Pneumologie 2017; 71(S 01): S1-S125
DOI: 10.1055/s-0037-1598543
Posterbegehung – Sektion Klinische Pneumologie
COPD II – Timm Greulich/Marburg, Barbara Wagener/Ballenstedt
Georg Thieme Verlag KG Stuttgart · New York

Effects of bronchodilator therapy and exercise training, added to a self-management behaviour-modification programme, on physical activity in COPD

T Troosters
1   Ku Leuven, Department of Rehabilitation Sciences and University Hospital Leuven, Pulmonary Rehabilitation and Respiratory Division
,
KL Lavoie
2   Montreal Behavioural Medicine Centre, Research Centre, Hopital du Sacré-Coeur de Montreal; Department of Psychology, University of Quebec at Montreal (Uqam)
,
N Leidy
3   Evidera, Bethesda, Maryland
,
F Maltais
4   Centre de Recherche, Institut Universitaire de Cardiologie et de Pneumologie de Quebec, Université Laval
,
M Sedeno
5   Mcgill University Health Centre
,
W Janssens
6   University Hospital Gasthuisberg, Respiratory Division
,
A Hamilton
7   Boehringer Ingelheim (Canada) Ltd
,
D Erzen
8   Boehringer Ingelheim Pharma GmbH & Co. KG
,
D de Sousa
7   Boehringer Ingelheim (Canada) Ltd
,
L Korducki
9   Boehringer Ingelheim Pharmaceuticals Inc.
,
J Bourbeau
5   Mcgill University Health Centre
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Publikationsdatum:
23. Februar 2017 (online)

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Introduction:

PHYSACTO® has shown improvements in exercise capacity in patients with COPD receiving bronchodilators (BDs)± exercise training (ExT) added to a self-management behaviour-modification programme (SMBM).

Aim:

We explored the influence of BDs ± ExT following SMBM on physical activity (PA) and perceived PA-related difficulty and symptoms in PHYSACTO® (NCT02085161).

Methods:

A 12-week (wk), randomised, partially double-blind, placebo (P)-controlled, parallel-group trial. Interventions (all with 12-wk SMBM): P; tiotropium (T) 5 µg; T + olodaterol (O) 5/5 µg; T+O 5/5 µg + 8-wk ExT. A triaxial accelerometer assessed PA (steps/day), the Functional Performance Inventory assessed patient-reported difficulty engaging in PA and the Chronic Respiratory Questionnaire assessed PA-related dyspnoea.

Results:

303 patients (post-BD FEV1: 57 (13) % predicted) were randomised and treated (full analysis set n = 274). Change in steps/day at Wk 12 is shown in the Table; no significant gain in PA was seen by adding T+O or T+O + ExT to SMBM, versus SMBM + P. However, PA-related difficulty and dyspnoea significantly decreased at Wk 12 for SMBM + T+O, versus SMBM + P.

Tab. 1

Intervention

Steps/daya at Wk 12

Adjusted mean (SE)

Adjusted mean change from baseline (SE)

95% CI

P value

SMBM + P (n = 55)

6517.71 (325.08)

1098.07 (325.08)

457.47, 1738.67

0.0009

SMBM + T (n = 57)

5572.83 (317.98)

153.19

(317.98)

-473.43, 779.81

0.6304

SMBM + T+O

(n = 60)

6813.88 (310.22)

1394.24 (310.22)

782.92, 2005.56

< 0.0001

SMBM + T+O + ExT (n = 57)

5976.43 (317.97)

556.79

(317.97)

-69.81, 1183.39

0.0813

Full analysis set. Analysis of covariance model with “treatment” and “baseline“ as covariates. Common baseline mean steps/day (SE): 5419.64 (186.15).

aMeasured via triaxial accelerometer.

Conclusions:

In moderate to severe COPD, SMBM increased PA and the addition of T+O to SMBM was associated with reduced PA-related difficulty and symptoms when compared to SMBM + P.

Funding:

Boehringer Ingelheim.

Content already presented at ERS congress 2016