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,David Gisi,Spencer Rezek,André Meichtry,Markus Wirz,Thomas Hess,Ariane Schwank,Noriane A Sievi,Swantje Beyer

doi:10.1186/s12890-021-01685-2

Abstract

BackgroundCounselling 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.MethodsA 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.ResultsOf 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.ConclusionsIn 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).

Highlights

Counselling is considered to be a promising approach to increasing physical activity (PA) in people with chronic obstructive pulmonary disease (COPD)
Sound evidence has shown that physical inactivity in COPD patients is associated with an increased number of hospitalizations [2,3,4], and that it is the strongest predictor of all-cause mortality [3, 5]
Patient recruitment and enrolment were started in June 2015 and ended in March 2020

Summary

Introduction

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 rehabilita‐ tion (PR) program, increased their daily PA. Physical activity (PA) promotion for patients with Chronic Obstructive Pulmonary Disease (COPD) is a research field of great importance. Both the American Thoracic Society (ATS) and the European Respiratory Society (ERS) have stressed that long-term self-management and adherence to exercise at home should be the Rausch Osthoff et al BMC Pulm Med (2021) 21:317 primary goal of pulmonary rehabilitation programs (PR) [1]. The use of Motivational Interviewing (MI) techniques for PA counselling have been supported within the PR community [10, 16]

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