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The goal of this pre-post design clinical trial is to develop a digital, theory-based Pursed Lip Breathing intervention protocol software system installed on smartphones (DT-PLB) and to preliminarily evaluate its feasibility and effects in stable Chronic Obstructive Pulmonary Disease (COPD). The main objectives are:
Participants will perform the following tasks during the intervention:
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Digital PLB intervention | Experimental | Participants will perform the following tasks during the intervention:
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Digital pursed lip breathing intervention | Other | After registration, participants will watch an educational video on the developed software, covering the definition, benefits, and techniques of pursed lip breathing. Following this, participants will engage in pursed lip breathing interventions, guided by voice and animated instructions from the software. These sessions will occur three times daily (morning, afternoon, and night) for 10 minutes each, lasting for 8 weeks. After each session, participants can choose to post texts on a peer social forum for peer support. Fellow participants can give 'comments' or 'likes'. The principal researcher will oversee texts, peer comments, removing information containing personal data, medical recommendations, and negative comments. Additionally, participants can earn health points by performing specific actions (e.g., watching the educational video and practicing pursed lip breathing) on the software, encouraging their participation in related activities. |
| Measure | Description | Time Frame |
|---|---|---|
| Recruitment rate | The number of participants who participate in the study divided by the number of participants eligible for participation | From baseline (T1) to the completion of the 8-week intervention (T2) |
| Retention rate | The number of subjects who complete the study divided by the number of subjects who participate in the study | From baseline (T1) to the completion of the 8-week intervention (T2) |
| Attrition rate | The number of subjects who drop out after participation divided by the number of subjects who participate in the study | From baseline (T1) to the completion of the 8-week intervention (T2) |
| Software usage Compliance | The compliance rate is one of compliance outcomes, reflecting the level of patient engagement in the intervention. Overall compliance will be defined as the compliance averaged in all patients. Compliance rate = (actual number of participation in the intervention/planned number of sessions)x 100%. In addition, minutes-consuming recorded on the software for participants during the research will be used to complement outcome measures of compliance. | Immediately after completion of the 8-week intervention |
| Adverse events associated with the DT-PLB intervention | In each DT-PLB session, the participants during the intervention will record whether they had any uncomfortable feelings | Immediately after completion of the 8-week intervention |
| Measure | Description | Time Frame |
|---|---|---|
| mMRC Dyspnea Scale | The Modified Medical Research Council (mMRC) Dyspnea Scale consists of five categories, ranging from 0 to 4, with higher scores indicating more severe breathlessness. A score of 0 indicates no breathlessness during activities, while a score of 4 suggests breathlessness. | From baseline (T1) to the completion of the 8-week intervention (T2) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Houqiang Huang, Master | Contact | +8618715799162 | 21442584@stu.mmu.ac.uk |
| Name | Affiliation | Role |
|---|---|---|
| Houqiang Huang, Master | Manchster Metropolitan University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| The Affiliated Hospital of Southwest Medical University | Luzhou | Sichuan | 646000 | China |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 40147988 | Derived | Huang H, Liu F, Mohammad M, Watson R, Hayter M, Huang M, Li Z. Digital gamification-based pursed lip breathing exercises driven by Behaviour Change Wheel in patients with COPD: a feasibility trial protocol using pre-post study design. BMJ Open. 2025 Mar 27;15(3):e090832. doi: 10.1136/bmjopen-2024-090832. |
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| ID | Term |
|---|---|
| D029424 | Pulmonary Disease, Chronic Obstructive |
| ID | Term |
|---|---|
| D008173 | Lung Diseases, Obstructive |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
| D002908 | Chronic Disease |
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| CAT scale | COPD assessment test (CAT)is a questionnaire-based tool that is commonly used to assess the impact of chronic obstructive pulmonary disease (COPD)on a patient's health status and quality of life. It consists of eight questions that cover a range of symptoms, including cough, sputum production, breathlessness, chest tightness, and activity limitations. Each question on the CAT is scored on a scale from 0 to 5, with a maximum possible score of 40. A higher score indicates a greater degree of symptom severity and a poorer health status. | From baseline (T1) to the completion of the 8-week intervention (T2) |
| The System Usability Scale | The system usability scale (SUS)is a standardized questionnaire that is used to evaluate the usability and user experience of a wide range of products, services, and systems. It produces a score between 0 and 100, with higher scores indicating better usability and user experience. The SUS has been validated and is widely used in both industry and research settings to evaluate the usability and user experience of a wide range of systems and products, including software applications, websites, and medical devices. | Immediately after completion of the 8-week intervention (T2) |
| Participants overall satisfaction | Participants will be required to rate their satisfaction with this software intervention, with a 10-point numeric rating scale (NRS) , where "1" represents "very dissatisfied" and "10" means "very satisfied". | Immediately after completion of the 8-week intervention (T2) |
| Six-minute-walking test | The Six-Minute Walk Test is a commonly used measure of functional exercise | From baseline (T1) to the completion of the 8-week intervention (T2) |
| Pulmonary function index:FEV1%predicted, FEV1/FVC | FEV1%predicted stands for "forced expiratory volume in one second predicted" and is a measure of lung function. It represents the maximum amount of air that a person can forcefully exhale from their lungs in one second. FEV1%predicted is expressed as a percentage of the predicted value for someone with the same characteristics who does not have lung disease. FEV1/FVC is another measure of lung function, which represents the ratio of the amount of air that a person can forcefully exhale in one second (FEV1)to the total amount of air that they can exhale(forced vital capacity or FVC)over the course of a full exhalation. A low FEV1/FVC ratio indicates that the airways are obstructed or narrowed, which is a characteristic feature of COPD. | From baseline (T1) to the completion of the 8-week intervention (T2) |
| Health points obtained by each participant performing formulated operations | Health points are set based on consensus, obtained by operating actions on this software:
| Immediately after completion of the 8-week intervention |
| D020969 |
| Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |