What are the PROactive instruments?

The Clinical visit version of PROactive Physical Activity in COPD (C-PPAC) and the Daily visit version of PROactive Physical Activity in COPD (D-PPAC), also known as the PROactive instruments, are two Patient Reported Outcomes (PROs), developed to assess the physical activity experience of people living with chronic obstructive pulmonary disease (COPD). They are considered hybrid instruments, as they combine data arising from questionnaires and from objective measures of physical activity via activity monitors.

Why are they important?

Physical activity is key for people with COPD. However, evidence shows that: (i) it is negatively impacted by the presence of the disease1-4; (ii) the inability to perform daily activities is one of the major concerns of patients with COPD5; and (iii) physical inactivity contributes to a worse disease prognosis6-7 .

A comprehensive assessment of physical activity in COPD requires both an objective evaluation (to measure frequency, intensity, time and type) and a subjective evaluation, to capture the experience of those performing the physical activities. As such, the PPAC instruments are the only tool that combines questionnaire items and activity monitor outputs to assess the amount of physical activity and the difficulty during physical activity, as experience by individuals with COPD.

Based on their proven validity, responsiveness and reliability8,9, together with its relative simplicity of measurement and interpretation, the PPAC instruments can and should be used when assessing physical activity in COPD. 

References

  1. Watz H, Pitta F, Rochester CL, Garcia-Aymerich J, ZuWallack R, Troosters T, et al. An official European respiratory society statement on physical activity in COPD. Eur Respir J. 2014;44(6):1521–37.
  2. Waschki B, Kirsten AM, Holz O, Mueller K, Sack A, Meyer T, et al. Disease progression and changes in physical activity in patients with COPD. 2015;1–64
  3. Gimeno-Santos E, Frei A, Steurer-Stey C, De Batlle J, Rabinovich RA, Raste Y, et al. Determinants and outcomes of physical activity in patients with COPD: A systematic review. Thorax. 2014;69(8):731–9. 
  4. Demeyer H, Mohan D, Burtin C, Vaes AW, Heasley M, Bowler MERP, et al. Objectively Measured Physical Activity in Patients with COPD : Recommendations from an International Task Force on Physical Activity. J COPD Found. 2021;8(4):528–50.
  5. Miravitlles M, Anzueto A, Legnani D, Forstmeier L, Fargel M. Patient’s perception of exacerbations of COPD — the PERCEIVE study. 2007;453–60.
  6. Garcia-Aymerich, J., Lange, P., Benet, M., Schnohr, P. & Antó, J. M. Regular physical activity reduces hospital admission and mortality in chronic obstructive pulmonary disease: A population based cohort study. Thorax 61, 772–778 (2006).
  7. Hopkinson, N. S. & Polkey, M. I. Does physical inactivity cause chronic obstructive pulmonary disease ? i, 565–572 (2010)
  8. Garcia-Aymerich J, Puhan MA, Corriol-Rohou S, De Jong C, Demeyer H, Dobbels F, et al. Validity and responsiveness of the Daily-and Clinical visit-PROactive Physical Activity in COPD (D-PPAC and C-PPAC) instruments. Thorax. 2021;76(3):228–38. 
  9. Gimeno-Santos E, Raste Y, Demeyer H, Louvaris Z, Jong C de, Rabinovich RA, et al. The PROactive instruments to measure physical activity in patients with chronic obstructive. Eur Respir J. 2015;46(4):988–1000. 
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