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Participation in Physical Activity During Center and Home-Based Pulmonary Rehabilitation for People With COPD: A
Aroub Lahham1, Christine F McDonald, Ajay Mahal
1Physiotherapy, La Trobe University, Melbourne, Victoria, Australia (Mss Lahham and Burge and Drs Lee, Cox, and Holland); Institute for Breathing and Sleep, Melbourne, Victoria, Australia (Mss Lahham, Burge, and Gillies and Drs McDonald, Lee, Hill, Cox, Moore, and Holland); Department of Respiratory and Sleep Medicine, Austin Health, Melbourne, Victoria, Australia (Dr McDonald); Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia (Dr McDonald); Nossal Institute for Global Health, The University of Melbourne, Melbourne, Victoria, Australia (Dr Mahal); Department of Physiotherapy, Alfred Hospital, Melbourne, Victoria, Australia (Mss Lee, Burge, Nicolson, and Holland); Department of Physiotherapy, Austin Hospital, Melbourne, Victoria, Australia (Mss Hill, Moore, and Gillies); and Public Health and Psychology, La Trobe University, Melbourne, Victoria, Australia (Dr O'Halloran).
Purpose:
To compare levels of physical activity during center and home-based pulmonary rehabilitation (PR) in people with chronic obstructive pulmonary disease.
Methods:
Forty-five consecutive participants (23 male, n = 20, in the home-based group) with mean age of 68 ± 8 yr and forced expiratory volume in the first second of expiration (FEV1) 53 ± 18% predicted undertook physical activity monitoring using the SenseWear Armband during the final week of the interventions of center or home-based PR. Differences in time spent in total physical activity (≥1.5 METs), time spent in moderate to vigorous intensity physical activity (≥3 METs), and steps were compared.
Results:
Home participants spent a median and interquartile range of 310 (199-328) min/d engaged in total physical activity (29% moderate to vigorous intensity physical activity) compared with 300 (204-370) min/d for the center group (28% moderate to vigorous intensity physical activity, P = .98). Daily step count did not differ between groups (home-based median 5232 [2067-7718] versus center-based median 4049 [1983-6040], P = .66). Of note, center-based participants took 38% more steps on days of program attendance compared with nonattendance days (mean difference: 761 steps/d; 95% CI, -56 to 1579, P = .06).
Conclusion:
For people with chronic obstructive pulmonary disease undertaking PR, no differences in physical activity levels between center and home-based programs were demonstrated. Understanding the impact of the indirect supervision and motivational interviewing technique utilized during home-based PR on levels of physical activity in people with chronic obstructive pulmonary disease may support clinical implementation of the model as an alternative option to traditional care.
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