Mechanisms associated with increased physical activity in patients undergoing self-management behaviour modification in the randomised PHYSACTO trial

Introduction In this analysis of the PHYSACTO® study, we assessed the efficacy of a self-management behaviour modification (SMBM) programme to improve physical activity (PA) levels, and the extent to which effects were mediated by readiness to change, motivation and confidence. Methods PHYSACTO® was...
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Gespeichert in:

Autor*in:	Jean Bourbeau [verfasserIn] Maria Sedeno [verfasserIn] Pei Zhi Li [verfasserIn] Thierry Troosters [verfasserIn] Alan Hamilton [verfasserIn] Dorothy De Sousa [verfasserIn] François Maltais [verfasserIn] Damijan Erzen [verfasserIn] Kim L. Lavoie [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2021

Übergeordnetes Werk:	In: ERJ Open Research - European Respiratory Society, 2015, 7(2021), 1
Übergeordnetes Werk:	volume:7 ; year:2021 ; number:1

Links:	Link aufrufen Link aufrufen Link aufrufen Journal toc

DOI / URN:	10.1183/23120541.00533-2020

Katalog-ID:	DOAJ007985932

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520			\|a Introduction In this analysis of the PHYSACTO® study, we assessed the efficacy of a self-management behaviour modification (SMBM) programme to improve physical activity (PA) levels, and the extent to which effects were mediated by readiness to change, motivation and confidence. Methods PHYSACTO® was a randomised, partially double-blind, parallel-group, 12-week trial to evaluate the effects of treatment on exercise capacity and PA. COPD patients received placebo, tiotropium 5 µg or tiotropium/olodaterol 5/5 µg, with or without exercise training, all with an SMBM intervention (the Living Well with COPD programme). Changes were assessed in readiness to change (stage of change visual analogue scale [VAS]), motivation (Treatment Self-Regulation Questionnaire [TSRQ]) and confidence (Perceived Competence Scale [PCS]) to engage in PA. Results PA was increased in all patients with complete PA data at Week 12 (n=262; +6038 steps·week−1, p<0.001). Significant increases were observed in patients' readiness to change (VAS 0.7 [0.6–0.8]), autonomous regulation (TRSQ 0.2 [0.1–0.3]) and confidence (PCS 0.5 [0.3–0.6]) (all p<0.01). Of note, 23% of the total effect of SMBM on steps·week−1 was found to be mediated by increases in readiness to change, 5% by TSRQ autonomous regulation and 12% by PCS. Conclusion Our study demonstrated that an SMBM programme delivered to COPD patients increased PA, mediated by an improvement of three key hypothesised mechanisms of change: readiness to change, autonomous motivation and confidence. For the first time, this study shows that an SMBM programme can be successful in altering the mechanisms of change targeted by the intervention.
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allfields	10.1183/23120541.00533-2020 doi (DE-627)DOAJ007985932 (DE-599)DOAJ9ca388a39de148a9834c340d2f61a5c3 DE-627 ger DE-627 rakwb eng Jean Bourbeau verfasserin aut Mechanisms associated with increased physical activity in patients undergoing self-management behaviour modification in the randomised PHYSACTO trial 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction In this analysis of the PHYSACTO® study, we assessed the efficacy of a self-management behaviour modification (SMBM) programme to improve physical activity (PA) levels, and the extent to which effects were mediated by readiness to change, motivation and confidence. Methods PHYSACTO® was a randomised, partially double-blind, parallel-group, 12-week trial to evaluate the effects of treatment on exercise capacity and PA. COPD patients received placebo, tiotropium 5 µg or tiotropium/olodaterol 5/5 µg, with or without exercise training, all with an SMBM intervention (the Living Well with COPD programme). Changes were assessed in readiness to change (stage of change visual analogue scale [VAS]), motivation (Treatment Self-Regulation Questionnaire [TSRQ]) and confidence (Perceived Competence Scale [PCS]) to engage in PA. Results PA was increased in all patients with complete PA data at Week 12 (n=262; +6038 steps·week−1, p<0.001). Significant increases were observed in patients' readiness to change (VAS 0.7 [0.6–0.8]), autonomous regulation (TRSQ 0.2 [0.1–0.3]) and confidence (PCS 0.5 [0.3–0.6]) (all p<0.01). Of note, 23% of the total effect of SMBM on steps·week−1 was found to be mediated by increases in readiness to change, 5% by TSRQ autonomous regulation and 12% by PCS. Conclusion Our study demonstrated that an SMBM programme delivered to COPD patients increased PA, mediated by an improvement of three key hypothesised mechanisms of change: readiness to change, autonomous motivation and confidence. For the first time, this study shows that an SMBM programme can be successful in altering the mechanisms of change targeted by the intervention. Medicine R Maria Sedeno verfasserin aut Pei Zhi Li verfasserin aut Thierry Troosters verfasserin aut Alan Hamilton verfasserin aut Dorothy De Sousa verfasserin aut François Maltais verfasserin aut Damijan Erzen verfasserin aut Kim L. Lavoie verfasserin aut In ERJ Open Research European Respiratory Society, 2015 7(2021), 1 (DE-627)830141227 (DE-600)2827830-6 23120541 nnns volume:7 year:2021 number:1 https://doi.org/10.1183/23120541.00533-2020 kostenfrei https://doaj.org/article/9ca388a39de148a9834c340d2f61a5c3 kostenfrei http://openres.ersjournals.com/content/7/1/00533-2020.full kostenfrei https://doaj.org/toc/2312-0541 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 7 2021 1
spelling	10.1183/23120541.00533-2020 doi (DE-627)DOAJ007985932 (DE-599)DOAJ9ca388a39de148a9834c340d2f61a5c3 DE-627 ger DE-627 rakwb eng Jean Bourbeau verfasserin aut Mechanisms associated with increased physical activity in patients undergoing self-management behaviour modification in the randomised PHYSACTO trial 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction In this analysis of the PHYSACTO® study, we assessed the efficacy of a self-management behaviour modification (SMBM) programme to improve physical activity (PA) levels, and the extent to which effects were mediated by readiness to change, motivation and confidence. Methods PHYSACTO® was a randomised, partially double-blind, parallel-group, 12-week trial to evaluate the effects of treatment on exercise capacity and PA. COPD patients received placebo, tiotropium 5 µg or tiotropium/olodaterol 5/5 µg, with or without exercise training, all with an SMBM intervention (the Living Well with COPD programme). Changes were assessed in readiness to change (stage of change visual analogue scale [VAS]), motivation (Treatment Self-Regulation Questionnaire [TSRQ]) and confidence (Perceived Competence Scale [PCS]) to engage in PA. Results PA was increased in all patients with complete PA data at Week 12 (n=262; +6038 steps·week−1, p<0.001). Significant increases were observed in patients' readiness to change (VAS 0.7 [0.6–0.8]), autonomous regulation (TRSQ 0.2 [0.1–0.3]) and confidence (PCS 0.5 [0.3–0.6]) (all p<0.01). Of note, 23% of the total effect of SMBM on steps·week−1 was found to be mediated by increases in readiness to change, 5% by TSRQ autonomous regulation and 12% by PCS. Conclusion Our study demonstrated that an SMBM programme delivered to COPD patients increased PA, mediated by an improvement of three key hypothesised mechanisms of change: readiness to change, autonomous motivation and confidence. For the first time, this study shows that an SMBM programme can be successful in altering the mechanisms of change targeted by the intervention. Medicine R Maria Sedeno verfasserin aut Pei Zhi Li verfasserin aut Thierry Troosters verfasserin aut Alan Hamilton verfasserin aut Dorothy De Sousa verfasserin aut François Maltais verfasserin aut Damijan Erzen verfasserin aut Kim L. Lavoie verfasserin aut In ERJ Open Research European Respiratory Society, 2015 7(2021), 1 (DE-627)830141227 (DE-600)2827830-6 23120541 nnns volume:7 year:2021 number:1 https://doi.org/10.1183/23120541.00533-2020 kostenfrei https://doaj.org/article/9ca388a39de148a9834c340d2f61a5c3 kostenfrei http://openres.ersjournals.com/content/7/1/00533-2020.full kostenfrei https://doaj.org/toc/2312-0541 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 7 2021 1
allfields_unstemmed	10.1183/23120541.00533-2020 doi (DE-627)DOAJ007985932 (DE-599)DOAJ9ca388a39de148a9834c340d2f61a5c3 DE-627 ger DE-627 rakwb eng Jean Bourbeau verfasserin aut Mechanisms associated with increased physical activity in patients undergoing self-management behaviour modification in the randomised PHYSACTO trial 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction In this analysis of the PHYSACTO® study, we assessed the efficacy of a self-management behaviour modification (SMBM) programme to improve physical activity (PA) levels, and the extent to which effects were mediated by readiness to change, motivation and confidence. Methods PHYSACTO® was a randomised, partially double-blind, parallel-group, 12-week trial to evaluate the effects of treatment on exercise capacity and PA. COPD patients received placebo, tiotropium 5 µg or tiotropium/olodaterol 5/5 µg, with or without exercise training, all with an SMBM intervention (the Living Well with COPD programme). Changes were assessed in readiness to change (stage of change visual analogue scale [VAS]), motivation (Treatment Self-Regulation Questionnaire [TSRQ]) and confidence (Perceived Competence Scale [PCS]) to engage in PA. Results PA was increased in all patients with complete PA data at Week 12 (n=262; +6038 steps·week−1, p<0.001). Significant increases were observed in patients' readiness to change (VAS 0.7 [0.6–0.8]), autonomous regulation (TRSQ 0.2 [0.1–0.3]) and confidence (PCS 0.5 [0.3–0.6]) (all p<0.01). Of note, 23% of the total effect of SMBM on steps·week−1 was found to be mediated by increases in readiness to change, 5% by TSRQ autonomous regulation and 12% by PCS. Conclusion Our study demonstrated that an SMBM programme delivered to COPD patients increased PA, mediated by an improvement of three key hypothesised mechanisms of change: readiness to change, autonomous motivation and confidence. For the first time, this study shows that an SMBM programme can be successful in altering the mechanisms of change targeted by the intervention. Medicine R Maria Sedeno verfasserin aut Pei Zhi Li verfasserin aut Thierry Troosters verfasserin aut Alan Hamilton verfasserin aut Dorothy De Sousa verfasserin aut François Maltais verfasserin aut Damijan Erzen verfasserin aut Kim L. Lavoie verfasserin aut In ERJ Open Research European Respiratory Society, 2015 7(2021), 1 (DE-627)830141227 (DE-600)2827830-6 23120541 nnns volume:7 year:2021 number:1 https://doi.org/10.1183/23120541.00533-2020 kostenfrei https://doaj.org/article/9ca388a39de148a9834c340d2f61a5c3 kostenfrei http://openres.ersjournals.com/content/7/1/00533-2020.full kostenfrei https://doaj.org/toc/2312-0541 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 7 2021 1
allfieldsGer	10.1183/23120541.00533-2020 doi (DE-627)DOAJ007985932 (DE-599)DOAJ9ca388a39de148a9834c340d2f61a5c3 DE-627 ger DE-627 rakwb eng Jean Bourbeau verfasserin aut Mechanisms associated with increased physical activity in patients undergoing self-management behaviour modification in the randomised PHYSACTO trial 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction In this analysis of the PHYSACTO® study, we assessed the efficacy of a self-management behaviour modification (SMBM) programme to improve physical activity (PA) levels, and the extent to which effects were mediated by readiness to change, motivation and confidence. Methods PHYSACTO® was a randomised, partially double-blind, parallel-group, 12-week trial to evaluate the effects of treatment on exercise capacity and PA. COPD patients received placebo, tiotropium 5 µg or tiotropium/olodaterol 5/5 µg, with or without exercise training, all with an SMBM intervention (the Living Well with COPD programme). Changes were assessed in readiness to change (stage of change visual analogue scale [VAS]), motivation (Treatment Self-Regulation Questionnaire [TSRQ]) and confidence (Perceived Competence Scale [PCS]) to engage in PA. Results PA was increased in all patients with complete PA data at Week 12 (n=262; +6038 steps·week−1, p<0.001). Significant increases were observed in patients' readiness to change (VAS 0.7 [0.6–0.8]), autonomous regulation (TRSQ 0.2 [0.1–0.3]) and confidence (PCS 0.5 [0.3–0.6]) (all p<0.01). Of note, 23% of the total effect of SMBM on steps·week−1 was found to be mediated by increases in readiness to change, 5% by TSRQ autonomous regulation and 12% by PCS. Conclusion Our study demonstrated that an SMBM programme delivered to COPD patients increased PA, mediated by an improvement of three key hypothesised mechanisms of change: readiness to change, autonomous motivation and confidence. For the first time, this study shows that an SMBM programme can be successful in altering the mechanisms of change targeted by the intervention. Medicine R Maria Sedeno verfasserin aut Pei Zhi Li verfasserin aut Thierry Troosters verfasserin aut Alan Hamilton verfasserin aut Dorothy De Sousa verfasserin aut François Maltais verfasserin aut Damijan Erzen verfasserin aut Kim L. Lavoie verfasserin aut In ERJ Open Research European Respiratory Society, 2015 7(2021), 1 (DE-627)830141227 (DE-600)2827830-6 23120541 nnns volume:7 year:2021 number:1 https://doi.org/10.1183/23120541.00533-2020 kostenfrei https://doaj.org/article/9ca388a39de148a9834c340d2f61a5c3 kostenfrei http://openres.ersjournals.com/content/7/1/00533-2020.full kostenfrei https://doaj.org/toc/2312-0541 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 7 2021 1
allfieldsSound	10.1183/23120541.00533-2020 doi (DE-627)DOAJ007985932 (DE-599)DOAJ9ca388a39de148a9834c340d2f61a5c3 DE-627 ger DE-627 rakwb eng Jean Bourbeau verfasserin aut Mechanisms associated with increased physical activity in patients undergoing self-management behaviour modification in the randomised PHYSACTO trial 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction In this analysis of the PHYSACTO® study, we assessed the efficacy of a self-management behaviour modification (SMBM) programme to improve physical activity (PA) levels, and the extent to which effects were mediated by readiness to change, motivation and confidence. Methods PHYSACTO® was a randomised, partially double-blind, parallel-group, 12-week trial to evaluate the effects of treatment on exercise capacity and PA. COPD patients received placebo, tiotropium 5 µg or tiotropium/olodaterol 5/5 µg, with or without exercise training, all with an SMBM intervention (the Living Well with COPD programme). Changes were assessed in readiness to change (stage of change visual analogue scale [VAS]), motivation (Treatment Self-Regulation Questionnaire [TSRQ]) and confidence (Perceived Competence Scale [PCS]) to engage in PA. Results PA was increased in all patients with complete PA data at Week 12 (n=262; +6038 steps·week−1, p<0.001). Significant increases were observed in patients' readiness to change (VAS 0.7 [0.6–0.8]), autonomous regulation (TRSQ 0.2 [0.1–0.3]) and confidence (PCS 0.5 [0.3–0.6]) (all p<0.01). Of note, 23% of the total effect of SMBM on steps·week−1 was found to be mediated by increases in readiness to change, 5% by TSRQ autonomous regulation and 12% by PCS. Conclusion Our study demonstrated that an SMBM programme delivered to COPD patients increased PA, mediated by an improvement of three key hypothesised mechanisms of change: readiness to change, autonomous motivation and confidence. For the first time, this study shows that an SMBM programme can be successful in altering the mechanisms of change targeted by the intervention. Medicine R Maria Sedeno verfasserin aut Pei Zhi Li verfasserin aut Thierry Troosters verfasserin aut Alan Hamilton verfasserin aut Dorothy De Sousa verfasserin aut François Maltais verfasserin aut Damijan Erzen verfasserin aut Kim L. Lavoie verfasserin aut In ERJ Open Research European Respiratory Society, 2015 7(2021), 1 (DE-627)830141227 (DE-600)2827830-6 23120541 nnns volume:7 year:2021 number:1 https://doi.org/10.1183/23120541.00533-2020 kostenfrei https://doaj.org/article/9ca388a39de148a9834c340d2f61a5c3 kostenfrei http://openres.ersjournals.com/content/7/1/00533-2020.full kostenfrei https://doaj.org/toc/2312-0541 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 7 2021 1
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Methods PHYSACTO® was a randomised, partially double-blind, parallel-group, 12-week trial to evaluate the effects of treatment on exercise capacity and PA. COPD patients received placebo, tiotropium 5 µg or tiotropium/olodaterol 5/5 µg, with or without exercise training, all with an SMBM intervention (the Living Well with COPD programme). Changes were assessed in readiness to change (stage of change visual analogue scale [VAS]), motivation (Treatment Self-Regulation Questionnaire [TSRQ]) and confidence (Perceived Competence Scale [PCS]) to engage in PA. Results PA was increased in all patients with complete PA data at Week 12 (n=262; +6038 steps·week−1, p<0.001). Significant increases were observed in patients' readiness to change (VAS 0.7 [0.6–0.8]), autonomous regulation (TRSQ 0.2 [0.1–0.3]) and confidence (PCS 0.5 [0.3–0.6]) (all p<0.01). Of note, 23% of the total effect of SMBM on steps·week−1 was found to be mediated by increases in readiness to change, 5% by TSRQ autonomous regulation and 12% by PCS. Conclusion Our study demonstrated that an SMBM programme delivered to COPD patients increased PA, mediated by an improvement of three key hypothesised mechanisms of change: readiness to change, autonomous motivation and confidence. 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author	Jean Bourbeau
spellingShingle	Jean Bourbeau misc Medicine misc R Mechanisms associated with increased physical activity in patients undergoing self-management behaviour modification in the randomised PHYSACTO trial
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topic_title	Mechanisms associated with increased physical activity in patients undergoing self-management behaviour modification in the randomised PHYSACTO trial
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title	Mechanisms associated with increased physical activity in patients undergoing self-management behaviour modification in the randomised PHYSACTO trial
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author_browse	Jean Bourbeau Maria Sedeno Pei Zhi Li Thierry Troosters Alan Hamilton Dorothy De Sousa François Maltais Damijan Erzen Kim L. Lavoie
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title_sort	mechanisms associated with increased physical activity in patients undergoing self-management behaviour modification in the randomised physacto trial
title_auth	Mechanisms associated with increased physical activity in patients undergoing self-management behaviour modification in the randomised PHYSACTO trial
abstract	Introduction In this analysis of the PHYSACTO® study, we assessed the efficacy of a self-management behaviour modification (SMBM) programme to improve physical activity (PA) levels, and the extent to which effects were mediated by readiness to change, motivation and confidence. Methods PHYSACTO® was a randomised, partially double-blind, parallel-group, 12-week trial to evaluate the effects of treatment on exercise capacity and PA. COPD patients received placebo, tiotropium 5 µg or tiotropium/olodaterol 5/5 µg, with or without exercise training, all with an SMBM intervention (the Living Well with COPD programme). Changes were assessed in readiness to change (stage of change visual analogue scale [VAS]), motivation (Treatment Self-Regulation Questionnaire [TSRQ]) and confidence (Perceived Competence Scale [PCS]) to engage in PA. Results PA was increased in all patients with complete PA data at Week 12 (n=262; +6038 steps·week−1, p<0.001). Significant increases were observed in patients' readiness to change (VAS 0.7 [0.6–0.8]), autonomous regulation (TRSQ 0.2 [0.1–0.3]) and confidence (PCS 0.5 [0.3–0.6]) (all p<0.01). Of note, 23% of the total effect of SMBM on steps·week−1 was found to be mediated by increases in readiness to change, 5% by TSRQ autonomous regulation and 12% by PCS. Conclusion Our study demonstrated that an SMBM programme delivered to COPD patients increased PA, mediated by an improvement of three key hypothesised mechanisms of change: readiness to change, autonomous motivation and confidence. For the first time, this study shows that an SMBM programme can be successful in altering the mechanisms of change targeted by the intervention.
abstractGer	Introduction In this analysis of the PHYSACTO® study, we assessed the efficacy of a self-management behaviour modification (SMBM) programme to improve physical activity (PA) levels, and the extent to which effects were mediated by readiness to change, motivation and confidence. Methods PHYSACTO® was a randomised, partially double-blind, parallel-group, 12-week trial to evaluate the effects of treatment on exercise capacity and PA. COPD patients received placebo, tiotropium 5 µg or tiotropium/olodaterol 5/5 µg, with or without exercise training, all with an SMBM intervention (the Living Well with COPD programme). Changes were assessed in readiness to change (stage of change visual analogue scale [VAS]), motivation (Treatment Self-Regulation Questionnaire [TSRQ]) and confidence (Perceived Competence Scale [PCS]) to engage in PA. Results PA was increased in all patients with complete PA data at Week 12 (n=262; +6038 steps·week−1, p<0.001). Significant increases were observed in patients' readiness to change (VAS 0.7 [0.6–0.8]), autonomous regulation (TRSQ 0.2 [0.1–0.3]) and confidence (PCS 0.5 [0.3–0.6]) (all p<0.01). Of note, 23% of the total effect of SMBM on steps·week−1 was found to be mediated by increases in readiness to change, 5% by TSRQ autonomous regulation and 12% by PCS. Conclusion Our study demonstrated that an SMBM programme delivered to COPD patients increased PA, mediated by an improvement of three key hypothesised mechanisms of change: readiness to change, autonomous motivation and confidence. For the first time, this study shows that an SMBM programme can be successful in altering the mechanisms of change targeted by the intervention.
abstract_unstemmed	Introduction In this analysis of the PHYSACTO® study, we assessed the efficacy of a self-management behaviour modification (SMBM) programme to improve physical activity (PA) levels, and the extent to which effects were mediated by readiness to change, motivation and confidence. Methods PHYSACTO® was a randomised, partially double-blind, parallel-group, 12-week trial to evaluate the effects of treatment on exercise capacity and PA. COPD patients received placebo, tiotropium 5 µg or tiotropium/olodaterol 5/5 µg, with or without exercise training, all with an SMBM intervention (the Living Well with COPD programme). Changes were assessed in readiness to change (stage of change visual analogue scale [VAS]), motivation (Treatment Self-Regulation Questionnaire [TSRQ]) and confidence (Perceived Competence Scale [PCS]) to engage in PA. Results PA was increased in all patients with complete PA data at Week 12 (n=262; +6038 steps·week−1, p<0.001). Significant increases were observed in patients' readiness to change (VAS 0.7 [0.6–0.8]), autonomous regulation (TRSQ 0.2 [0.1–0.3]) and confidence (PCS 0.5 [0.3–0.6]) (all p<0.01). Of note, 23% of the total effect of SMBM on steps·week−1 was found to be mediated by increases in readiness to change, 5% by TSRQ autonomous regulation and 12% by PCS. Conclusion Our study demonstrated that an SMBM programme delivered to COPD patients increased PA, mediated by an improvement of three key hypothesised mechanisms of change: readiness to change, autonomous motivation and confidence. For the first time, this study shows that an SMBM programme can be successful in altering the mechanisms of change targeted by the intervention.
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title_short	Mechanisms associated with increased physical activity in patients undergoing self-management behaviour modification in the randomised PHYSACTO trial
url	https://doi.org/10.1183/23120541.00533-2020 https://doaj.org/article/9ca388a39de148a9834c340d2f61a5c3 http://openres.ersjournals.com/content/7/1/00533-2020.full https://doaj.org/toc/2312-0541
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author2	Maria Sedeno Pei Zhi Li Thierry Troosters Alan Hamilton Dorothy De Sousa François Maltais Damijan Erzen Kim L. Lavoie
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Of note, 23% of the total effect of SMBM on steps·week−1 was found to be mediated by increases in readiness to change, 5% by TSRQ autonomous regulation and 12% by PCS. Conclusion Our study demonstrated that an SMBM programme delivered to COPD patients increased PA, mediated by an improvement of three key hypothesised mechanisms of change: readiness to change, autonomous motivation and confidence. 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Mechanisms associated with increased physical activity in patients undergoing self-management behaviour modification in the randomised PHYSACTO trial

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