Physical Activity Counselling during Pulmonary Rehabilitation in Patients with COPD: A Randomised Controlled Trial

BackgroundPulmonary rehabilitation programs only modestly enhance daily physical activity levels in patients with chronic obstructive pulmonary disease (COPD). This randomised controlled trial investigates the additional effect of an individual activity counselling program during pulmonary rehabilitation on physical activity levels in patients with moderate to very severe COPD.MethodsEighty patients (66±7 years, 81% male, forced expiratory volume in 1 second 45±16% of predicted) referred for a six‐month multidisciplinary pulmonary rehabilitation program were randomised. The intervention group was offered an additional eight-session activity counselling program. The primary outcomes were daily walking time and time spent in at least moderate intense activities.ResultsBaseline daily walking time was similar in the intervention and control group (median 33 [interquartile range 16–47] vs 29 [17–44]) whereas daily time spent in at least moderate intensity was somewhat higher in the intervention group (17[4–50] vs 12[2–26] min). No significant intervention*time interaction effects were observed in daily physical activity levels. In the whole group, daily walking time and time spent in at least moderate intense activities did not significantly change over time.ConclusionsThe present study identified no additional effect of eight individual activity counselling sessions during pulmonary rehabilitation to enhance physical activity levels in patients with COPD.Trial Registrationclinicaltrials.gov NCT00948623背景 肺康复（pulmonary rehabilitation）方案仅能适度提升慢性阻塞性肺疾病（chronic obstructive pulmonary disease, COPD）患者的日常体力活动水平。本随机对照试验旨在探究肺康复期间附加个体化活动咨询方案对中至极重度COPD患者的体力活动水平的额外增益效果。 方法 共纳入80例拟接受6个月多学科肺康复方案的患者（年龄66±7岁，男性占比81%，一秒用力呼气容积（forced expiratory volume in 1 second）为预计值的45±16%），并将其随机分组。干预组额外接受8次活动咨询方案干预。主要结局指标为每日步行时长及至少中等强度活动的累计时长。 结果 干预组与对照组的基线每日步行时长无显著差异（中位数33 [四分位间距16–47] vs 29 [17–44]）；但干预组每日至少中等强度活动的时长略高于对照组（17[4–50] vs 12[2–26] 分钟）。未观察到干预措施×时间交互作用对患者日常体力活动水平产生显著影响。整体队列中，每日步行时长及至少中等强度活动的时长未随时间出现显著变化。 结论 本研究未发现肺康复期间附加8次个体化活动咨询方案可进一步提升COPD患者的体力活动水平。 试验注册 clinicaltrials.gov NCT00948623