Related Experiment Video
Updated: Jun 23, 2025
Home-Based Prescribed Pulmonary Exercise in Patients with Stable Chronic Obstructive Pulmonary Disease
Published on: August 24, 2019
Interventions with a clear focus on achieving behaviour change are important for maintaining training-related gains
Sarah Hug1, Vinicius Cavalheri2, Hollie Lawson-Smith3
1Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Australia; Physiotherapy Department, Royal Perth Hospital, Perth, Australia.
Questions:
In people with chronic obstructive pulmonary disease (COPD) who complete an exercise training program (ETP) offered at a sufficient dose to result in training-related gains, to what extent are these gains maintained 12 months after program completion? Do variables such as the application of behaviour change techniques moderate the maintenance of these training-related gains?
Design:
Systematic review, meta-analysis and meta-regression of randomised controlled trials.
Participants:
People with stable COPD.
Intervention:
Trials were included if they applied ≥ 4 weeks of a whole-body ETP and reported outcome data immediately following program completion and 12 months after initial program completion. The control group received usual care that did not include a formal exercise training component.
Outcome Measures:
Exercise tolerance, health-related quality of life and dyspnoea during activities of daily living.
Data Sources:
EMBASE, PEDro, PubMed and the Cochrane Library.
Results:
Nineteen randomised trials with 2,103 participants were found, of which 12 had a sufficiently similar design to be meta-analysed. At 12 months after ETP completion, compared with the control group, the experimental group demonstrated better exercise tolerance (SMD 0.48, 95% CI 0.19 to 0.77) and quality of life (SMD 0.22, 95% CI 0.03 to 0.41) with no clear effect on dyspnoea. Meta-regression using data from all 19 trials demonstrated that the magnitude of between-group differences at the 12-month follow-up was moderated by: behaviour change being a core aim of the strategies implemented following completion of the ETP; the experimental group receiving more behaviour change techniques during the program; and the magnitude of between-group change achieved from the program.
Conclusion:
At 12 months after completion of an ETP of ≥ 4 weeks, small gains were maintained in exercise tolerance and health-related quality of life. Applying behaviour change techniques with a clear focus on participants integrating exercise into daily life beyond initial program completion is important to maintain training-related gains.
Registration:
CRD42020193833.
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