Control group (sham-treatment)
According to the national guidelines of the Dutch College of General Practitioners (NHG) and the Multidisciplinary
Guideline on non-pharmacological treatment of COPD, the GP and the nurse practitioner should give advice to
improve the physical condition [5,43]. Verbal advice will be supported by a written brochure. This brochure is developed in collaboration with the NHG as part of a preceding implementation project of physiotherapy for COPD patients in primary care [44].
In addition, the patients in the control group will participate in a sham-treatment at the physiotherapy practice.
This treatment consists of 30 minutes once a week “exercise” training, with ratings of perceived exertion
and dyspnoea of 2 or lower on a modified Borg-scale. It is unlikely that a physiologic training stimulus will occur
at these levels of exertion. There will be no breathing exercises or resistance training. Furthermore, patients will
be advised to do at least 30 minutes of moderate intense physical activities on at least five days a week according
to the ACSM-recommendation for physical activity [33].
Outcome measures
All outcomes will be assessed at baseline (T0), at the end of intervention after four months (T1) and at the end of follow-up (T2) at six months.