Chapter 8 150 Baseline (T0) questionnaires Baseline data from the participating physiotherapists will be collected at the time of enrolment (T0): gender (male/female), master’s degree (yes/no), and professional experience in a primary physiotherapy practice (years). Baseline data from the patients will be collected after signing informed consent and inclusion (T0): age (years), gender (male/female), education (coded into low/middle/higher), smoking status (never smoked/quit smoking/still smoking), health related quality of life (1-5), and disease burden (0-60) (all provided by the patient). The physiotherapist will provide information on the characteristics of the disease (T0): classification of severity of airflow limitation (Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification) (GOLD II/III/IV), degree of baseline functional disability due to dyspnea (MRC dyspnea score) (1/2/3/4/5), duration of COPD since diagnosis (years), and duration of physiotherapy (years). Study measures Exercise capacity Exercise capacity will be assessed by the physiotherapist at every measurement moment (from T0-T4) using the 6-minute walk distance (6MWD). The change in 6MWD is a potential patient-centered outcome measure for therapies aimed at maintaining/improving exercise capacity [21]. Patients have to try to cover as much distance as possible in six minutes; the physiotherapist measures the walking distance [22]. Health related quality of life Health related quality of life will be assessed by the PROMIS Global02 [23] at each measurement moment (T0-T4) by the patient. The PROMIS Global02 is derived from the Overall Health V1.2. scale and asks about the patient’s perceived quality of life. The exact question is, "Overall, how do you feel about your quality of life?" The PROMIS Global02 uses a five-point rating scale (5 = excellent, 4 = very good, 3 = good, 2 = fair, 1 = poor). A higher score indicates better health related quality of life [23]. Disease burden Specific COPD disease burden will be reported by the patient at each measurement moment (T0-T4) using the Clinical COPD Questionnaire (CCQ). The questionnaire consists of ten items divided into three domains: symptoms, functional state and mental state. Individual items within the CCQ are equally weighted, and the mean item score will be used as the total scale score. Additionally, it is possible to calculate the scores on each of the three domains separately. The total CCQ score, and the score on each of the three domains, varies between 0 (very good health status) to 6 (extremely poor health status) [24].
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