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Inspiration Point-A Digital Pulmonary Rehabilitation Tool Management Interventions

Primary Purpose

COPD

Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Usual Care Pulmonary Rehabilitation Program
Pulmonary Rehabilitation Software-Based Home Program
Sponsored by
Blue Marble Rehab Inc
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional other trial for COPD focused on measuring pulmonary rehabilitation, digital, telehealth, software, electronic health

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Participants will have physician permission and diagnosis COPD (FEV1 >30%-80%),
  • Gold level A-D, and
  • Ability to perform the 6 Minute Walk Test (6MWT).
  • This means that participants must meet the standard definition of COPD and have a post-bronchodilator measurement of FEV1/FVC < 0.7.
  • All COPD Assessment Test scores will be accepted.
  • Patients must have an mMRC score = 1-4.
  • Additionally, patients must have taken a Pulmonary Function Test within 1 year or they must retake (for baseline measurement) before participating in the study.
  • Patients must not have had a Pulmonary Rehabilitation class within the last 6 months.
  • If participants have had a recent cardiac event within 6 months (such as a myocardial infarction or an abnormal cardiac catheterization) they must obtain cardiologist approval before participating in the study.
  • In an effort to evaluate feasibility we will request that participants have their own Wi-Fi. Participants may use their own mobile device if they prefer but Blue Marble will have ample supply to provide to participants a device for the purposes of this study.
  • Target representativeness for gender, based on COPD demography will be ~50% women, based on recent trends indicating that women have an equal, and perhaps slightly greater risk of COPD compared to men3.
  • The Ethnicity/Race target recruitment, consistent with the US and the population at each site.
  • Participants must speak, read, and understand English at or above the 6th-grade level (as indicated by having a driver's license or self-report of completion of some high school).

Exclusion Criteria for participants with COPD:

  • Pulmonary functional fitness that precludes participation in outpatient/home PR program (i.e. requires in-patient supervision or severity of a co-morbidity that represents a contradiction to exercise in a self-directed program) will be exclusionary.
  • A participant who desaturates below SaO2 <88% during the pre-test 6MWT and does not have personal oxygen available will be referred for further evaluation and can be included once they have an O2 titration and supplemental oxygen.
  • Other exclusions include if a patient's oxygen use exceeds 4 liters per minute (LPM) or those who score less than 100 meters during the entry 6-minute walk distance.
  • Participants with coronary problems will be excluded based on specific morbidity and severity. These coronary exclusions include coronary artery disease with unstable angina.
  • Additional exclusions include: any respiratory disorder other than COPD that contraindicates participation in a home-based program.
  • The inability to learn how to use Inspiration Point
  • An acute neurological or cardiovascular condition such as stroke or acute heart surgery.
  • Active cancer with an anticipated survival of less than 6 months or treatment that will preclude them from participating in Pulmonary Rehab.
  • A participant with high fall risk as per physician determination.
  • The presence of a neurologic disorder that precludes a potential participant from following a typical COPD exercise program or demonstrating hand function sufficient to interface with the tablet.
  • This also includes patients with prior or current neurologic event/condition presenting fall risk or requiring assist device for ambulation will also be excluded.

Sites / Locations

  • Wake Forest Baptist Health
  • Duke University Healthcare
  • Cabin Creek Health Systems Inc
  • New River Health Association

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Experimental

Arm Label

Usual Care

Software Tool

Arm Description

Participants in the Usual Care Pulmonary Rehabilitation will receive usual care pulmonary rehab program. Usual care programs typically consist of exercises including upper extremity strengthening, lower extremity strengthening, aerobic exercises such as walking and balance training. Each program is personalized as per the participant's ability. The intervention is usual care exercise and education, which is personalized for each participant. No drugs are being tested in this study.

Participants in the Pulmonary Rehabilitation Software-Based Home Program will use a digital software tool (APP) to obtain the pulmonary rehab home program. Home programs typically consist of exercises including upper extremity strengthening, lower extremity strengthening, aerobic exercises such as walking and balance training. Each program is personalized as per the participant's ability. The intervention is exercise and education, which is personalized for each participant. No drugs are being tested in this study.

Outcomes

Primary Outcome Measures

6 Minute Walk Test
Measures distance walked in 6 minutes

Secondary Outcome Measures

Modified Medical Research Council Dyspnea Scale (mMRC)
Single question questionnaire describing shortness of breath. Total Score Range from 0-4, 0 is better.
Medical Outcomes Scale VR-12
Survey of health status and quality of life From (https://www.rand.org/health-care/surveys_tools/mos/36-item-short-form/scoring.html) "Scoring the RAND 36-Item Health Survey is a two-step process. First, precoded numeric values are recoded per the scoring key given in Table 1. Note that all items are scored so that a high score defines a more favorable health state. In addition, each item is scored on a 0 to 100 range so that the lowest and highest possible scores are 0 and 100, respectively. Scores represent the percentage of total possible score achieved. In step 2, items in the same scale are averaged together to create the 8 scale scores. Table 2 lists the items averaged together to create each scale. Items that are left blank (missing data) are not taken into account when calculating the scale scores. Hence, scale scores represent the average for all items in the scale that the respondent answered."
St Georges Respiratory Questionnaire (SGRQ)
A self-administered disease-specific instrument designed to measure the impact on overall health, daily life, and perceived well-being in patients with obstructive airways disease. The questionnaire has 50 items Scores range from 0-100, with higher scores indicating more limitations https://www.thoracic.org/members/assemblies/assemblies/srn/questionaires/sgrq.php
Lung Information Needs Questionnaire (LINQ)
The questionnaire used to identify a person with COPD's need for information about their disease. The questionnaire measures the extent to which the patient needs more information, as perceived by the patient and clinician. It is scored to produce an overall score and 6 domain scores (Disease knowledge, medicines, self-management, exercise, diet, smoking). The score is the sum of all 6 domains with a range from 0-25. High scores indicate high information needs, a lower score is better.
Software Usability Scale (SUS)
Measures usability and learnability of software tools. Total Score provides percentile score indicating usability/learnability. Range 0-100, Higher (100%) is better.
Timed Up and Go Test (TUG)
Measures the time taken to stand up from a chair, walk 10 feet, turn around, and return to sitting.
30 Second Sit to Stand Test (30STST)
Measures the number of times a participant can stand from a seated position in 30 seconds
4 Stage Balance Test (4SBT)
Measures balance in 4 increasing more challenging positions
COPD Assessment Test (CAT)
An 8 item test which measures the effect of COPD on a patient's overall health. The items on this test measure a patient's cough, sputum, breathlessness, chest tightness, confidence, activity, sleep and energy levels
Depression Screen (DS)
A 2 question survey which can be used to evaluate your risk of depression
Charlson Index (CCI)
The Charlson comorbidity index predicts the one-year mortality for a patient who may have a range of comorbid conditions, such as heart disease or cancer (a total of 22 conditions). This index is helpful to ensure the groups are equal for the study comparison and statistics.
Fall Risk Questionnaire (FRQ)
The FRQ is comprised of 13 questions about a person's history of falls and potential fall risk.
Positive Affect and Well-Being Short Form (PROMIS)
This test is a health-related quality of life questionnaire.
Single Item Literacy Screener (SILS)
The SILS is a single item survey which determines literacy and health literacy. It is a direct assessment of a patient's need for assistance in reading health materials.

Full Information

First Posted
August 9, 2017
Last Updated
June 8, 2023
Sponsor
Blue Marble Rehab Inc
Collaborators
Wake Forest University Health Sciences
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1. Study Identification

Unique Protocol Identification Number
NCT03801330
Brief Title
Inspiration Point-A Digital Pulmonary Rehabilitation Tool Management Interventions
Official Title
Inspiration Point-A Digital Pulmonary Rehabilitation Tool for Use With Self- Management Interventions
Study Type
Interventional

2. Study Status

Record Verification Date
June 2023
Overall Recruitment Status
Completed
Study Start Date
November 1, 2020 (Actual)
Primary Completion Date
April 25, 2023 (Actual)
Study Completion Date
April 25, 2023 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Blue Marble Rehab Inc
Collaborators
Wake Forest University Health Sciences

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to measure the feasibility of use of a digital pulmonary rehabilitation tool compared with standard care home program pulmonary rehabilitation.
Detailed Description
The study design is a between subjects (Usual care/App) repeated measures (pre/post) design to compare the feasibility of usual care compared with the digital app, Inspiration Point, used in the home for 8 weeks.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
COPD
Keywords
pulmonary rehabilitation, digital, telehealth, software, electronic health

7. Study Design

Primary Purpose
Other
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
48 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Usual Care
Arm Type
Active Comparator
Arm Description
Participants in the Usual Care Pulmonary Rehabilitation will receive usual care pulmonary rehab program. Usual care programs typically consist of exercises including upper extremity strengthening, lower extremity strengthening, aerobic exercises such as walking and balance training. Each program is personalized as per the participant's ability. The intervention is usual care exercise and education, which is personalized for each participant. No drugs are being tested in this study.
Arm Title
Software Tool
Arm Type
Experimental
Arm Description
Participants in the Pulmonary Rehabilitation Software-Based Home Program will use a digital software tool (APP) to obtain the pulmonary rehab home program. Home programs typically consist of exercises including upper extremity strengthening, lower extremity strengthening, aerobic exercises such as walking and balance training. Each program is personalized as per the participant's ability. The intervention is exercise and education, which is personalized for each participant. No drugs are being tested in this study.
Intervention Type
Other
Intervention Name(s)
Usual Care Pulmonary Rehabilitation Program
Intervention Description
Participants in the Usual Care Pulmonary Rehabilitation Program group will complete an 8 week clinic based Pulmonary Rehabilitation Program (usual care).
Intervention Type
Other
Intervention Name(s)
Pulmonary Rehabilitation Software-Based Home Program
Intervention Description
Participants in the Pulmonary Rehabilitation Software-Based Home Program group will complete an 8-week home-based Pulmonary Rehabilitation Program using a software app (software)
Primary Outcome Measure Information:
Title
6 Minute Walk Test
Description
Measures distance walked in 6 minutes
Time Frame
Change from baseline 6 Minute Walk Test score at 2 months
Secondary Outcome Measure Information:
Title
Modified Medical Research Council Dyspnea Scale (mMRC)
Description
Single question questionnaire describing shortness of breath. Total Score Range from 0-4, 0 is better.
Time Frame
Change from baseline Modified Medical Research Council Dyspnea Scale (mMRC) score at 2 months
Title
Medical Outcomes Scale VR-12
Description
Survey of health status and quality of life From (https://www.rand.org/health-care/surveys_tools/mos/36-item-short-form/scoring.html) "Scoring the RAND 36-Item Health Survey is a two-step process. First, precoded numeric values are recoded per the scoring key given in Table 1. Note that all items are scored so that a high score defines a more favorable health state. In addition, each item is scored on a 0 to 100 range so that the lowest and highest possible scores are 0 and 100, respectively. Scores represent the percentage of total possible score achieved. In step 2, items in the same scale are averaged together to create the 8 scale scores. Table 2 lists the items averaged together to create each scale. Items that are left blank (missing data) are not taken into account when calculating the scale scores. Hence, scale scores represent the average for all items in the scale that the respondent answered."
Time Frame
Change from baseline VR-12 score at 2 months
Title
St Georges Respiratory Questionnaire (SGRQ)
Description
A self-administered disease-specific instrument designed to measure the impact on overall health, daily life, and perceived well-being in patients with obstructive airways disease. The questionnaire has 50 items Scores range from 0-100, with higher scores indicating more limitations https://www.thoracic.org/members/assemblies/assemblies/srn/questionaires/sgrq.php
Time Frame
Change from baseline St Georges Questionnaire score at 2 months
Title
Lung Information Needs Questionnaire (LINQ)
Description
The questionnaire used to identify a person with COPD's need for information about their disease. The questionnaire measures the extent to which the patient needs more information, as perceived by the patient and clinician. It is scored to produce an overall score and 6 domain scores (Disease knowledge, medicines, self-management, exercise, diet, smoking). The score is the sum of all 6 domains with a range from 0-25. High scores indicate high information needs, a lower score is better.
Time Frame
Change from baseline Lung Information Needs Questionnaire score at 2 months
Title
Software Usability Scale (SUS)
Description
Measures usability and learnability of software tools. Total Score provides percentile score indicating usability/learnability. Range 0-100, Higher (100%) is better.
Time Frame
Change from baseline Software Usability Scale (SUS)score at 2 months
Title
Timed Up and Go Test (TUG)
Description
Measures the time taken to stand up from a chair, walk 10 feet, turn around, and return to sitting.
Time Frame
Change from baseline TUG score at 2 months
Title
30 Second Sit to Stand Test (30STST)
Description
Measures the number of times a participant can stand from a seated position in 30 seconds
Time Frame
Change from baseline 30STST score at 2 months
Title
4 Stage Balance Test (4SBT)
Description
Measures balance in 4 increasing more challenging positions
Time Frame
Change in 4STBT score at 2 months
Title
COPD Assessment Test (CAT)
Description
An 8 item test which measures the effect of COPD on a patient's overall health. The items on this test measure a patient's cough, sputum, breathlessness, chest tightness, confidence, activity, sleep and energy levels
Time Frame
Change in CAT score at 2 months
Title
Depression Screen (DS)
Description
A 2 question survey which can be used to evaluate your risk of depression
Time Frame
Change in DS score at 2 months
Title
Charlson Index (CCI)
Description
The Charlson comorbidity index predicts the one-year mortality for a patient who may have a range of comorbid conditions, such as heart disease or cancer (a total of 22 conditions). This index is helpful to ensure the groups are equal for the study comparison and statistics.
Time Frame
Change in CCI score at 2 months
Title
Fall Risk Questionnaire (FRQ)
Description
The FRQ is comprised of 13 questions about a person's history of falls and potential fall risk.
Time Frame
Change in FRQ score at 2 months
Title
Positive Affect and Well-Being Short Form (PROMIS)
Description
This test is a health-related quality of life questionnaire.
Time Frame
Change in PROMIS score at 2 months
Title
Single Item Literacy Screener (SILS)
Description
The SILS is a single item survey which determines literacy and health literacy. It is a direct assessment of a patient's need for assistance in reading health materials.
Time Frame
Change in SILS score at 2 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Participants will have physician permission and diagnosis COPD (FEV1 >30%-80%), Gold level A-D, and Ability to perform the 6 Minute Walk Test (6MWT). This means that participants must meet the standard definition of COPD and have a post-bronchodilator measurement of FEV1/FVC < 0.7. All COPD Assessment Test scores will be accepted. Patients must have an mMRC score = 1-4. Additionally, patients must have taken a Pulmonary Function Test within 1 year or they must retake (for baseline measurement) before participating in the study. Patients must not have had a Pulmonary Rehabilitation class within the last 6 months. If participants have had a recent cardiac event within 6 months (such as a myocardial infarction or an abnormal cardiac catheterization) they must obtain cardiologist approval before participating in the study. In an effort to evaluate feasibility we will request that participants have their own Wi-Fi. Participants may use their own mobile device if they prefer but Blue Marble will have ample supply to provide to participants a device for the purposes of this study. Target representativeness for gender, based on COPD demography will be ~50% women, based on recent trends indicating that women have an equal, and perhaps slightly greater risk of COPD compared to men3. The Ethnicity/Race target recruitment, consistent with the US and the population at each site. Participants must speak, read, and understand English at or above the 6th-grade level (as indicated by having a driver's license or self-report of completion of some high school). Exclusion Criteria for participants with COPD: Pulmonary functional fitness that precludes participation in outpatient/home PR program (i.e. requires in-patient supervision or severity of a co-morbidity that represents a contradiction to exercise in a self-directed program) will be exclusionary. A participant who desaturates below SaO2 <88% during the pre-test 6MWT and does not have personal oxygen available will be referred for further evaluation and can be included once they have an O2 titration and supplemental oxygen. Other exclusions include if a patient's oxygen use exceeds 4 liters per minute (LPM) or those who score less than 100 meters during the entry 6-minute walk distance. Participants with coronary problems will be excluded based on specific morbidity and severity. These coronary exclusions include coronary artery disease with unstable angina. Additional exclusions include: any respiratory disorder other than COPD that contraindicates participation in a home-based program. The inability to learn how to use Inspiration Point An acute neurological or cardiovascular condition such as stroke or acute heart surgery. Active cancer with an anticipated survival of less than 6 months or treatment that will preclude them from participating in Pulmonary Rehab. A participant with high fall risk as per physician determination. The presence of a neurologic disorder that precludes a potential participant from following a typical COPD exercise program or demonstrating hand function sufficient to interface with the tablet. This also includes patients with prior or current neurologic event/condition presenting fall risk or requiring assist device for ambulation will also be excluded.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Sheryl Flynn, PT PhD
Organizational Affiliation
Blue Marble Health
Official's Role
Principal Investigator
Facility Information:
Facility Name
Wake Forest Baptist Health
City
Charlotte
State/Province
North Carolina
ZIP/Postal Code
28203
Country
United States
Facility Name
Duke University Healthcare
City
Durham
State/Province
North Carolina
ZIP/Postal Code
27705
Country
United States
Facility Name
Cabin Creek Health Systems Inc
City
Dawes
State/Province
West Virginia
ZIP/Postal Code
25054
Country
United States
Facility Name
New River Health Association
City
Scarbro
State/Province
West Virginia
ZIP/Postal Code
25917
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No
IPD Sharing Plan Description
To be determined

Learn more about this trial

Inspiration Point-A Digital Pulmonary Rehabilitation Tool Management Interventions

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