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CompletedNCT03457103CATCHUpdated Aug 18, 2021Results posted

Capnometry-Assisted Breathing Training for COPD

A Phase 2 interventional study of Capnometry-Assisted Training for COPD to Slow the Breath (CATCH) and Pulmonary Rehabilitation (PR) in Chronic Obstructive Pulmonary Disease, sponsored by NYU Langone Health. Completed at 1 site in United States. Open to participants aged 40 Years and older. Per ClinicalTrials.gov, last updated 2021-08-18.

Sponsored by NYU Langone Health · Phase 2, Interventional, and Treatment

Phase
Phase 2
Study type
Interventional
Enrollment
31
Allocation
Randomized
Ages
40 Years and older
Sex
All
01

Study summary

Capnometry-Assisted Breathing Training for COPD (CATCH) is a behavioral intervention that aims to promote optimal, self-regulated, mindful breathing. A portable capnometer is used in-session to provide continuous visual feedback of Respiratory Rate (RR), End-Tidal Carbon Dioxide Tension (ETCO2), and breathing pattern. The tailored CATCH intervention will emphasize a slow, quiet, regular, nasal breathing pattern, as well as pursed lips breathing (PLB). CATCH is once weekly for 6 weeks, for a total of 6 sessions; each session is approximately 60 minutes long. The principal investigator will implement the CATCH intervention. The principal investigator will implement the CATCH intervention. Patients will use the Address Stress app on a smart phone or computer tablet as part of their home breathing exercises.

02

Conditions studied

  • Chronic Obstructive Pulmonary Disease
03

Who can participate

Ages eligible
40 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • over 40 years of age
  • has COPD documented in their electronic medical record, as defined by FEV1/FVC of \< 0.70 on pulmonary function testing (spirometry), or as shown on a chest CT
  • Can maintain oxygen saturation (SaO2) ≥ 90% on room air at rest
  • Is medically cleared to participate in NYULMC's outpatient pulmonary rehabilitation program
  • English speaking. Pregnant patients will not be enrolled in the study

Exclusion criteria

Exclusion Criteria:

  • Requires 24-hour supplemental oxygen
  • Has cognitive impairment as measured by ≤23/30 on the Mini Mental State Examination (MMSE)
  • Is actively being treated for lung cancer (E.g. with chemotherapy or upcoming surgery)
  • Has morbid obesity (BMI > 40)
  • Is currently smoking
  • Has unstable cardiac disease defined by a history of a myocardial infarction in the past 3 months
04

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Participant)
Enrollment
31 participants (actual)

Study arms

  • Experimental
    CATCH Group

    A portable capnometer (CapnoTrainer, Better Physiology, Cheyenne, WY) will be used in-session to provide continuous visual feedback of RR, ETCO2, rhythm, and depth of breathing, and ratio of inspirations to expiration. CATCH will be once weekly for 6 weeks, for a total of 6 sessions; each session will be approximately 60 minutes duration. The principal investigator will implement the CATCH intervention

    Device: Capnometry-Assisted Training for COPD to Slow the Breath (CATCH) · Device: Pulmonary Rehabilitation (PR)

  • Active comparator
    Control Group

    Pulmonary Rehabilitation (PR). Patients in both treatment groups will participate in a 10-week (16 - 20 sessions) comprehensive PR program.

    Device: Pulmonary Rehabilitation (PR)

Interventions

  • DeviceCapnometry-Assisted Training for COPD to Slow the Breath (CATCH)

    Tailored intervention emphasizing slow, quiet, regular nasal breathing pattern.

  • DevicePulmonary Rehabilitation (PR)

    Patients in both treatment groups will participate in a 10 week (16-20 sessions) comprehensive PR program. The control group will receive the 10-Week PR program with traditional breathing training sessions (without biofeedback). The program comprises 2 or 3 exercise training sessions per week by physical therapists (each 1 hour duration).

05

What researchers measure

Primary outcomes

  1. Number of Participants With Adherence to Home Breathing Exercises

    Time frame: Day 1

Secondary outcomes

  1. Difference in Mean 6MWT Distance Between Pre and Post Intervention

    The six-minute walk test (6MWT) measures the distance an individual is able to walk over a total of six minutes on a hard, flat surface. The goal is for the individual to walk as far as possible in six minutes.

    Time frame: Week 0 and Week 10

  2. Difference in Mean Dyspnea Management Questionnaire Computer Adaptive Test (DMQ-CAT) Anxiety Score Between Pre and Post Intervention

    The DMQ-CAT Dyspnea Anxiety is a 14 item scale; each item is scored off a 7 point likert scale for a total range of 0 to 98 where higher scores correlate with higher anxiety

    Time frame: 2 weeks pre intervention and 4 weeks post intervention

  3. Mean Difference in Heart Rate Maximum Between Pre and Post Intervention

    Time frame: 0 weeks and 10 weeks

  4. Difference in Mean PROMIS Fatigue Score Between Pre and Post Intervention

    Patient-Reported Outcomes Measurement Information System (PROMIS) Fatigue 7a questionnaire. Raw scores range from 7-35, with higher scores indicating higher levels of fatigue.

    Time frame: 0 weeks and 10 weeks

  5. Mean Difference in Resting Respiratory Rate Between Pre and Post Intervention

    Time frame: 0 weeks and 10 weeks

  6. Difference in Mean Score on St George's Respiratory Questionnaire (SGRQ) Between Pre and Post Intervention

    Disease-specific instrument designed to measure impact on overall health, daily life, and perceived well-being in patients with obstructive airways disease. Scores range from 0 to 100, with higher scores indicating more limitations.

    Time frame: Week 0 and Week 10

06

Results

Posted Aug 18, 2021

Participant flow

Participant flow — Overall Study
MilestoneCATCH GroupControl Group
Started229
Completed143
Not completed86
Withdrew: Illness/hospitalization42
Withdrew: Lost to follow-up21
Withdrew: Withdrawal by subject12
Withdrew: Financial/ insurance issues11

Outcome measures

PrimaryNumber of Participants With Adherence to Home Breathing Exercises
Time frame:
Day 1
Reported as:
Count of participants · Participants
Number of Participants With Adherence to Home Breathing Exercises
ParticipantsCATCH GroupControl Group
Number of Participants With Adherence to Home Breathing Exercises105
SecondaryDifference in Mean 6MWT Distance Between Pre and Post Intervention

The six-minute walk test (6MWT) measures the distance an individual is able to walk over a total of six minutes on a hard, flat surface. The goal is for the individual to walk as far as possible in six minutes.

Time frame:
Week 0 and Week 10
Reported as:
Mean · meters
Difference in Mean 6MWT Distance Between Pre and Post Intervention
metersCATCH GroupControl Group
Difference in Mean 6MWT Distance Between Pre and Post Intervention39.37 (14.13 to 64.61)24.99 (-32.53 to 82.52)
SecondaryDifference in Mean Dyspnea Management Questionnaire Computer Adaptive Test (DMQ-CAT) Anxiety Score Between Pre and Post Intervention

The DMQ-CAT Dyspnea Anxiety is a 14 item scale; each item is scored off a 7 point likert scale for a total range of 0 to 98 where higher scores correlate with higher anxiety

Time frame:
2 weeks pre intervention and 4 weeks post intervention
Reported as:
Mean · score on DMQ-CAT (Anxiety)
Difference in Mean Dyspnea Management Questionnaire Computer Adaptive Test (DMQ-CAT) Anxiety Score Between Pre and Post Intervention
score on DMQ-CAT (Anxiety)CATCH GroupControl Group
Difference in Mean Dyspnea Management Questionnaire Computer Adaptive Test (DMQ-CAT) Anxiety Score Between Pre and Post Intervention2.43 (.09 to 4.77)-3.16 (-8.89 to 2.57)
SecondaryMean Difference in Heart Rate Maximum Between Pre and Post Intervention
Time frame:
0 weeks and 10 weeks
Reported as:
Mean · beats per minute
Mean Difference in Heart Rate Maximum Between Pre and Post Intervention
beats per minuteCATCH GroupControl Group
Mean Difference in Heart Rate Maximum Between Pre and Post Intervention6.2 (-1.32 to 13.72)3 (-35.12 to 41.12)
SecondaryDifference in Mean PROMIS Fatigue Score Between Pre and Post Intervention

Patient-Reported Outcomes Measurement Information System (PROMIS) Fatigue 7a questionnaire. Raw scores range from 7-35, with higher scores indicating higher levels of fatigue.

Time frame:
0 weeks and 10 weeks
Reported as:
Mean · score on PROMIS questionnaire
Difference in Mean PROMIS Fatigue Score Between Pre and Post Intervention
score on PROMIS questionnaireCATCH GroupControl Group
Difference in Mean PROMIS Fatigue Score Between Pre and Post Intervention-4.18 (-8.16 to -0.21)5.2 (-21.39 to 31.79)
SecondaryMean Difference in Resting Respiratory Rate Between Pre and Post Intervention
Time frame:
0 weeks and 10 weeks
Reported as:
Mean · Breaths per minute
Mean Difference in Resting Respiratory Rate Between Pre and Post Intervention
Breaths per minuteCATCH GroupControl Group
Mean Difference in Resting Respiratory Rate Between Pre and Post Intervention-2.75 (-7.56 to 2.05)-4.2 (-26.26 to 17.87)
SecondaryDifference in Mean Score on St George's Respiratory Questionnaire (SGRQ) Between Pre and Post Intervention

Disease-specific instrument designed to measure impact on overall health, daily life, and perceived well-being in patients with obstructive airways disease. Scores range from 0 to 100, with higher scores indicating more limitations.

Time frame:
Week 0 and Week 10
Reported as:
Mean · score on SGRQ questionnaire
Difference in Mean Score on St George's Respiratory Questionnaire (SGRQ) Between Pre and Post Intervention
score on SGRQ questionnaireCATCH GroupControl Group
Difference in Mean Score on St George's Respiratory Questionnaire (SGRQ) Between Pre and Post Intervention-11.76 (-19.68 to -3.83)-9.96 (-38.07 to 18.14)

Adverse events

Collected over 1 year. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
CATCH Group0/22 (0%)0/22 (0%)0/22 (0%)
Control Group0/9 (0%)0/9 (0%)0/9 (0%)

Baseline characteristics

Age, Continuous
Age, Continuous(years)CATCH GroupControl GroupTotal
Mean72.8 ± 10.4571.4 ± 7.6272.1 ± 9.03
Sex: Female, Male
Sex: Female, Male(Participants)CATCH GroupControl GroupTotal
Female14418
Male8513
Ethnicity (NIH/OMB)
Ethnicity (NIH/OMB)(Participants)CATCH GroupControl GroupTotal
Hispanic or Latino303
Not Hispanic or Latino19928
Unknown or Not Reported000
Race (NIH/OMB)
Race (NIH/OMB)(Participants)CATCH GroupControl GroupTotal
American Indian or Alaska Native000
Asian000
Native Hawaiian or Other Pacific Islander000
Black or African American527
White17724
More than one race000
Unknown or Not Reported000
Region of Enrollment
Region of Enrollment(Participants)CATCH GroupControl GroupTotal
United States22931
07

Study locations

1 site
  • New York University School of Medicine
    New York, New York 10016, United States
08

References and documents

Study documents

  • Protocol and statistical analysis plan · May 14, 2019

Documents are hosted by the registry — open the source record to download them.

09

Registry details

Key details

Study ID
NCT03457103
Lead sponsor
NYU Langone Health
Responsible party
Sponsor
First posted
Mar 7, 2018
Start date
Jun 16, 2015
Primary completion
Aug 2, 2019
Completion
Aug 2, 2019
Results posted
Aug 18, 2021
Last update
Aug 18, 2021

Study contacts

Anna Maria Norweg, MD
study director · NYU Langone Health

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
Yes
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