Effect of counselling during pulmonary rehabilitation on self-determined motivation to be physically active for people with chronic obstructive pulmonary disease: a pragmatic RCT

Anne-Kathrin Rausch Osthoff, Swantje Beyer, David Gisi, Spencer Rezek, Ariane Schwank, André Meichtry, Noriane A Sievi, Thomas Hess, Markus Wirz, Anne-Kathrin Rausch Osthoff, Swantje Beyer, David Gisi, Spencer Rezek, Ariane Schwank, André Meichtry, Noriane A Sievi, Thomas Hess, Markus Wirz

Abstract

Background: Counselling is considered to be a promising approach to increasing physical activity (PA) in people with chronic obstructive pulmonary disease (COPD). The aim of the current study was to investigate whether a PA counselling program for people with COPD, when embedded in a comprehensive outpatient pulmonary rehabilitation (PR) program, increased their daily PA.

Methods: A two-armed, single blind randomized controlled trial was conducted as a component of a 12-week outpatient pulmonary rehabilitation program. The participants randomized into the intervention group received five counselling sessions, based on the principles of motivational interviewing (MI), with a physiotherapist. The participants' steps per day and other proxies of PA were measured using an accelerometer (SenseWear Pro®) at baseline, at the end of the PR program, and three months later. The group-by-time interaction effect was analyzed.

Results: Of the 43 participants,17 were allocated to the intervention group and 26 to the usual-care control group (mean age 67.9 ± 7.9; 21 (49%) males; mean FEV1 predicted 47.1 ± 18.6). No difference between groups was found for any measure of PA at any point in time.

Conclusions: In this study, counselling, based on MI, when embedded in a comprehensive PR program for people with COPD, showed no short-term or long-term effects on PA behavior. To investigate this potentially effective counselling intervention and to analyze the best method, timing and tailoring of an intervention embedded in a comprehensive outpatient PR program, further adequately powered research is needed.

Trial registration: Clinical Trials.gov NCT02455206 (05/21/2015), Swiss National Trails Portal SNCTP000001426 (05/21/2015).

Keywords: Behavioral change; COPD; Motivational interviewing; Physical activity promotion.

Conflict of interest statement

All authors declare that they have no competing interests.

© 2021. The Author(s).

Figures

Fig. 1
Fig. 1
Consort diagram describing the flow of patients. PR, pulmonary rehabilitation; IG, intervention group receiving physical activity counselling, CG, control group receiving usual care
Fig. 2
Fig. 2
A Mean steps per day, and B Mean MET at baseline (T0), 12 weeks (T1) and 24 weeks after PR (T2)

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