The PROactive innovative conceptual framework on physical activity.

Area of Science:

• Pulmonary Medicine
• Patient-Reported Outcomes
• Health Psychology

Background:

• Physical activity is a key therapeutic target in Chronic Obstructive Pulmonary Disease (COPD).
• The patient perspective on physical activity and its measurement in COPD remains poorly understood.
• Existing measures may not fully capture the lived experience of physical activity for COPD patients.

Purpose of the Study:

• To develop and content-validate patient-reported outcome (PRO) instruments measuring physical activity from the COPD patient's perspective.
• To gain comprehensive insight into what physical activity means to individuals with COPD.
• To identify key themes related to physical activity, including impact, symptoms, and adaptations.

Main Methods:

• A conceptual framework guided the development of the PROactive PRO instruments.
• Qualitative studies involving 116 COPD patients across four European countries included interviews and focus groups.
• Cognitive debriefings with 39 patients refined item clarity and instructions.

Main Results:

• Three core themes emerged: impact of COPD on physical activity amount, symptoms during activity, and adaptations made.
• These themes were consistent across diverse countries, demographics, and COPD phenotypes (Global Initiative for Chronic Obstructive Lung Disease stages).
• The process resulted in two instruments: one with 30 items (daily recall) and another with 34 items (7-day recall).

Conclusions:

• This study provides the first comprehensive insight into physical activity from the COPD patient's viewpoint.
• The PROactive PRO instruments demonstrate content validity, forming a basis for further empirical validation.
• These tools can improve the assessment of physical activity in COPD clinical practice and research.