A Lifestyle Activity Intervention in Patients with Chronic Obstructive Pulmonary Disease

Abstract

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. Evidence indicates that long-term participation in exercise therapy can maintain improvements in physical function and quality of life in individuals with COPD. Recent data have shown that regular physical activity is associated with a reduction in COPD related hospitalizations and mortality. Collectively, these data support the benefit of and need for promoting long-term adherence to physically active lifestyles in COPD patients. PURPOSE: To compare the effectiveness of a traditional exercise therapy (TET) program with a behavioral lifestyle activity program (LAP) in promoting participation in physical activity. The LAP was designed to teach behavioral skills that encourage the daily accumulation of self-selected physical activities which are part of daily life and of at least moderate intensity. METHODS: Moderate physical activity (kcal/week) was assessed in 176 COPD patients via a structured interview 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. Interventionist contact was similar (36 hours) between the two groups. Patients were assessed at baseline and 3, 6 and 12 months post-randomization. RESULTS: Compared to baseline values, self-reported moderate physical activity increased three months post-randomization with no significant difference (p = 0.84) found between the TET (2,497 ± 192 kcal/week) and the LAP (2,440 ± 202 kcal/week). At 6 and 12 months post-randomization, there were no significant differences (p = 0.32 and 0.66, respectively) in self-reported levels of moderate physical activity between the TET (2,200 ± 186 and 2,229 ± 219 kcal/week, respectively) and the LAP (2,470 ± 196 and 2,372 ± 233 kcal/week, respectively). CONCLUSIONS: Following three months of participation, both the TET and the LAP were equally effective in increasing participation in moderate levels of physical activity. Both the TET and the LAP were equally effective in maintaining moderate levels of physical activity 12 months post-randomization. Supported by NIH grants HL 53755 and AG 21332