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Trial registered on ANZCTR

Registration number
Ethics application status
Date submitted
Date registered
Date last updated
Type of registration
Prospectively registered

Titles & IDs
Public title
Functional assessment using the Glitttre Endurance Test in chronic obstructive pulmonary disease (COPD)
Scientific title
Evaluating functional capacity in people with chronic obstructive pulmonary disease (COPD) using the Glittre Endurance Test
Secondary ID [1] 292151 0
Universal Trial Number (UTN)
Trial acronym
Linked study record

Health condition
Health condition(s) or problem(s) studied:
Chronic obstructive pulmonary disease 303592 0
Condition category
Condition code
Respiratory 303000 303000 0 0
Chronic obstructive pulmonary disease

Study type
Description of intervention(s) / exposure
The intervention will be an eight week pulmonary rehabilitation program in which participants will attend twice a week for exercise training in a gymnasium, The intervention will be delivered by physiotherapists with experience in pulmonary rehabilitation.

Pulmonary rehabilitation is part of usual care. Participants will attend two sessions per week for approximately 1 hour per session during which time they will perform 20 minutes of stationary cycling, 20 minutes of walking (over-ground or using a treadmill), 10 minutes of upper limb strength and endurance training (e.g. lat pull down and pect dec using a fixed weight machine for strength training and free weights for endurance training) and 10 minutes of lower limb strength training (e.g. quads and leg press using a fixed weight machine, sit to stand, steps, wall squats).

The intensity and duration of the exercises is based on the participant’s performance at their initial assessment. For walking training the initial intensity will be set at 80% of the six-minute walk test speed. For stationary cycling, the initial intensity will be set at 60 % of the peak work rate estimated using the distance walked in the best six-minute walk test based on the equation of Hill et al 2008.

Participants will exercise at their individually prescribed exercise intensity and duration but their exercise sessions will be in the gymnasium with other participants.

A number of tests of exercise capacity will be performed before and after the pulmonary rehabilitation program. These tests will be: the 6 minute walk test, the endurance shuttle walk test (ESWT) (Revill et al, 1999) and the Glittre Activities of Daily Living (Glittre ADL) test (Skumlien et al 2006) which are standard tests regularly used in pulmonary rehabilitation programs. Participants will perform one modified Glittre ADL test in which no weighted backpack will be worn. The study will also develop and evaluate a new test, the Glittre Endurance test, which will be a modification of the Glittre ADL test

The Glittre Endurance test will be performed on the same track as the Glittre ADL test. However, the Glittre Endurance test will be performed without a backpack. For this test participants will be asked to perform the test at a speed equivalent to 90% of the speed that achieved in the Glittre ADL test (without a backpack) and to keep going for as long as possible (to a maximum of 20 minutes) or until unable to keep up the pace. The pace will be set by an audio signal. No verbal encouragement will be given during the test. Participants will be asked to score their dyspnoea and rate of perceived exertion using the 0-10 category-ratio scale (Borg 1982) at the beginning and end of the test. Pulse rate and oxygen saturation (SpO2) will be measured during the test by a pulse oximeter. The test will be terminated at patients request or at the discretion of the clinician based on clinical signs and symptoms.

Energy expenditure will be measured during the Glittre Endurance test and the ESWT using an activity monitors, the Axivity AX3 (New Castle up on Tyne, UK) and the Actigraph GT1M (Pensacola, FL, USA).

Physical activity levels of participants before commencing the pulmonary rehabilitation program will be measured over seven days by wearing of the activity monitor.

Participants will be invited to participate and will be provided with the Participant Information Sheet and any questions arising will be answered by the physiotherapists involved in the study. After agreement, participants will be asked to sign the Participant Consent Form and to attend the pulmonary rehabilitation service for testing. The participation in the study is voluntary. Subjects can withdraw at any time without having to give a reason.

The intervention will be supervised so adherence will be monitored by attendance at exercise training sessions.
Intervention code [1] 298294 0
Comparator / control treatment
No control group
Control group

Primary outcome [1] 302370 0
The responsiveness of the Glittre ADL and Glittre Endurance test as a functional outcome measure after pulmonary rehabilitation.
Timepoint [1] 302370 0
Baseline and after 8 weeks of pulmonary rehabilitation
Secondary outcome [1] 335747 0
The correlation of the Glittre Endurance test with daily physical activity.
Timepoint [1] 335747 0
At baseline the physical activity monitor will be worn for seven days and these data will be compared with the Glittre Endurance Test

Key inclusion criteria
Diagnosis of COPD (FEV1/FVC ratio < 0.7) with GOLD Stage I, II, III or IV disease severity.
Stable over the past month (i.e no admissions to hospital, change in medications or increase in respiratory symptoms).
Minimum age
40 Years
Maximum age
No limit
Both males and females
Can healthy volunteers participate?
Key exclusion criteria
. Concomitant cardiovascular, orthopaedic or neurological conditions that are likely to impair exercise performance
. Other significant pulmonary disease (e.g asthma)
. BMI > 35 kg/m2
. Major psychiatric illness
. In ability to understand English
. Inability to give informed consent
. Inability to perform or to understand the tests proposed for the study.

Study design
Purpose of the study
Allocation to intervention
Non-randomised trial
Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Masking / blinding
Blinded (masking used)
Who is / are masked / blinded?

The people assessing the outcomes
The people analysing the results/data
Intervention assignment
Single group
Other design features
Not Applicable
Type of endpoint(s)
Statistical methods / analysis
A sample size of 50 participants will be sufficient to provide 80% power to detect as significant, at the 5% level, a minimum 150 seconds difference in the mean Glittre Endurance test after pulmonary rehabilitation, assuming a standard deviation (SD) of 250 seconds. These data are based on findings from the Endurance Shuttle Walk Test which is a test with similar constructs (Leung et al, 2010). This sample size will also be sufficient for the evaluation of the other aims of the project.

Recruitment status
Not yet recruiting
Date of first participant enrolment
Date of last participant enrolment
Date of last data collection
Sample size
Accrual to date
Recruitment in Australia
Recruitment state(s)
Recruitment hospital [1] 8314 0
Royal Prince Alfred Hospital - Camperdown
Recruitment hospital [2] 8315 0
Concord Repatriation Hospital - Concord
Recruitment hospital [3] 8316 0
Prince of Wales Hospital - Randwick
Recruitment hospital [4] 8334 0
Royal North Shore Hospital - St Leonards
Recruitment postcode(s) [1] 16378 0
2050 - Camperdown
Recruitment postcode(s) [2] 16379 0
2139 - Concord
Recruitment postcode(s) [3] 16380 0
2031 - Randwick
Recruitment postcode(s) [4] 16404 0
2065 - St Leonards

Funding & Sponsors
Funding source category [1] 296686 0
Government body
Name [1] 296686 0
Scholarship from the Brazilian Government (CAPES)
Address [1] 296686 0
Setor Bancário Norte (SBN)
Quadra 2, Bloco L, Lote 06, Edifício CAPES
Zip code: 70.040-031
Brasília, DF
Country [1] 296686 0
Funding source category [2] 296687 0
Government body
Name [2] 296687 0
Department of Education and Training - Australian Endeavour Research Fellowship
Address [2] 296687 0
International Group
Department of Education
PO Box 9880
Canberra ACT 2601
Country [2] 296687 0
Primary sponsor type
University of Sydney
Camperdown NSW 2006
Secondary sponsor category [1] 295643 0
Name [1] 295643 0
Federal University of Minas Gerais
Address [1] 295643 0
Av. Pres. Antônio Carlos, 6627 - Pampulha
Belo Horizonte - MG
Country [1] 295643 0

Ethics approval
Ethics application status
Ethics committee name [1] 297912 0
SLHD Ethics Review Committee (RPAH Zone)
Ethics committee address [1] 297912 0
Research Ethics and Governance Office (REGO)
RPAH Medical Centre
Suite 210A, 100 Carillon Avenue
Ethics committee country [1] 297912 0
Date submitted for ethics approval [1] 297912 0
Approval date [1] 297912 0
Ethics approval number [1] 297912 0
X14-0199 & HREC/14/RPAH/261

Brief summary
Chronic Obstructive Pulmonary Disease (COPD) is a highly prevalent condition affecting approximately two million Australians (14% of the population over 40 years). It is estimated that the overall costs of COPD is $8.8 billion per annum in direct health costs and indirect costs such as lost productivity. One of the most effective interventions for managing COPD is pulmonary rehabilitation which reduces symptoms of breathlessness and fatigue, increases functional exercise capacity, improves quality of life and reduces hospital admissions. To ensure that pulmonary rehabilitation programs are achieving appropriate outcomes, valid but easily available and inexpensive tests are needed. The Glittre ADL test is a relatively new test of functional activities. However, to show improvement on the Glittre ADL, patients need to be able to increase the speed of activities. Often people with COPD after a pulmonary rehabilitation program, cannot significantly improve the speed with which they perform activities but may be able to perform the activities for longer (i.e greater endurance), with less breathlessness and fatigue. We are interested to trial a modification of the Glittre ADL test to better reflect endurance capacity for functional tasks. We also wish to determine how this measure relates to levels of daily activity since higher levels of physical activity have been associated with better health outcomes in people with COPD.

The aims of this project are: a) To develop and evaluate the a new test, the Glittre Endurance test, in people with COPD; b) To determine the relationship between the Glittre Endurance test and levels of daily physical activity measured by an activity monitor; c) To evaluate the responsiveness of the Glittre Endurance test as an outcome measure following pulmonary rehabilitation.
Trial website
Trial related presentations / publications
Public notes
Attachments [1] 1778 1778 0 0
Attachments [2] 1779 1779 0 0
Attachments [3] 1780 1780 0 0

Principal investigator
Name 75442 0
Prof Jennifer Alison
Address 75442 0
University of Sydney
Faculty of Health Sciences
PO Box 170, Lidcombe
New South Wales
Country 75442 0
Phone 75442 0
+612 9351 9371
Fax 75442 0
Email 75442 0
Contact person for public queries
Name 75443 0
Prof Jennifer Alison
Address 75443 0
University of Sydney
Faculty of Health Sciences
PO Box 170, Lidcombe
New South Wales
Country 75443 0
Phone 75443 0
Fax 75443 0
Email 75443 0
Contact person for scientific queries
Name 75444 0
Prof Jennifer Alison
Address 75444 0
University of Sydney
Faculty of Health Sciences
PO Box 170, Lidcombe
New South Wales
Country 75444 0
Phone 75444 0
+612 9351 9371
Fax 75444 0
Email 75444 0

No data has been provided for results reporting
Summary results
Not applicable