The effects of walking prescription to promote physical activity in chronic obstructive pulmonary disease

Abstract

Background: Depression and Anxiety is a common symptom and one of the barriers for physical activity (PA) promotion in patients with Chronic Obstructive Pulmonary Disease (COPD). Although several psychological / lifestyle interventions exists in PR, yet evidence on behaviour interventions to promote PA in COPD patients with anxiety and depression is sparse. We investigated the effects of walking prescription on promotion of PA, exercise endurance and better quality of life in COPD patients with anxiety and depression. Methods: Retrospective analysis was performed on data from 29 COPD patients [FEV1: 59.08 (22.00) %] who completed an 8 weeks outpatients PR programme. All patients received 30 mins supervised exercise training for 3 session and 1 hour of self management education for 2 sessions per week. A baseline walking prescription of 80 % average of their initial 6MWT was prescribed for 4-5 days per week in physical activity log (PAL). Baseline and post rehabilitation outcomes include 6 min walk test (6MWT), PAL, COPD Assessment Test (CAT), Borg scale, Modified Medical Research Council dyspnoea scale (MMRC) and Hospital anxiety and depression scale (HAD). Results: Significant improvement was noted in all outcome measures except depression score compared to baseline. A direct relationship was found between PA and exercise endurance versus an inverse relationship with anxiety and depression score in patients with COPD. Conclusion: This study supports the addition of walking prescription in pulmonary rehabilitation as a cost effective, motivational tool to enhance lifestyle behavior change and promote physical activity in COPD patients.