A lifestyle activity intervention in patients with chronic obstructive pulmonary disease

Abstract

Background: Chronic obstructive pulmonary disease (COPD) patients have lower levels of physical activity compared to age-matched controls, and they limit physical activities requiring normal exertion. Our purpose was to compare the effectiveness of a traditional exercise therapy (TET) program with a behavioral lifestyle activity program (LAP) in promoting physical activity.

Methods: Moderate physical activity (kcal/week) was assessed in 176 COPD patients using the Community Health Activities Model for Seniors questionnaire. Patients were randomized to either a three month TET program that meet thrice weekly or a LAP. The LAP was designed to teach behavioral skills that encouraged the daily accumulation of self-selected physical activities of at least moderate intensity. Interventionist contact was similar (36 h) between the two groups. Patients were assessed at baseline and 3, 6 and 12 months.

Results: Compared to baseline values, self-reported moderate physical activity increased three months post-randomization with no significant difference (p = 0.99) found between the TET (2501 +/- 197 kcal/week) and the LAP (2498 +/- 211 kcal/week). At 6 and 12 months post-randomization, there were no significant differences (p = 0.37 and 0.69, respectively) in self-reported levels of moderate physical activity between the TET (2210 +/- 187 and 2213 +/- 218 kcal/week, respectively) and the LAP (2456 +/- 198 and 2342 +/- 232 kcal/week, respectively).

Conclusion: Although there was no difference between treatment groups, the TET and the LAP were both effective at in increasing moderate levels of physical activity at 3 months and maintaining moderate physical activity levels 12 months post-randomization. This clinical trial is registered with ClinicalTrials.gov. Its identifier is NCT00328484.

Copyright 2010 Elsevier Ltd. All rights reserved.

Figures

Figure 1

* CHAMPS data from two participants was excluded from analysis due to improper administration of the baseline questionnaire to the participants. Given baseline values were used as a covariate, data from these participants were also excluded from the follow-up analysis. An analysis that did not control for baseline CHAMPS levels, but included all follow-up data for these participants produced similar results and did not change the overall conclusions.

Figure 2

Moderate physical activity levels in kcals per week by intervention arm at baseline and follow-up. Data are reported as mean ± standard error of the mean. Means were estimated from mixed effects analysis of covariance for repeated measures adjusted for gender and baseline values.

Figure 3

Self-reported disability by intervention arm at baseline and follow-up. Data are reported as mean ± standard error of the mean. Means were estimated from mixed effects analysis of covariance for repeated measures adjusted for gender and baseline values.