Interventions to modify physical activity in patients with COPD: a systematic review

Area of Science:

• Pulmonary Medicine
• Rehabilitation Science
• Exercise Physiology

Background:

• Physical activity (PA) is crucial for managing chronic obstructive pulmonary disease (COPD).
• A systematic assessment of interventions to increase PA in COPD patients is lacking.
• Existing interventions vary widely in approach and effectiveness.

Purpose of the Study:

• To systematically review interventional studies assessing PA as an outcome in COPD patients.
• To identify effective interventions for increasing PA in individuals with COPD.
• To evaluate the quality of evidence for PA interventions in COPD.

Main Methods:

• Systematic literature search across five databases (Medline, Embase, PsycINFO, CINAHL, Web of Science) conducted in March 2015.
• Inclusion of prospective, randomized/non-randomized, cohort, and experimental studies defining COPD via spirometry and using PA as an outcome.
• Data extraction and quality assessment by two independent reviewers.

Main Results:

• Sixty studies were included, identifying seven intervention groups.
• Physical activity (PA) counseling, particularly combined with coaching, increased PA levels in COPD patients.
• Pulmonary rehabilitation (PR) showed positive effects on PA in 13 studies, with no changes in seven; PR programs exceeding 12 weeks consistently improved PA.

Conclusions:

• Interventions specifically targeting PA enhancement and longer-duration pulmonary rehabilitation programs appear most effective for increasing PA in COPD.
• High-quality, well-designed clinical trials employing objective PA assessments in COPD patients are essential for robust evidence generation.