There is a need to increase and maintain physical activity in patients with chronic obstructive pulmonary disease (COPD). We assessed 12-month efficacy and effectiveness of the Urban Training intervention on physical activity in COPD patients.This randomised controlled trial (NCT01897298) allocated 407 COPD patients from primary and hospital settings 1:1 to usual care (n=205) or Urban Training (n=202). Urban Training consisted of a baseline motivational interview, advice to walk on urban trails designed for COPD patients in outdoor public spaces and other optional components for feedback, motivation, information and support (pedometer, calendar, physical activity brochure, website, phone text messages, walking groups and a phone number). The primary outcome was 12-month change in steps·day−1 measured by accelerometer.Efficacy analysis (with per-protocol analysis set, n=233 classified as adherent to the assigned intervention) showed adjusted (95% CI) 12-month difference +957 (184–1731) steps·day−1 between Urban Training and usual care. Effectiveness analysis (with intention-to-treat analysis set, n=280 patients completing the study at 12 months including unwilling and self-reported non-adherent patients) showed no differences between groups. Leg muscle pain during walks was more frequently reported in Urban Training than usual care, without differences in any of the other adverse events.Urban Training, combining behavioural strategies with unsupervised outdoor walking, was efficacious in increasing physical activity after 12 months in COPD patients, with few safety concerns. However, it was ineffective in the full population including unwilling and self-reported non-adherent patients.

WBVT provided significant improvements in functional capacity in severe COPD patients without changes in muscular force.

Background There is limited information about the impact of coronavirus disease (COVID‐19) on the muscular dysfunction, despite the generalized weakness and fatigue that patients report after overcoming the acute phase of the infection. This study aimed to detect impaired muscle efficiency by evaluating delta efficiency (DE) in patients with COVID‐19 compared with subjects with chronic obstructive pulmonary disease (COPD), ischaemic heart disease (IHD), and control group (CG). Methods A total of 60 participants were assigned to four experimental groups: COVID‐19, COPD, IHD, and CG ( n = 15 each group). Incremental exercise tests in a cycle ergometer were performed to obtain peak oxygen uptake (VO 2 peak). DE was obtained from the end of the first workload to the power output where the respiratory exchange ratio was 1. Results A lower DE was detected in patients with COVID‐19 and COPD compared with those in CG ( P ≤ 0.033). However, no significant differences were observed among the experimental groups with diseases ( P > 0.05). Lower VO 2 peak, peak ventilation, peak power output, and total exercise time were observed in the groups with diseases than in the CG ( P < 0.05). A higher VO 2 , ventilation, and power output were detected in the CG compared with those in the groups with diseases at the first and second ventilatory threshold ( P < 0.05). A higher power output was detected in the IHD group compared with those in the COVID‐19 and COPD groups ( P < 0.05) at the first and second ventilatory thresholds and when the respiratory exchange ratio was 1. A significant correlation ( P < 0.001) was found between the VO 2 peak and DE and between the peak power output and DE ( P < 0.001). Conclusions Patients with COVID‐19 showed marked mechanical inefficiency similar to that observed in COPD and IHD patients. Patients with COVID‐19 and COPD showed a significant decrease in power output compared to IHD during pedalling despite having similar response in VO 2 at each intensity. Resistance training should be considered during the early phase of rehabilitation.

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Purpose On March 16, 2020, the Spanish government declared a state of alarm due to the rapid spread of coronavirus disease 2019 (COVID-19). Patients with chronic obstructive pulmonary disease (COPD) were restricted to remain confined at home, and medical visits were cancelled for 3 months. The impact of this lockdown on the manifestations of COPD and the quality-of-life of these patients has not been explored. Patients and Methods One hundred patients with COPD were interviewed by telephone from May 2–18, 2020. The interviews included questions about the lockdown, missed medical appointments, fears of the disease, possible COVID-19 infection, and exacerbations of COPD suffered during this period and their management. In addition, the COPD Assessment Test, the Hospital Anxiety and Depression, and the 5-Dimension Euro Quality-of-Life questionnaires were administered. Results Sixty-four (64%) patients claimed to have strictly complied with the lockdown, and only 42 (42%) stated they had left home at least once during lockdown. Only one patient (1%) was hospitalized due to COVID-19, and 13 (13%) patients presented an exacerbation of COPD self-managed at home with no admissions due to exacerbation of COPD during this period. A medical consultation or complementary test was cancelled in 90% of the patients, but 61% had a medical telephone visit with a high degree of satisfaction (mean 9.3/10). Most patients declared that their feeling regarding lung disease and general health was similar or even better during lockdown (82% and 81%, respectively). Conclusion Our results indicate that in general lockdown had a low impact on COPD patients. Only one patient was affected by COVID-19, but moderate exacerbations of COPD were not infrequent. Although many medical visits and test were cancelled, patients were very satisfied with the medical telephone visits.