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Pedometers to enhance physical activity in COPD: a randomised controlled trial
Mendoza L, Horta P, Espinoza J, Aguilera M, Balmaceda N, Castro A, Ruiz M, Diaz O, Hopkinson NS
The European Respiratory Journal 2015 Feb;45(2):347-354
clinical trial
7/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

Physical inactivity is a cardinal feature of chronic obstructive pulmonary disease (COPD), and is associated with increased morbidity and mortality. Pedometers, which have been used in healthy populations, might also increase physical activity in patients with COPD. COPD patients taking part in a 3-month individualised programme to promote an increase in their daily physical activity were randomised to either a standard programme of physical activity encouragement alone, or a pedometer-based programme. Assessments were performed by investigators blinded to treatment allocation. Change in average 1-week daily step count, 6-min walking distance (6MWD), modified Medical Research Council scale, St George's respiratory questionnaire (SGRQ) and COPD assessment test (CAT) were compared between groups. 102 patients were recruited, of whom 97 completed the programme (pedometer group: n = 50; control group: n = 47); 60.8% were male with a mean +/- SD age of 68.7 +/- 8.5 years, and forced expiratory volume in 1 s (FEV1) 66.1 +/- 19.4% and FEV1/forced vital capacity 55.2 +/- 9.5%. Both groups had comparable characteristics at baseline. The pedometer group had significantly greater improvements in: physical activity 3080 +/- 3,254 steps/day versus 138.3 +/- 1,950 steps/day (p < 0.001); SGRQ -8.8 +/- 12.2 versus -3.8 +/- 10.9 (p = 0.01); CAT score -3.5 +/- 5.5 versus -0.6 +/- 6.6 (p = 0.001); and 6MWD 12.4 +/- 34.6 versus -0.7 +/- 24.4 m (p = 0.02) than patients receiving activity encouragement only. A simple physical activity enhancement programme using pedometers can effectively improve physical activity level and quality of life in COPD patients.
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