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Home-Based Prescribed Pulmonary Exercise in Patients with Stable Chronic Obstructive Pulmonary Disease
Published on: August 24, 2019
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Behavioural interventions targeting physical activity improve psychocognitive outcomes in COPD
Kim L Lavoie1,2, Maria Sedeno3, Alan Hamilton4
1Montreal Behavioural Medicine Centre, Research Centre, CIUSSS-NIM Hôpital du Sacré-Coeur de Montreal, Montreal, Canada.
ERJ Open Research
|November 14, 2019
Summary
Self-management behaviour modification (SMBM) improved psychological and cognitive health in COPD patients. Increased physical activity and exercise capacity were linked to reductions in anxiety, depression, and cognitive decline.
Area of Science:
- Pulmonary Medicine
- Behavioral Science
- Clinical Psychology
Background:
- Chronic Obstructive Pulmonary Disease (COPD) significantly impacts patients' psychological well-being and cognitive function.
- Self-management behaviour modification (SMBM) and exercise training (ExT) are potential interventions to improve COPD patient outcomes.
- The role of bronchodilators in conjunction with SMBM and ExT requires further investigation for psychological and cognitive benefits.
Purpose of the Study:
- To investigate the impact of SMBM, with or without bronchodilators and ExT, on psychological and cognitive outcomes in COPD patients.
- To analyze secondary outcomes from the PHYSACTO trial, focusing on anxiety, depression, and cognitive function.
- To determine the relationship between improvements in physical activity/exercise capacity and psychological/cognitive gains.
Main Methods:
- A 12-week, four-group, randomized, partially double-blind, placebo-controlled trial involving 304 COPD patients.
- Interventions included SMBM with tiotropium, SMBM with tiotropium/olodaterol, SMBM with tiotropium/olodaterol plus ExT, or placebo.
- Outcomes assessed were anxiety (HADS-A), depression (HADS-D, PHQ-9), and cognitive function (MoCA).
Main Results:
- All participants showed statistically and clinically significant improvements in anxiety, depression, and cognitive function after 12 weeks, irrespective of the treatment group.
- Greater improvements in anxiety and cognitive function were associated with increased physical activity and exercise capacity, respectively.
- Enhanced depression scores correlated with increases in either physical activity or exercise capacity.
Conclusions:
- SMBM, with or without bronchodilators or ExT, is associated with improved psychological and cognitive functioning in COPD patients.
- Interventions aimed at increasing daily physical activity and exercise capacity show promise for enhancing mental health and cognition in COPD.
- Targeting physical activity and exercise capacity may be a viable strategy to mitigate psychological distress and cognitive impairment in COPD management.
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