COPD Online Rehabilitation (CORe)
- Conditions
- Pulmonary Disease, Chronic Obstructive
- Interventions
- Behavioral: Online COPD rehabilitation (experimental)Behavioral: Supervised COPD Rehabilitation (control group)
- Registration Number
- NCT02667171
- Lead Sponsor
- University Hospital Bispebjerg and Frederiksberg
- Brief Summary
International and national publications emphasize that COPD rehabilitation is a key cornerstone in the standard treatment of COPD, based on more than 15 years of research in COPD rehabilitation. COPD rehabilitation improves quality of life, anxiety and depression and physical function. COPD rehabilitation including special physical training, patient-directed education and smoking cessation is core rehabilitation elements, which today are recommended as mandatory content in standard COPD rehabilitation.
Standard COPD rehabilitation is an established offer in all regions and municipalities in Denmark. It is however a well-known challenge, that persons with the most severe COPD symptoms and co-morbidities are most likely not to receive COPD rehabilitation. Frequent exacerbations, socially isolation, transport distance to rehabilitation are main reasons why people with severe COPD disease deliberately chooses not to receive COPD rehabilitation. Why there at present are no rehabilitation alternatives for patients with the most severe COPD symptoms, supervised COPD Online rehabilitation in groups, delivered by health professionals in the COPD patients' own home via a computer screen could likely encourage more people to participate. The number of RCT's investigating the effect of supervised Online delivered COPD rehabilitation in groups versus established COPD rehabilitation are very limited.
The purpose of this randomized study is to investigate the short-term and long-term efficacy of 10 weeks of online COPD rehabilitation versus conventional supervised COPD rehabilitation in people with severe and very severe COPD. The outcome of the intervention is measured on walking distance, muscle endurance, activity level, quality of life and COPD symptoms respectively. Outcomes are measures before intervention start, end of intervention. This study also collects follow-up update after 3, 6 and 12 month. The follow-up data will be in separate publication.
Hypothesis
1. COPD online rehabilitation provides significant larger improvements than the usual care on walking distance, muscle endurance, activity level, and quality of life and COPD symptoms in people with severe and very severe COPD.
2. COPD online rehabilitation and conventional COPD rehabilitation, provides clinically relevant improvement on walking distance, muscle endurance, activity level, quality of life and COPD symptoms in people with severe and very severe COPD.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 134
- Clinical diagnosis of COPD defined as a ratio of forced expiratory volume at one second (FEV1) to forced vital capacity < 0.70
- FEV1 <50%, corresponding to severe or very severe COPD
- Symptoms equivalent to the Medical Research Council (MRC) from 2 to 5
- Concurrent participation in or recent completion of pulmonary rehabilitation within the last six months.
- Dementia/ Cognitive impairment or uncontrolled psychiatric illness,
- An impaired hearing and / or vision which causes the instructions in the rehabilitation is not understood.
- Unable to understand and / or speak Danish.
- Unable to read Danish.
- Severe co-morbidity that are contraindicated to rhe clinical exercise protocol.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Online COPD rehabilitation Online COPD rehabilitation (experimental) Supervised Online COPD rehabilitation, delivered in groups through a computer screen in patients own home. Rehabilitation contains exercise training and education sessions three times per week for a duration of 10 weeks. Control group Supervised COPD Rehabilitation (control group) The control group will receive standardized conventional supervised COPD rehabilitation, delivered in groups. Rehabilitation contains exercise training and education sessions twice a week for a duration of 8-12 weeks.
- Primary Outcome Measures
Name Time Method Change in 6-Minute Walk Test Distance (6MWT) baseline (before intervention), after 10 weeks, after 22 weeks (average of 3 month follow up) In-clinic test that measures exercise capacity
- Secondary Outcome Measures
Name Time Method Mortality after 10 weeks, after 22 weeks (average of 3 month follow up), after 36 weeks (average of 6 month follow up), after 62 weeks (average of 12 month follow up) from registers
Change in 30 second sit-to-stand test (30-STST) baseline (before intervention), after 10 weeks, after 22 weeks (average of 3 month follow up) In-clinic test that measures muscle endurance/strength
Change in Clinical COPD Questionaire (CCQ) baseline (before intervention), after 10 weeks, after 22 weeks (average of 3 month follow up) Patient completed questionnaires that assess quality of life and COPD symptoms. Ten Item questionaire with total score from 0-60 points.
Change in COPD Assessment Test (CAT) baseline (before intervention), after 10 weeks, after 22 weeks (average of 3 month follow up) Patient completed questionnaires that assess quality of life and COPD symptoms. Five item questionaire with total score from 0-40 points.
number of hospital admissions number of hospital admissions - after 10 weeks, after 22 weeks (average of 3 month follow up), after 36 weeks (average of 6 month follow up), after 62 weeks (average of 12 month follow up) from registers
Change in Activity level (ActivPAL) Worn by the patients around the clock for 5 days in a private home at baseline (before intervention), after 10 weeks, after 22 weeks (average of 3 month follow up) Worn by the patients around the clock for 5 days in a private home.
Change in Hospital Anxiety and Depression Scale (HADS) baseline (before intervention), after 10 weeks, after 22 weeks (average of 3 month follow up) Patient completed questionnaires that assess anxiety and depression symptoms. Seven item domain questions for depression with total score form 0-21 point. Seven item domain questions for anxiety with total score fra 0-21 points. Total score from 0-42 points
Outpatient visits in hospital and at general practioner number of outpatients visits in hospital and at general practioner - after 10 weeks, after 22 weeks (average of 3 month follow up), after 36 weeks (average of 6 month follow up), after 62 weeks (average of 12 month follow up) from registers
Change in Euro Qol (EQ5D) baseline (before intervention), after 10 weeks, after 22 weeks (average of 3 month follow up) Patient completed questionnaires that assess quality of life. Total score fra 0-1 on EQ5D-health domain. Total score from 0-100mm on EQ5D-vas domain. No total domain score
Total attendance in rehabilitation after 10 weeks registered
Number of hospital days number of hospital days - after 10 weeks, after 22 weeks (average of 3 month follow up), after 36 weeks (average of 6 month follow up), after 62 weeks (average of 12 month follow up) from registers
Trial Locations
- Locations (7)
Hillerød hospital
🇩🇰Hillerød, Denmark
Bispebjerg and Frederiksberg Hospital
🇩🇰Copenhagen, Copenhagen Northwest, Denmark
Frederikssund hospital
🇩🇰Frederikssund, Denmark
Gentofte Hospital
🇩🇰Hellerup, Denmark
Amager Hospital
🇩🇰Copenhagen, Denmark
Herlev Hospital
🇩🇰Herlev, Denmark
Hvidovre Hospital
🇩🇰Hvidovre, Denmark