Awareness without actionable knowledge: understanding physical activity recommendations among people with COPD

Physical activity (PA) promotion is a cornerstone of non-pharmacological Chronic Obstructive Pulmonary Disease (COPD) management. Recognising the benefits of PA may not be sufficient to guide behaviour if people with COPD do not know the specific PA recommendations. This actionable knowledge may support PA engagement. This study aimed to characterise awareness of PA benefits, inactivity risks and knowledge of the WHO recommendations among people with COPD, exploring associations with participants' characteristics.

A cross-sectional survey-based study with community-dwelling adults with COPD was conducted. Four hospitals and a patient association recruited participants to complete an online questionnaire on sociodemographic/clinical data, PA levels, barriers/benefits to exercise, knowledge of PA guidelines and perceived benefits/risks.

Among the 126 participants (mean age of 66.5±12 years), 36.5% had completed higher education. Although 72.2% reported having previously seen, heard or read information about PA recommendations, specific knowledge of the minimum targets was low. Correct responses were observed for 16.7%, 11.9% and 9.5% of participants regarding moderate-intensity PA (MPA), vigorous-intensity PA (VPA) and strength training, respectively. Participants commonly recognised general benefits of PA and risks of inactivity. In multivariable analysis, educational level and PA levels were associated with MPA knowledge.

Despite recognising PA benefits and inactivity risks, participants lacked specific knowledge of WHO recommendations. This mismatch may indicate a potential psychological capability gap between general awareness and the knowledge required to integrate PA into daily life. These findings support the inclusion of clear, literacy-sensitive guidance on PA frequency, intensity, duration and type in COPD care.