Do wheeled walkers increase physical activity in people with chronic obstructive pulmonary disease (COPD)?

INTERVENTION: On completion of a pulmonary rehabilitation program, participants will be randomised to either Group 1 or 2 using a computer‐generated random number sequence. Following randomisation, a Research Assistant will visit the homes of all participants. Those participants randomised to Group 1 will receive a wheeled walker during the first home visit and a Research Assistant will provide standardised instructions regarding its use and encourage daily ambulation with the device. Those participants randomised to Group 2 will receive encouragement regarding daily ambulation, but no wheeled walker. Four weeks after the first home visit, participants will be provided with two devices that measure physical activity and instructed to wear the devices for 5 days. At the end of these 5 days, a Research Assistant will perform a second home visit to collect the devices and other outcome measures. Those participants randomised Group 1 will have their wheeled walker removed and those participants randomised Group 2 will have a wheeled walker issued and be provided with standardised instructions regarding its use. During this home visit, all participants will receive the same encouragement from a Research Assistant to perform daily ambulation. Four weeks later, participants will again be provided with the devices that measure physical activity and instructed to wear them for 5 days. At the end of this 5 day period, a Research Assistant will perform a third and final home visit to collect the devices and other outcome measures. The four week period of time without the wheeled walker represents the 'wash‐out' period. CONDITION: Chronic obstructive pulmonary disease (COPD) PRIMARY OUTCOME: Daily physical activity will be measured during the waking hours of five consecutive days using the ActivPAL and Stepwatch activity monitors. Participants will also be asked to estimate how the average amount of time they spent walking during the preceding week. SECONDARY OUTCOME: Fear of falling will be measured using a standardised questionnaire called the Survey of Activities and Fear of falling in the Eldery (SAFE). Health‐related quality of life will be measured using the Chronic Respiratory Disease Questionnaire. Preference (with vs. without wheeled walker) will be measured using standardised questions. Wheeled walker use will be measured using a magnetic odemeter on the front wheel of the walker. INCLUSION CRITERIA: Diagnosis of COPD Six‐minute walk distance < 450 m prior to pulmonary rehabilitation Deemed approp for a wheeled walker by a physiotherapist