Persons With Chronic Obstructive Pulmonary Disease and High Levels of Activation Improved Their Physical Activity...

Daily physical activity is part of the self-management of patients with chronic obstructive pulmonary disease (COPD), and didactic information sessions may be insufficient for the provision of these skills. Prior activation can determine sensitivity to these sessions. We evaluated whether the activation in patients with COPD, as measured by the Patient Activation Measure (PAM)-13 questionnaire, determined their responses to an educational group session on physical activity (PA), which were measured with actigraphy by the number of steps/day.

We conducted an uncontrolled clinical trial in an outpatient clinic with 75 patients with nonexacerbating COPD (forced expiratory volume in 1 second 30%-80%) who were selected consecutively. Patients were provided with an actigraph that they used for 15 days and completed the PAM-13 questionnaire. On the eighth day, they attended a group educational session where they were given PA information. We compared the changes in activity after the session by pooled PAM levels and the correlation between the change in the number of steps/day and the PAM-13 questionnaire.

A total of 26 patients had activation levels of 1-2, while 49 patients had levels of 3-4. After the session, patients in Levels 1-2 decreased their number of steps (-596±42), while those in Levels 3-4 increased them (680±253, p<0.01). The level of activation was positively correlated with change in the number of steps/day (p<0.05).

COPD patients with greater activation showed greater improvements in daily PA after a group educational session.