clinically important improvements.

    “A recent study [24] reported the effect of PA behavioural modification interventions or PR alone on patients' experiences of PA using the C-PPAC instrument, indicating clinically important improvements.”

    From Behavioural modification interventions alongside pulmonary rehabilitation improve COPD patients’ experiences of physical activity (2021) · cites this paper as [24]

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  • The effect of adding physical activity behavioural modification interventions to pulmonary rehabilitation compared with pulmonary rehabilitation alone on patient physical activity experiences was not reported in that study.

    “The effect of adding PA behavioural modification interventions to PR as compared to PR alone on patient PA experiences was, however, not reported in that study [24].”

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Authors
Garcia-Aymerich, J., Puhan, M. A., Corriol-Rohou, S., de Jong, C., Demeyer, H., Dobbels, F., Erzen, D., Frei, A., Gimeno-Santos, E., Hopkinson, N. S., Ivanoff, N., Karlsson, N., Louvaris, Z., Polkey, M. I., Rabinovich, R. A., Scuri, M., Tabberer, M., Vogiatzis, I., & Troosters, T.
Affiliations
  • University of Zurich (CH)
  • Universitair Ziekenhuis Leuven (BE)
  • KU Leuven (BE)
  • Imperial College London (GB)
  • Almirall (Spain) (ES)
  • AstraZeneca (Sweden) (SE)
  • National and Kapodistrian University of Athens (GR)
  • Royal Brompton & Harefield NHS Foundation Trust (GB)
  • The Queen's Medical Research Institute (GB)
  • Chiesi (Italy) (IT)
  • GlaxoSmithKline (United Kingdom) (GB)
Venue
Thorax
Publisher
BMJ
Published
2021-01-21
Volume
76
Issue
3
Pages
228-238
ISSN
  • 0040-6376 (ISSN-L)
  • 1468-3296
OpenAlex
W3125972857
Cited by
43
References
22
Citations by year
2026: 4 · 2025: 4 · 2024: 9 · 2023: 10 · 2022: 10 · 2021: 6
FWCI
5.68
Type
journal article
Language
en
Open access
Locations
  • Thorax (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • Northumbria Research Link (Northumbria University) (acceptedVersion)
  • Zurich Open Repository and Archive (University of Zurich) (acceptedVersion, cc-by-nc)
  • Ghent University Academic Bibliography (Ghent University) (submittedVersion, cc-by-nc)
  • Lirias (KU Leuven) (submittedVersion, other-oa)
  • University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, cc-by)
  • Repositori digital de la UPF (Universitat Pompeu Fabra) (submittedVersion, cc-by-nc)
  • Spiral (Imperial College London) (submittedVersion, cc-by-nc)
  • Zurich Open Repository and Archive (University of Zurich) (submittedVersion, cc-by-nc)
  • University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, cc-by-nc)
  • Zurich Open Repository and Archive (University of Zurich)
Funders
  • European Commission (IMI JU # 115011)
  • Fonds Wetenschappelijk Onderzoek
  • Royal Brompton and Harefield NHS Foundation Trust
  • CERCA Programme, Generalitat de Catalunya
  • NIHR Respiratory Biomedical Research Unit
Topics
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
  • Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
  • Health Sciences › Medicine › Physiology › Physical Activity and Health
Keywords
chronic obstructive pulmonary disease, physical activity, physical activity experience, minimal important difference, responsiveness, construct validity, internal consistency, pulmonary rehabilitation, COPD exacerbations, health-related quality of life, dyspnea, exercise capacity
MeSH terms
Exercise Therapy, Follow-Up Studies, Forced Expiratory Volume, Humans, Prospective Studies, Psychometrics, Quality of Life, Surveys and Questionnaires, Exercise, Exercise Tolerance, Pulmonary Disease, Chronic Obstructive

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