Plain English Summary
Background and study aims
Chronic obstructive pulmonary disease (COPD) is a lung disease causing difficulty or discomfort in normal breathing. COPD is the fourth leading cause of death worldwide and should not simply be considered as a smokers cough, but a highly under-diagnosed disease influenced by a range of factors. This study aims to find out the role of physical activity and psychological and social factors in the development and progression of COPD.
Who can participate?
Adults aged 40 75 years of age residing in Leicestershire and Rutland (UK) are eligible to participate.
What does the study involve?
Participants will be asked to attend one 2-hour testing visit at Glenfield Hospital. Testing will involve spirometry (to assess lung function); measures of height, weight, waist circumference and percentage body fat; a blood sample from the arm (to test for cholesterol and glucose levels); blood pressure measurement; 10-metre shuttle walk test (fitness) and strength tests (leg and grip). On completion of the visit, participants will be asked to wear two activity monitors (one worn on the waist and one worn on the wrist) for eight days. A small number of them, up to 50 COPD patients, will be invited to participate in a one-on-one interview in which they will discuss their feelings and beliefs surrounding their diagnosis and indications towards physical activity programmes.
What are the possible benefits and risks of participating?
Participants will receive a comprehensive health check as well as written information and explanation of their physical activity levels. Any clinically important results will be passed on to their GP. Ultimately, taking part in the research will help to facilitate better care for COPD patients and those at risk of developing COPD. As with all physical activity, there is a very small risk of accident or injury during the exercise tests (walking and strength tests). All the exercise will be supervised by trained research staff and will take place on NHS premises with resuscitation equipment available and trained staff on hand to use it. Taking blood samples from the arm may cause slight pain or bruising afterwards.
Where is the study run from?
The study is run from the Respiratory Biomedical Research Unit, Glenfield Hospital, Leicestershire, UK.
When is the study starting and how long is it expected to run for?
Recruitment started in January 2014 and the study will end in May 2014.
Who is funding the study?
The study is funded by the Department of Health, UK.
Who is the main contact?
Dr Lauren Sherar
Dr Lauren Sherar
Physical and psycho-social profiling of patients with mild-to-moderate chronic obstructive pulmonary disease data to inform an intervention
To investigate demographic characteristics, symptoms, fitness, childhood disadvantaged factors, function, objectively assessed physical activity/sedentary behaviour, health-related quality of life (HRQL) and psychosocial characteristics (e.g. anxiety, depression, self-efficacy, perceptions of disease, etc) in COPD patients and non-COPD controls grouped by spirometric classification and self-reported disability (MRC breathlessness score).
A secondary objective is to conduct one-on-one interviews to obtain real life experiences/stories about developing COPD and the impact of timing and personal context on these responses. To examine environmental factors influencing willingness or motivation to exercise and receptivity towards physical activity programmes.
NRES Committee East Midlands - Nottingham 2, 01/11/2012, ref: 13/EM/0389
Observational cross-sectional single-centre study
Primary study design
Secondary study design
Patient information sheet
Patient information can be found at http://www.pharaohstudy.com/
Chronic obstructive pulmonary disease (COPD)
COPD patients will be identified from GP records. Control (smoking and non-smoking) participants and some COPD patients will respond to newspaper/radio/website advertisements.
Participants will be required to attend the testing site on one occasion for approximately two hours. Blood pressure, height, weight and waist circumference will be measured and percentage body fat will be assessed using a bioelectrical impedance scale. Upon anthropometry completion, a single (4-hour fasted) blood draw will be taken to assess cardio-metabolic markers (total cholesterol, HDL-cholesterol, LDL-cholesterol, triglycerides, glucose, C-reactive protein, HbA1c). A spirometery assessment will require each participant to take a maximal inspiration before performing a forced exhalation. Participants will be asked to complete an incremental shuttle walking test (ISWT), which is a standardized field walking test that provokes a symptom-limited maximal performance providing an objective measurement of disability. Participants will be asked to walk up and down a 10 m course with the speed of the walk dictated by an audio signal played on a CD. Participants will continue walking until they feel unable to maintain the necessary speed without becoming unduly breathless. Participants will complete the tests twice, with a 30-minute rest period in between and the highest value (distance walked) of the two walks will be recorded. Quadriceps (leg) strength will be tested by asking participants to perform a maximal knee extension of the dominant leg against resistance. A grip strength test will require participants to squeeze a dynamometer with as much force as possible. Questionnaires will be used to collect information on childhood experiences (e.g., number of siblings, access to a car and access to hot water in the house during childhood) that may be associated with respiratory disease in later life; domain-specific (occupation, transportation, home-based and leisure-time) physical activity levels over the last 7 days; time spent sitting during a weekday and weekend day whilst travelling, at work, watching television, using a computer and for leisure; domestic, work and recreational physical activity over the past 12 months; participants perceived health status; shortness of breath severity; physical, social, emotional and functional well-being; self-efficacy to pulmonary rehabilitation; impact of COPD on a persons life, and how this changes over time. Lastly, participants will be asked to wear a wrist-worn and a waist-worn activity monitor (i.e., accelerometer) for 8 days and then return the monitor by mail. A sub-sample of up to 50 COPD patients will be followed up and invited to participate in optional one-to-one interviews. COPD patients will be asked to share their thoughts on coping with and managing their disease and whether (and how) they feel disease may limit their activity levels. The interview would be digitally recorded and professionally transcribed; with transcripts returned to participants for verification.
Primary outcome measure
Time spent sedentary and in light, moderate and vigorous physical activity objectively assessed using an Actigraph GT3x-BT accelerometer and a wrist-worn GeneActiv.
All primary and secondary outcome measures will be taken at one time point for each participant. A sub-study of COPD patients will be invited, within 3 weeks on the baseline measure, to take part in a qualitative interview at their home.
Secondary outcome measures
1. Exercise capacity - meters on the best Incremental Shuttle Walk Test (ISWT)
2. Biographical themes obtained from qualitative interviews
Overall trial start date
Overall trial end date
Reason abandoned (if study stopped)
Participant inclusion criteria
Male and female, 40-75 years and residing in Leicestershire, UK
Target number of participants
644 (322 COPD patients and 322 non-COPD patient controls)
Participant exclusion criteria
1. Clinically relevant medical or psychiatric condition(s) which could interfere with completing the testing protocol 2. Pregnancy
3. Impaired hearing sufficient to prevent the participant carrying out the shuttle walk tests, which require walking at a speed controlled by an external audible bleep signal. Use of walking aids will be allowed as long as the same aids are used in the walking tests as in free living
Recruitment start date
Recruitment end date
Countries of recruitment
Trial participating centre
Trial participating centre
Respiratory Biomedical Research Unit
Glenfield Hospital Groby Road
University Hospitals of Leicester NHS Trust (UK)
Leicester Royal Infirmary
+44(0)116 258 8351
Department of Health (UK)
Funding Body Type
Funding Body Subtype
Results and Publications
Publication and dissemination plan
Publication in a peer reviewed journal.
IPD sharing plan:
The datasets generated during and/or analysed during the current study are/will be available upon request from http://www.lboro.ac.uk/research/mi-lab/research/pharaoh/pharaohconditionsofuse/ (data request form submitted to MI-Lab@lboro.ac.uk)
Intention to publish date
Participant level data
Available on request
Basic results (scientific)
2016 dataset in http://openhealthdata.metajnl.com/articles/10.5334/ohd.28/
2017 results in: https://www.ncbi.nlm.nih.gov/pubmed/28961483
2018 results in: https://www.ncbi.nlm.nih.gov/pubmed/28866643
2018 results in: https://www.ncbi.nlm.nih.gov/pubmed/29973076