This study looks at whether Street Racket is a feasable activity that can be added to pulmonary rehabilitation for people with chronic lung disease. Participants complete short questionnaires at the start and end of the program to rate the feasibility and rate their breathlessness during each session. Attendance is recorded to understand how well the activity is used and whether there are any barriers.
Pulmonary rehabilitation (APR) is an effective and cost-efficient treatment for people with chronic lung diseases, as it can reduce hospital admissions and improve health. Despite this, many patients do not take part or drop out early. Common reasons include low motivation, difficulty attending sessions, or fear that the exercises are too demanding. Street Racket is a simple, playful, and flexible form of physical activity that may help overcome these barriers. It is easy to adapt, enjoyable in a group setting, and similar in intensity to existing pulmonary rehabilitation exercises. Social and team-based activities like Street Racket may also have positive effects on mental well-being. The study aims to assess how feasible the activity is, how well it is accepted by participants, and whether it can offer a more engaging and sustainable training option within APR. Participation in Street Racket sessions is voluntary and possible with or without study participation. For those who take part in the study, the training itself is exactly the same as for non-participants. The only difference is the additional data collection. Participants are asked to complete a short questionnaire after their first and last Street Racket session about how appropriate and feasible the activity feels. During each session, participants also rate their average and maximum breathlessness. Attendance is recorded, and if someone is absent, the reason is noted when known. In addition, routinely collected data from pulmonary rehabilitation-such as diagnosis, medication, and standard clinical test results-are analyzed. Training sessions are adapted to group size and ability level and usually consist of several short playing intervals with breaks and a cool-down. The activity can be modified to match different fitness levels, allowing people with varying physical capacities to participate together. Study participation ends automatically when the pulmonary rehabilitation program is completed.
Study Type
INTERVENTIONAL
Allocation
NA
Street racket will be offered as an additional, optional training once session for patients once every two weeks within the ambulatory pulmonary rehabilitation program. The session begins with a 10-minute warm-up led by a physiotherapist, followed by 45 minutes of street racket play. The content of each session will be adapted based on group size and the playing level of the participants. A typical session structure consists of four intervals of 8 minutes of play, each separated by 2-minute breaks, and concludes with 5 minutes of cool-down. Depending on the patients need the training protocol can be adapted, for instance to include more cognitive or balance elements
Consultant Clinic of Pulmonology, University Hospital of Zurich
Zurich, Switzerland
NOT_YET_RECRUITINGConsultant Clinic of Pulmonology, University Hospital of Zurich
Zurich, Switzerland
RECRUITINGAcceptability, appropriateness and feasibility of Street Racket
The primary endpoints acceptability, appropriateness and feasibility will be assessed using patient reported outcomes with the Acceptability of Intervention Measure (AIM), Intervention Appropriateness Measure (IAM), \& Feasibility of Intervention Measure (FIM). These instruments have demonstrated strong psychometric properties and will collectively be referred to as the AAF questionnaire. The validated German translation of the AAF, which has also shown reliable and valid psychometric properties will be used in this study. The AAF questionnaire comprises three sections-Acceptability, Appropriateness, and Feasibility-each containing four questions rated on a 5-point Likert scale (1 = Completely disagree, 5 = Completely agree). Scores for each section will be calculated as the mean of the four responses. A mean score above 12 in each section will be considered indicative of a positive result.
Time frame: Each at the first training and at the end of the pulmonary rehabilitation (after max. 3 months).
Incidence of Treatment-Emergent Adverse Events (Safety and Tolerability)
Number and type of adverse events as defined as (serious) adverse events.
Time frame: After each street racket session, from enrollment until termination of ambulatory pulmonary rehabilitation (max 3 months).
Adherance rate
Percentage of attended sessions, Documented reasons for non-attendance
Time frame: After each street racket session, from enrollment until termination of ambulatory pulmonary rehabilitation (max 3 months).
Drop-out rate
Drop-out rate in %, categorized reasons for withdrawal (e.g. medical, motivation, logistics, time)
Time frame: After each street racket session, from enrollment until termination of ambulatory pulmonary rehabilitation (max 3 months).
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Purpose
TREATMENT
Masking
NONE
Enrollment
12
Perceived dyspnea
After each session the participants will be asked to assess their peak dyspnea level and mean dyspnea level during the session on the modified Borg scale ranging from 0 (no dyspnea) to 10 (maximal dyspnea), which will be recorded on their personal log book.
Time frame: After each street racket session, from enrollment until termination of ambulatory pulmonary rehabilitation (max 3 months).
Hospital Anxiety and Depression Scale (HADS)
The Hospital Anxiety and Depression Scale (HADS) has been proven to be reliable and valid in assessing anxiety and depression in healthy as well as clinical populations and older adults from 65 to 80 years although showing ceiling effects. Change in HADS (baseline to post intervention) to explore psychological wellbeing. The HADS is a routinely used questionnaire and is required to be filled out by every patient at the start and end of ambulatory pulmoanry rehabilitation. The HADS consists of two domains, one for anxiety and one for depression. In each domain a sum of the questions is calculated ranging from 0-21 where 0-7 indicates normal, 8-10 mild symptoms and 11-21 moderate to severe symptoms.
Time frame: After each street racket session, from enrollment until termination of ambulatory pulmonary rehabilitation (max 3 months).
Qualitative Participant Feedback
To gather patient feedback, understand barriers and facilitators as well as improving the Intervention and meet patients' needs, two open-ended questions will be added at the end of the AAF. * "What suggestions do you have for improve Street Racket for APR?" * "What feedback would you like to give us on Street Racket?"
Time frame: After each street racket session, from enrollment until termination of ambulatory pulmonary rehabilitation (max 3 months).