Abstract
Motivation can be broadly defined as what moves people to act. Low motivation is a frequently reported factor for the reduced physical activity (PA) levels observed in patients with chronic obstructive pulmonary disease (COPD). This study assessed patients’ motives to be physically active, according to three pulmonary rehabilitation (PR) participation groups (Never PR, Previous PR and Current PR) and explored whether these motives were related to the PA levels and clinical characteristics. The motives to be physically active were assessed with the Exercise Motivation Inventory-2 (EMI-2, 14 motivational factors, five dimensions) and PA with accelerometry (PA groups: <5000 steps/day vs. ≥5000 steps/day). The clinical variables included symptoms, impact of the disease, exercise capacity and comorbidities. Ninety-two patients (67.4 ± 8.1 years, 82.6% male, forced expiratory volume in 1s (FEV1) 48.3 ± 18.9% predicted; 30.4% Never PR, 51% Previous PR and 18.5% Current PR) participated. The motivational dimensions related to health/fitness presented the highest scores (3.8 ± 1.1; 3.4 ± 1.3). The motives to be active were not significantly different between PA groups (p > 0.05) but having less symptoms and ≥two comorbidities were associated with higher scores in psychological/health and body-related motives, respectively (p < 0.05). The findings may encourage health professionals to actively explore with patients their motives to be physically active to individualise PA promotion.
Highlights
Optimising physical activity (PA) in patients with chronic obstructive pulmonary disease (COPD) is a major goal, as this population is highly inactive in daily life, and low physical activity (PA) levels are related to poor health outcomes [1].Low motivation is one of the most frequently reported factors for reducedPA levels in patients with COPD [2,3], in addition to the impact of symptoms such as dyspnoea on exertion and fatigue [4,5]
The findings may encourage health professionals to actively explore with patients their patients highly valued health and fitness motives, and there was a trend for patients who motives to be physically active to individualise PA promotion
Patients who participated in pulmonary rehabilitation (PR) before (Previous PR) seemed to find PA more enjoyable than those who never enrolled in PR, the results were only nearly significant
Summary
Optimising physical activity (PA) in patients with chronic obstructive pulmonary disease (COPD) is a major goal, as this population is highly inactive in daily life, and low physical activity (PA) levels are related to poor health outcomes (e.g., acute exacerbations, increased risk of hospitalisations and death) [1].Low (or lack of) motivation is one of the most frequently reported factors for reducedPA levels in patients with COPD [2,3], in addition to the impact of symptoms such as dyspnoea on exertion and fatigue [4,5]. Optimising physical activity (PA) in patients with chronic obstructive pulmonary disease (COPD) is a major goal, as this population is highly inactive in daily life, and low physical activity (PA) levels are related to poor health outcomes (e.g., acute exacerbations, increased risk of hospitalisations and death) [1]. The Self-Determination Theory (SDT) provides a framework to understand motivation for behaviour change, and it is one of the most recommended theories to be used in PA promotion [7]. According to this theory, human motivation is a dynamic process that oscillates in a continuum from amotivation and extrinsic motivation to intrinsic motivation [8,9]. Understanding the individual motives for engaging in PA may help in the development of effective interventions to improve patients’ PA levels
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