BACKGROUND Exercise-based cardiac rehabilitation can reduce the risk of all-cause mortality, cardiovascular events, and sudden death in post-PCI patients, restore physical strength, and allow them to return to society as early as possible. However, low participation and poor adherence to cardiac rehabilitation are prevalent across countries, with the poorest adherence among post-PCI patients in China. Given that the spouse is the primary caregiver of a patient after PCI, the health, behavior, and values of the couple are closely related. This study designed a couple-based exercise program based on the dyadic coping theory to promote the exercise of patients and their spouses in order to improve the compliance of patients with cardiac rehabilitation exercise, so as to improve the effect of cardiac rehabilitation. METHODS This study is a quasi-experiment, the dyads (N = 68) will be recruited to participate in a 12-week study. They will be recruited to the intervention group that will receive the Couple-Based exercise program and the control group that will receive routine exercise-based cardiac rehabilitation. The primary outcomes were exercise adherence and exercise self-efficacy. Secondary outcomes were the 6-minute walk test, the 9-item Patient Health Questionnaire, and the Generalized Anxiety Disorder Scale. Outcomes were collected at baseline and post-intervention (12 weeks). Statistical analysis will be performed using SPSS V. 25.0 software. RESULT After a three-week follow-up, the results showed that there were significant differences in exercise adherence, exercise self-efficacy, 6-minute walk test and anxiety-depression in patients in the co-exercise binary group compared to the control group (p > 0.05), indicating that the intervention program of co-exercise for couples helped to improve exercise adherence, exercise self-efficacy, 6-minute walk test and anxiety-depression in patients compared to usual care depression. DISCUSSION Couples exercising together can change the conventional exercise interventions, with a shift occurring from the individual level to the dyadic level, an approach that optimizes the situation for both partners, as the physical and mental health of the couple is closely linked. TRIAL REGISTRATION: This study was registered with the Chinese Clinical Trials Registry on April 12, 2022 under registration number ChiCTR2200058600.

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.