Validity and responsiveness of the Daily- and Clinical visit-PROactive Physical Activity in COPD (D-PPAC and C-PPAC) instruments. Issue 3 (21st January 2021)

• Record Type: Journal Article
• Authors: 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; Troosters, Thierry
• Other Names: author non-byline.; Ivanoff Nathalie author non-byline.; Karlsson Niklas author non-byline.; Corriol-Rohou Solange author non-byline.; Jarrod Ian author non-byline.; Erzen Damijen author non-byline.; Scuri Mario author non-byline.; Montaccini Roberta author non-byline.; Kamel Nadia author non-byline.; Tabberer Maggie author non-byline.; McLoughlin Katrina author non-byline.; Allinder Matthew author non-byline.; Troosters Thierry author non-byline.; Dobbels Fabienne author non-byline.; Demeyer Heleen author non-byline.; Garcia-Aymerich Judith author non-byline.; Serra Ignasi author non-byline.; Gimeno-Santos Elena author non-byline.; Foundation Netherlands Asthma author non-byline.; Boer Pim de author non-byline.; Kulich Karoly author non-byline.; Glendenning Alastair author non-byline.; Polkey Michael I author non-byline.; Hopkinson Nick S author non-byline.; Vogiatzis Ioannis author non-byline.; Louvaris Zafeiris author non-byline.; Molen Thys van der author non-byline.; Jong Corina De author non-byline.; Rabinovich Roberto A author non-byline.; MacNee Bill author non-byline.; Puhan Milo A author non-byline.; Frei Anja author non-byline.;
• Is Part Of: Thorax. Volume 76:Issue 3(2021)
• Page Start: 228
• Page End: 238
• Publication Date: 2021-01-21
• Subjects: COPD epidemiology -- exercise; Chest -- Diseases -- Periodicals; Thorax; Chest -- Diseases; Periodicals; Periodicals; 617.54
• DOI: 10.1136/thoraxjnl-2020-214554
• Languages: English
• ISSNs: 0040-6376

Abstract

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.