Changes and interactions of physical activity in patients with occupational respiratory diseases after a behavioral exercise intervention: A study protocol

Abstract

Introduction: An active lifestyle represents a challenge for patients with chronic respiratory diseases because of pathophysiological alterations which lead to reduced physical activity (PA). Patients fall into a downward spiral of deconditioning with increased symptoms and reduced PA. Various studies suggest that a higher PA level in these subjects increases quality of life and reduces risk of hospital admissions and mortality, so that the long-term maintenance of PA in these patients is an important aim in disease management. As ordinary fitness training during inpatient rehabilitation seems to be insufficient, behavior changes promise long-term success. Methods and analysis: The objective of this longitudinal analysis is to investigate various physiological and psychological determinants of PA in patients with occupational respiratory diseases. The randomized controlled trial will examine the effects of a behavioral exercise intervention during inpatient pulmonary rehabilitation (PR) on the basis of objective (by ActigraphGT3x+®) and subjective physical activity measured 4 weeks before the start of the rehabilitation and 2, 6 and 12 months after rehabilitation. In addition, psychological determinants such as anxiety, depression and self-efficacy, will be investigated. Participants were randomized in an intervention group (IG) and control group (CG). The IG participated in a behavioral exercise intervention of 9 sessions, in addition to the regular PR. The CG received standard PR over 4 weeks. The behavioral exercise intervention is based on a theoretical framework of various behavior change models in order to maintain or increase PA with the help of volitional and motivational strategies including knowledge transfer, goal setting, action planning and barrier management. Every session consists of theoretical and practical elements to enable participants to pursue an active lifestyle. Conclusion: The purpose of the current study (a randomized controlled trial) is to examine the effectiveness of a behavioral exercise intervention during an inpatient rehabilitation of patients with occupational respiratory diseases on several outcomes, for example, physical activity and mental health. Thus, the results will contribute to optimize a sustainable disease management.