http://bura.brunel.ac.uk/handle/2438/8617 Sun, 03 May 2026 01:16:11 GMT 2026-05-03T01:16:11Z http://bura.brunel.ac.uk/handle/2438/33231 Title: The minimal important deterioration of the incremental shuttle walk test in chronic obstructive pulmonary disease: a prospective cohort study Authors: Jenkins, TO; Edwards, GD; Patel, S; Canavan, J; Kon, S; Barker, RE; Jones, S; Walsh, JA; Ingram, K; Nolan, CM; Man, WD-C Abstract: Introduction: The incremental shuttle walk test (ISWT) is a standardized field walking test used to assess cardiorespiratory fitness, particularly in individuals with chronic cardiorespiratory conditions like chronic obstructive pulmonary disease (COPD), bronchiectasis, and idiopathic pulmonary fibrosis.1–3 It has been widely adopted as a validated measure of exercise tolerance in pulmonary rehabilitation. The minimum important difference (MID)—sometimes called the Minimal Clinically Important Difference—is the smallest change in an outcome that patients or their clinicians perceive as beneficial (or harmful). The MID is useful for evaluating the effectiveness (or not) of clinical interventions, and for epidemiological research, but can also be used to evaluate decline over time, especially in progressive conditions. To date, the minimum important improvement for the ISWT in COPD cohorts undergoing pulmonary rehabilitation has been established as between 35.0 m and 36.1 m using distribution- and anchor-based methods.1 However, the minimum important decline of the ISWT has not been established, and it is plausible that patients with COPD may perceive decline in a different way to improvement. The aims of this study were to describe the change in ISWT over 1 year in people with COPD and to estimate the minimum important decline of the ISWT using distribution- and anchor-based methods. Description: Supplementary material: Supplementary data is available at Annals of the American Thoracic Society online at: https://academic.oup.com/annalsats/article/23/4/637/8435331#supplementary-data . Fri, 23 Jan 2026 00:00:00 GMT http://bura.brunel.ac.uk/handle/2438/33231 2026-01-23T00:00:00Z http://bura.brunel.ac.uk/handle/2438/33210 Title: Evaluating Patient and Public Involvement and Engagement Activity Within the 3DPiPPIn Trial: A Qualitative Exploration of Contributors' Perspectives on Their Impact Authors: Umoabasi, I; Mansell, SK; Mandal, S; Kilbride, C; Hilton, ST; Main, E; Schievano, S; Callaghan, T Abstract: Introduction: Patient and Public Involvement and Engagement (PPIE) is now considered essential to the delivery of high-quality, patient-centred and translational research. However, despite widespread recognition of this, PPIE remains poorly understood, inconsistently utilised and inadequately reported. Objective: This study aimed to report, discuss and analyse the PPIE activities undertaken within 3DPiPPIn—a randomised control trial investigating the feasibility of using 3D printing to develop customised masks for patients receiving positive airway pressure (PAP) therapy. Emphasis was placed on analysing the wider impacts of these activities, including the impact on Patient Advisory Group (PAG) members. Methods: Data were collected from PAG members via 1:1 semi-structured interviews, which took place either face-to-face or online as per members' preference. Interviews were recorded, transcribed verbatim and analysed in NVivo using Braun and Clarke's Six-Phase Reflexive Thematic Analysis. Results: Three PAG members were interviewed; two were conducted remotely via Microsoft Teams, while the third took place face-to-face. Analysis resulted in the identification of three themes: ‘Disparate perceptions of PPIE influence in research’, ‘Empowered and enriched through PPIE’ and ‘Navigating the evolving experience and hurdles of PPIE’. PAG members described their influence on the trial as variable, feeling their involvement was impactful in some instances and insignificant in others. Despite this, they unanimously agreed that PAG involvement had a positive personal impact and that their experiences of PPIE were diverse and dynamic. Within the subtheme ‘Supports and stumbling blocks for PPIE’, members reflected on facilitators and barriers to PPIE. For example, the relaxed environment created by the Principal Investigator was seen to have promoted open discussion, while personal challenges sometimes diverted their focus from their role as a PAG member. Conclusion: This Reflexive Thematic Analysis explored the impact of PPIE on the 3DPiPPIn trial from the perspective of its PAG members. It exemplifies PPIE best practice and highlights areas for improvement to other researchers, advocating for meaningful rather than tokenistic PPIE. By encouraging excellence in PPIE, this report could enhance public engagement in research and, by demonstrating the impact and importance of quality PPIE, could inspire funders to ensure the provision of adequate PPIE resources. Trial Registration: Embedded within the 3DPiPPIn trial (ISRCTN 74082423). Description: Patient or Public Contribution: Members of the 3DPiPPIn PAG co-designed this PPIE impact evaluation; however, their involvement extended throughout the trial. They also provided insights that shaped the recruitment strategy, methodology, lay summary and dissemination plan for the 3DPiPPIn study.; Data Availability Statement: Data supporting this study cannot be made available due to ethical reasons. Further enquires can be directed to the corresponding author.; Supporting Information is available online at: https://onlinelibrary.wiley.com/doi/10.1111/hex.70674#support-information-section . Mon, 20 Apr 2026 00:00:00 GMT http://bura.brunel.ac.uk/handle/2438/33210 2026-04-20T00:00:00Z http://bura.brunel.ac.uk/handle/2438/33191 Title: Perceived Acceptability of SPACE for COPD© as a Maintenance Option Following Pulmonary Rehabilitation Discharge: A Qualitative Interview Study with Patients and Facilitators Using Framework Analysis Authors: Barradell, A; Alqahtani, K; Hong, A; Lapworth, J; Greenall, K; Al-Naabi, I; Szczepura, A; Man, W; Nolan, C; Doe, G; Gardiner, N; Gerlis, C; Bourne, C; Singh, S; Houchen-Wolloff, L Abstract: Introduction: Following completion of Pulmonary Rehabilitation (PR), the biopsychosocial benefits often decline. PR maintenance is recommended to extend the benefits; however, detail lacks on what this should entail. SPACE for COPD© is a light touch, evidenced-based self-management intervention which we tested as a maintenance strategy during the COVID-19 pandemic. We explored the acceptability of SPACE for COPD© as a maintenance option following PR for both patients and facilitators using qualitative research methods. Methods: We conducted semi-structured interviews and focus groups with patients and intervention facilitators involved in the SPACE for COPD© maintenance study. These were audio recorded, transcribed verbatim and analysed using Framework Analysis. Results: Seventeen patients were interviewed; 13 (76.5%) of which were programme completers: five (29.4%) received a group-based intervention, four (23.5%) received one-to-one, and eight (47.1%) received hybrid. Two focus groups were conducted with eight facilitators; six (75%) were physiotherapists, one (12.5%) was a nurse, and one (12.5%) was a health psychologist. Analysis generated six themes: (1) the changing structure of maintenance SPACE for COPD©; (2) the integral role of the facilitator; (3) engagement with the manual required time and commitment from patients; (4) staying active on maintenance SPACE for COPD© was facilitated by goal setting and exercise; (5) biopsychosocial outcomes of maintenance SPACE for COPD©; and (6) the future of maintenance SPACE for COPD©. Conclusion: Maintenance SPACE for COPD© was acceptable and could be implemented into the PR healthcare pathway during the COVID-19 pandemic. It helped patients to adopt and integrate new exercise habits if they could adapt and personalise these to their home lives. Adaptions made during the COVID-19 pandemic created a menu of options. Building upon this personalisation is required to ensure the intervention is accessible and patient-centred. Description: Disclosure: Dr Linzy Houchen-Wolloff has a copyright “SPACE for COPD©” held by University Hospitals of Leicester NHS Trust. The authors report no other conflicts of interest in this work. Wed, 22 Apr 2026 00:00:00 GMT http://bura.brunel.ac.uk/handle/2438/33191 2026-04-22T00:00:00Z http://bura.brunel.ac.uk/handle/2438/33190 Title: Minimal important difference of quadriceps maximal voluntary contraction (QMVC) in COPD: a prospective cohort study Authors: Jenkins, TO; Edwards, GD; Patel, S; Canavan, J; Kon, SSC; Barker, RE; Jones, SE; Walsh, JA; Ingram, KA; Maddocks, M; Polkey, MI; Nolan, CM; Man, W Abstract: Background: Quadriceps maximal voluntary contraction (QMVC) reliably measures quadriceps muscle force and predicts mortality in chronic obstructive pulmonary disease (COPD). However, the minimal important difference (MID) of QMVC is not well-established. Aim To estimate the MID of QMVC parameters in people with COPD following pulmonary rehabilitation (PR). Methods: QMVC was measured before and after 8 weeks of outpatient PR in people with COPD. Absolute and % change in QMVC, and change in normalised QMVC were calculated using paired t-tests. Anchor and distribution-based methods (0.5×SD change, SEM, minimal detectable change at 95% confidence, effect size and 1.96 SEM) were used to estimate the MID. Results: Of 903 participants, 383 were excluded due to PR non-completion or missing QMVC data with 520 included in the analysis (37% female; mean (SD) age 70.2 (8.4) years; forced expiratory volume in 1 s 51.4 (21.4)% predicted). QMVC parameters increased with PR; mean (95% CI) or mean (SD) change: QMVC 2.0 kg (1.5 kg to 2.5 kg), 10.6% (27.7%) and normalised QMVC 5.0% predicted (3.9% to 6.2%). Anchor-based MID estimates were precluded due to weak/no correlation with external anchors. Using distribution-based methods, the MID for QMVC change, QMVC % change and normalised QMVC change were estimated as mean (range) 3.55 kg (1.84 kg to 5.11 kg), 18.34% (9.60% to 26.60%) and 7.78% (3.78% to 12.48%) for all participants. However, MID estimates for absolute and % change in QMVC differed markedly between men and women. Normalised QMVC estimates demonstrated smaller sex-based discrepancies. Conclusion: We provide MID estimates for QMVC parameters. Sex-specific or normalised MID estimates for QMVC should be used to facilitate the interpretation of change. Description: Data availability statement: Data are available upon reasonable request. Data are available upon reasonable request from the corresponding author. Tue, 27 Jan 2026 00:00:00 GMT http://bura.brunel.ac.uk/handle/2438/33190 2026-01-27T00:00:00Z