Key result
Behavioral and exercise interventions show inconsistent effects on physical activity in COPD.
Why the study?
Reduced physical activity is the strongest predictor of all-cause mortality in COPD patients, but the landscape of physical activity, barriers, facilitators, and assessment tools is not fully mapped.
Changing physical activity behavior in COPD patients requires multidisciplinary collaboration, and current interventions show inconsistent results.
Multiple barriers limit physical activity in COPD; leaves open optimal intervention strategies.
Background Reduced physical activity (PA) was the strongest predictor of all-cause mortality in patients with chronic obstructive pulmonary disease (COPD). This scoping review aimed to map the evidence on the current landscape of physical activity, barriers and facilitators, and assessment tools across COPD patients. Methods Arksey and O'Malley's scoping review methodology framework guided the conduct of this review. An electronic search was conducted on five English databases (PubMed, Cochrane library, PsycINFO, CINAHL and Web of Science (Medline)) and three Chinese databases (CNKI, CQVIP and WAN-FANG) in November 2021. Two authors independently screened the literature, extracted the studies characteristics. Results The initial search yielded 3686 results, of which 1754 were duplicates. Of the remaining 135 articles, 42 studies met the inclusion criteria. Among the reviewed articles, there were 14 (33.3%) cross-sectional study, 9 (21.4%) cohort study, 4 (9.5%) longitudinal study, 3 qualitative study, 12 (28.7%) randomized control trials (RCTs). The main barriers identified were older age, women, lung function, comorbidities, COPD symptoms (fear of breathlessness, severe fatigue, anxiety and depression), GOLD stage, frequency of exacerbation, oxygen use, low motivation and environment-related (season and weather). Twelve studies have evaluated the effects of physical exercise (e.g., walking training), pulmonary rehabilitation, pedometer, self-efficacy enhancing intervention, behavioral modification intervention on physical activity and have had inconsistent results. Conclusions Changing physical activity behavior in patients with COPD requires multidisciplinary collaboration. Future studies need to identify the best instruments to measure physical activity in clinical practice. Future studies should focus on the effects of different types, time and intensity of physical activity in COPD patients and conduct randomized, adequately-powered, controlled trials to evaluate the long-term effectiveness of behavioral change interventions in physical activity.
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项新月 et al. (2022) conducted a review in chronic obstructive pulmonary disease (COPD) (n=42). Physical activity was evaluated. A scoping review of 42 studies identified multiple barriers to physical activity in COPD patients and found inconsistent effects of various behavioral and exercise interventions.
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