Trajectories of endurance activity following pulmonary rehabilitation in COPD patients

• Published in: The European respiratory journal Vol. 39; no. 2; pp. 272 - 278
• Main Authors: SOICHER, J. E, MAYO, N. E, GAUVIN, L, HANLEY, J. A, BERNARD, S, MALTAIS, F, BOURBEAU, J
• Format: Journal Article
• Language: English
• Published: Leeds Maney 01-02-2012
• Subjects: Activities of Daily Living - psychology; Aged; Biological and medical sciences; Chronic obstructive pulmonary disease, asthma; Exercise Therapy - methods; Exercise Therapy - psychology; Female; Health Behavior; Humans; Longitudinal Studies; Male; Medical sciences; Middle Aged; Miscellaneous; Outpatients - psychology; Patient Participation - psychology; Physical Endurance - physiology; Physical Fitness - physiology; Physical Fitness - psychology; Pneumology; Program Evaluation; Pulmonary Disease, Chronic Obstructive - physiopathology; Pulmonary Disease, Chronic Obstructive - psychology; Pulmonary Disease, Chronic Obstructive - rehabilitation; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Physical exercise; Human; Lung disease; Respiratory disease; Behavioural medicine; Lung; Activity; exercise; Medicine; Chronic; Bronchus disease; Chronic obstructive pulmonary disease; Endurance; Obstructive pulmonary disease; Rehabilitation; Trajectory; Pneumology
• ISSN: 0903-1936; 1399-3003
• DOI: 10.1183/09031936.00026011

Maintenance of physical activity following pulmonary rehabilitation remains a challenge for patients with chronic obstructive pulmonary disease (COPD). The objectives of this study were to identify patterns of endurance activity after completion of pulmonary rehabilitation and to characterise people who succeed and those who have difficulty maintaining endurance activity. In a longitudinal study embedded within a randomised clinical trial, 206 individuals with COPD underwent a 3-month pulmonary rehabilitation programme. Weekly duration of endurance activity was assessed at 4, 6, 8 and 12 months after the start of rehabilitation. Trajectory modelling was used to determine the most common patterns of activity during the post-rehabilitation phase from 4-12 months. Three distinct patterns were identified, two of which indicated difficulty in maintaining endurance activity: 61 individuals reported a high activity level at 4 months (2.7 h·week(-1)) and stayed high; 114 individuals started at a low activity level (mean 1.0 h·week(-1)) and stayed low; and 31 individuals started high (3.0 h·week(-1)) and declined. The low activity group was characterised by more severe disease and greater respiratory impairment. The high and declined group had less severe disease and respiratory impairment, but reported greater barriers to exercise. Pulmonary rehabilitation should include interventions aimed at minimising barriers, in order to induce long-term behaviour change.