AIMS AND OBJECTIVES: The Clinical PROactive Physical Activity in COPD (C-PPAC) instrument, combines a questionnaire assessing the domains of amount and difficulty of physical activity (PA) with activity monitor data (steps/day and vector magnitude units) to assess patients' experiences of PA. The C-PPAC instrument is responsive to pharmacological and non-pharmacological interventions and to changes in clinically relevant variables. We compared the effect of PA behavioural modification interventions alongside pulmonary rehabilitation (PR) to PR alone on the C-PPAC scores in COPD patients with low baseline PA levels. METHODS: In this randomised controlled trial, 48 patients (means +/- SD: FEV1: 50 +/- 19%, baseline steps/day: 3450 +/- 2342) were assigned 1:1 to receive PR alone, twice weekly for 8 weeks, or PA behavioural modification interventions (comprising motivational interviews, monitoring and feedback using a pedometer and goal setting) alongside PR (PR+PA). The C-PPAC instrument was used to assess PA experience, including a perspective of the amount and difficulty of PA. RESULTS: There were clinically important improvements in favour of the PR+PA interventions compared to PR alone in: (1) the C-PPAC total score (mean (95% CI) difference 8 (4 to 12) points, p = 0.001), the difficulty (mean (95% CI) difference 8 (3 to 13) points, p = 0.002) and the amount (mean (95% CI) difference 8 (3 to 16) points, p = 0.005) domains and (2) the CAT score (mean (95% CI) difference -2.1 (-3.8 to -0.3) points, p = 0.025). CONCLUSION: PA behavioural modification interventions alongside PR improve the experiences of PA in patients with advanced COPD and low baseline PA levels. (NCT03749655).

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