A community-based exercise programme in COPD self-management: Two-year follow-up of the COPE-II study

Introduction It is still unknown how to best maintain effects of COPD exercise programmes. We present the long-term effects of a community-based exercise programme incorporated in a self-management programme, compared to a self-management programme only in COPD patients. Methods All patients participated in four self-management sessions. Additionally, intervention patients participated in an 11-month community-based exercise programme led by physiotherapists. Patients trained three times/week for five months and two times/week during the subsequent six months. To encourage behavioural change towards exercise, one of these weekly training sessions was home-based (unsupervised). No formal training was offered to intervention patients in the second year. Modified intention-to-treat analyses were performed. Results The intervention and control condition were randomly assigned to 80 and 79 patients, respectively. Although the between-group difference in maximal exercise capacity was statistically significant after 12 months (35.1 meters (95%CI: 8.4 to 61.8)), it was not after 24 months (12.2 meters (95%CI: -16.6 to 41.0)). The between-group difference in daily physical activity was maintained after 24 months (1193 steps/day (95%CI: 203 to 2182)) compared to 12 months (1190.4 steps/day (95%CI: 255.6 to 2125.2)). A beneficial effect was found on CRQ dyspnoea score (0.35 (95%CI: 0.03 to 0.67)) but not on other CRQ domains, CCQ and HADS. Conclusions Our intervention was effective in achieving a behavioural change reflected by a sustained increase in daily physical activity, not accompanied by a sustained between-group difference in maximal exercise capacity after two years of follow-up.