Validity and responsiveness of the Daily- and Clinical visit-PROactive Physical Activity in COPD (D-PPAC and C-PPAC) instruments

Garcia-Aymerich, Judith, Puhan, Milo A, Corriol-Rohou, Solange, de Jong, Corina, Demeyer, Heleen, Dobbels, Fabienne, Erzen, Damijan, Frei, Anja, Gimeno-Santos, Elena, Hopkinson, Nicholas S, Ivanoff, Nathalie, Karlsson, Niklas, Louvaris, Zafeiris, Polkey, Michael I, Rabinovich, Roberto A, Scuri, Mario, Tabberer, Maggie, Vogiatzis, Ioannis and Troosters, Thierry (2021) Validity and responsiveness of the Daily- and Clinical visit-PROactive Physical Activity in COPD (D-PPAC and C-PPAC) instruments. Thorax, 76 (3). pp. 228-238. ISSN 0040-6376

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Official URL: https://doi.org/10.1136/thoraxjnl-2020-214554

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.

Item Type: Article
Additional Information: Funding Information: Funding Supported by the European Commission Innovative Medicines Initiative Joint Undertaking [IMI JU number 115011]. This project was also supported by the NIHR Respiratory Biomedical Research Unit at the Royal Brompton and Harefield NHS Foundation Trust and Imperial College who part-funded MIP’s salary. ISGlobal acknowledges support from the Spanish Ministry of Science and Innovation through the ’Centro de Excelencia Severo Ochoa 2019-2023’ Program (CEX2018-000806-S), and support from the Generalitat de Catalunya through the CERCA Program. HD is a postdoctoral research fellow of the FWO Flanders.
Subjects: A300 Clinical Medicine
A900 Others in Medicine and Dentistry
B100 Anatomy, Physiology and Pathology
C600 Sports Science
Department: Faculties > Health and Life Sciences > Sport, Exercise and Rehabilitation
Depositing User: Rachel Branson
Date Deposited: 25 Jan 2021 10:50
Last Modified: 01 Mar 2021 13:16
URI: http://nrl.northumbria.ac.uk/id/eprint/45289

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