Consistent support from healthcare professionals, interaction with peers, and regular exercise can help people with chronic obstructive pulmonary disease (COPD) remain physically active over the long-term, a systematic review of multiple studies shows.
The report identifies both barriers and beneficial elements for physical activity following pulmonary rehabilitation. It highlights patients’ need for maintaining supportive social interactions and regular exercise to stay active.
The review study, titled “Facilitators and barriers to physical activity following pulmonary rehabilitation in COPD: a systematic review of qualitative studies,” was published in the journal Primary Care Respiratory Medicine.
Pulmonary rehabilitation — a patient-tailored approach combining exercise, education, and behavioral changes — can improve physical capacity, reduce shortness of breath, and enhance the quality of life of COPD patients.
However, these programs are typically short, lasting only a few weeks (usually six to eight weeks), and do not seem to foster long-term physical abilities. Additionally, improvements in physical capacity due to rehabilitation do not always result in an increase in daily physical activity and lasting behavioral changes.
“Being physically active is extremely important for people with COPD, however, people with the disease find it difficult to remain physically active once they have finished pulmonary rehabilitation,” Arwel Jones, PhD, research fellow at the Lincoln Institute for Health in the U.K., and senior author of the study, said in a news release.
So, researchers at the University of Lincoln and the University of Oxford conducted a systematic review of several published studies to understand what influences patients’ physical activity and what can guide better health interventions to improve long-term COPD management.
In total, researchers analyzed data from 16 studies, including published studies, theses, and conference summaries, and examined patient-reported factors that encouraged or prevented maintenance of a physically active lifestyle following pulmonary rehabilitation programs.
Researchers found that the main barriers patients face to remaining active are social isolation, limited opportunities to attend exercise sessions, and COPD symptoms such as breathlessness that create anxiety or fear and discourage patients from participating in physical activities.
Regular contact with healthcare professionals, which creates a sense of trust, security, and comfort, is important to motivate patients to be physically active, the study said.
Interaction with peers also was found to be beneficial, as it can help patients overcome loneliness, receive encouragement after rehabilitation, and improve access to regular exercise sessions.
“The results provide clear guidance for future research design and we hope that the research can be used to inform future strategies in the NHS [the U.K.’s National Health Service] to promote physical activity after pulmonary rehabilitation,” added Hayley Robinson, the study’s lead author.