Exercise training alone or with the addition of activity counseling improves physical activity levels in copd: A systematic review and meta-analysis of randomized controlled trials

Aroub Lahham, Christinef McDonald, Anne E. Holland

Research output: Contribution to journalReview ArticleResearchpeer-review

38 Citations (Scopus)

Abstract

Physical inactivity is associated with poor outcomes in COPD, and as a result, interventions to improve physical activity (PA) are a current research focus. However, many trials have been small and inconclusive. Objective: The aim of this systematic review and meta-analysis was to study the effects of randomized controlled trials (RCTs) targeting PA in COPD. Methods: Databases (Physiotherapy Evidence Database [PEDro], Embase, MEDLINE, CINAHL and the Cochrane Central Register for Controlled Trials) were searched using the following keywords: “COPD”, “intervention” and “physical activity” from inception to May 20, 2016; published RCTs that aimed to increase PA in individuals with COPD were included. The PEDro scale was used to rate study quality. Standardized mean differences (effect sizes, ESs) with 95% confidence intervals (CIs) were determined. Effects of included interventions were also measured according to the minimal important difference (MID) in daily steps for COPD (599 daily steps). Results: A total of 37 RCTs with 4,314 participants (mean forced expiratory volume in one second (FEV1) % predicted 50.5 [SD=10.4]) were identified. Interventions including exercise training (ET; n=3 studies, 103 participants) significantly increased PA levels in COPD compared to standard care (ES [95% CI]; 0.84 [0.44–1.25]). The addition of activity counseling to pulmonary rehabilitation (PR; n=4 studies, 140 participants) showed important effects on PA levels compared to PR alone (0.47 [0.02–0.92]), achieving significant increases that exceeded the MID for daily steps in COPD (mean difference [95% CI], 1,452 daily steps [549–2,356]). Reporting of methodological quality was poor in most included RCTs. Conclusion: Interventions that included ET and PA counseling during PR were effective strategies to improve PA in COPD.

Original languageEnglish
Pages (from-to)3121-3136
Number of pages16
JournalInternational Journal of COPD
Volume11
Issue number1
DOIs
Publication statusPublished - 8 Dec 2016
Externally publishedYes

Keywords

  • Chronic obstructive
  • Interventions
  • Physical activity
  • Pulmonary disease

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