Physical activity in COPD: a scoping review of methods and behaviour change techniques

Long-term maintenance of active lifestyles is a key goal in chronic obstructive pulmonary disease (COPD) management, but it remains challenging. Implementation best practices are still under investigation. This scoping review of the literature aimed to characterise intervention methodologies to promote physical activity (PA)/ reduce sedentary behaviour (SB) in people with COPD and identify the behaviour change techniques (BCT) used. Studies describing these interventions were searched on PubMed, Scopus, Web of Science and PsycNET until May 2025. Two reviewers independently screened and reviewed articles. The 112 studies included comprised 73 interventions - 68 on PA promotion, 3 on SB reduction, 2 on both. Mean intervention duration was 21±19 weeks, 56 included a telemedicine approach, with 15 implemented peri-Pulmonary Rehabilitation. Regarding activity promotion, 32 mentioned education, 18 motivational interviewing and 19 counselling/coaching. Total daily PA was promoted in 52% of interventions, with personalised initial prescription (45%) and progression (25%), frequently using step count as baseline measure (33%). The most frequent BCT were related with self-monitoring and goal setting (73%), with a mean of 8±3 BCT/intervention. This scoping review highlights heterogeneity in unsupervised PA and SB interventions in COPD. Future research should identify the optimal approach, behaviour change strategies, and timing.