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Firstly, three-dimensional finite element bridge models are developed and assessed using the incremental dynamic analysis method.
Functional exercise capacity was assessed using the incremental shuttle walk test (ISWT).
For patients only, maximal exercise tolerance was assessed using the Incremental Shuttle Walking Test (ISWT), an incremental, externally paced exercise capacity test conducted according to standardised procedure [ 25].
Functional exercise capacity was assessed using the incremental shuttle walk test (ISWT) with time to recovery of oxygen saturation, Borg dyspnoea score and heart rate following the walk also documented [ 23].
Thirdly, although the initial trial found no change in functional exercise capacity, assessed using the incremental shuttle walk test, patients reported that they felt able to do more and cope better with daily tasks, so we added physical activity monitoring to see if this translated into changes in daily activity.
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Following an exercise tolerance test to ensure no cardiovascular contraindications to maximal exercise [25], VO2max was assessed using the modified Taylor incremental treadmill test protocol [26], with 1-minute expired air samples taken continuously using Douglas Bags and heart rate monitored by short-range telemetry.
Cost-effectiveness of the GetREAL intervention will be assessed by combining service costs with the primary outcome (assessed using the Time Use Diary [ 31]) using an incremental cost-effectiveness ratio.
Functional capacity was assessed using the six- and twelve-minute walk tests; incremental- and endurance-shuttle walk tests; and the stair-climbing test.
The goodness-of-fit of each model was assessed using the Sattora-Bentler scaled chi-square, the comparative fit index [ 36] (CFI) and the incremental fit index [ 37] (IFI).
Subjective sleepiness was assessed using the Stanford Sleepiness Scale.
Depression was assessed using the MADRS [22].
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