Physical Activity Counselling during Pulmonary Rehabilitation in Patients with COPD: A Randomised Controlled Trial

Chris Burtin, Daniel Langer, Hans van Remoortel, Heleen Demeyer, Rik Gosselink, Marc Decramer, Fabienne Dobbels, Wim Janssens, Thierry Troosters, Chris Burtin, Daniel Langer, Hans van Remoortel, Heleen Demeyer, Rik Gosselink, Marc Decramer, Fabienne Dobbels, Wim Janssens, Thierry Troosters

Abstract

Background: Pulmonary rehabilitation programs only modestly enhance daily physical activity levels in patients with chronic obstructive pulmonary disease (COPD). This randomised controlled trial investigates the additional effect of an individual activity counselling program during pulmonary rehabilitation on physical activity levels in patients with moderate to very severe COPD.

Methods: Eighty patients (66 ± 7 years, 81% male, forced expiratory volume in 1 second 45 ± 16% of predicted) referred for a six-month multidisciplinary pulmonary rehabilitation program were randomised. The intervention group was offered an additional eight-session activity counselling program. The primary outcomes were daily walking time and time spent in at least moderate intense activities.

Results: Baseline daily walking time was similar in the intervention and control group (median 33 [interquartile range 16-47] vs 29 [17-44]) whereas daily time spent in at least moderate intensity was somewhat higher in the intervention group (17[4-50] vs 12[2-26] min). No significant intervention*time interaction effects were observed in daily physical activity levels. In the whole group, daily walking time and time spent in at least moderate intense activities did not significantly change over time.

Conclusions: The present study identified no additional effect of eight individual activity counselling sessions during pulmonary rehabilitation to enhance physical activity levels in patients with COPD.

Trial registration: clinicaltrials.gov NCT00948623.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1. Patient flow chart.
Fig 1. Patient flow chart.
Fig 2. Relative changes in daily time…
Fig 2. Relative changes in daily time spent walking, daily steps, daily time spent in at least moderate intense activities (>3.6 metabolic equivalents) and at least mild intense activities (>2.0 metabolic equivalents) after three months (3m) and after six months of rehabilitation (6m) compared to baseline.
Data are expressed as percentage of change of least square means compared to baseline. No intervention*time effects were observed. * indicates time effect for the whole group (p

Fig 3. Absolute changes in daily time…

Fig 3. Absolute changes in daily time spent walking, daily steps, daily time spent in…

Fig 3. Absolute changes in daily time spent walking, daily steps, daily time spent in at least moderate intense activities (>3.6 metabolic equivalents) and at least mild intense activities (>2.0 metabolic equivalents) after three months (3m) and after six months of rehabilitation (6m) in active and inactive patients at baseline.
A median split of baseline physical activity level is performed for each variable. Data are analysed using mixed models including daylight time as covariate. Box plots indicate median, quartile 1 and 3 and percentile 10 and 90. No Interaction effects (p
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CB was a doctoral fellow of Research Foundation – Flanders. DL is a postdoctoral fellow of Research Foundation – Flanders.
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Fig 3. Absolute changes in daily time…
Fig 3. Absolute changes in daily time spent walking, daily steps, daily time spent in at least moderate intense activities (>3.6 metabolic equivalents) and at least mild intense activities (>2.0 metabolic equivalents) after three months (3m) and after six months of rehabilitation (6m) in active and inactive patients at baseline.
A median split of baseline physical activity level is performed for each variable. Data are analysed using mixed models including daylight time as covariate. Box plots indicate median, quartile 1 and 3 and percentile 10 and 90. No Interaction effects (p

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