Cognitive Load and Inhaler Technique in COPD

Summary

This study evaluates whether cognitive load affects inhaler technique in adults with chronic obstructive pulmonary disease (COPD). During a single study visit, participants will complete assessments of cognitive function, mobility, and respiratory status. Dual-task mobility will be assessed using the Timed Up and Go test performed alone and while completing a cognitive task. Inhaler technique will then be evaluated in two conditions: usual inhaler use without an additional task and inhaler use while maintaining a short sequence of digits in working memory. Inhaler technique will be scored using a standardized five-step device-specific checklist, and inhaler use time will also be recorded. The study will examine whether inhaler technique worsens under cognitive load and whether this deterioration is associated with dual-task mobility performance, cognitive function, respiratory symptoms, and functional capacity. No inhaler training or correction will be provided between the two inhaler conditions. All assessments are performed during a single visit.

Eligibility

Inclusion Criteria:

* Adults aged 18 years or older
* Confirmed diagnosis of chronic obstructive pulmonary disease (COPD)
* Clinically stable at the time of assessment
* Current use of at least one handheld maintenance inhaler (pMDI, SMI, or DPI)
* Able to understand and follow study instructions
* Able to perform the Timed Up and Go test
* Able to complete the cognitive tasks and inhaler technique assessment
* Able and willing to provide written informed consent

Exclusion Criteria:

* Recent COPD exacerbation with incomplete recovery to baseline clinical status
* Acute respiratory or other acute medical condition at the time of assessment
* Known severe cognitive impairment or dementia that prevents completion of study procedures
* Neurological or musculoskeletal impairment that prevents safe completion of the Timed Up and Go test
* Severe visual, hearing, or communication impairment that prevents completion of the cognitive or inhaler tasks
* Inability to independently handle or use the study inhaler device for assessment purposes

Conditions1

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