Barriers toward Physical Activity in COPD: A Quantitative Cross-Sectional, Questionnaire-Based Study

Sritharan, Sajitha Sophia; Østergaard, Elisabeth Bomholt; Callesen, Jacob Lynge; Elkjaer, Maria L.; Sand, Louise; Hilberg, Ole; Skaarup, Søren Helbo; Løkke, Anders

doi:10.1080/15412555.2021.1922371

Cited by 19 publications

(19 citation statements)

References 45 publications

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“…These findings suggest that symptoms (but not exercise capacity or disease severity/impact) have a role in patients’ motivation to be physically active. In fact, the most significant self-reported barrier towards PA was found to be low motivation [ 2 ], and it was associated with a fear of breathlessness, which supports our findings. It can therefore be hypothesised that more symptomatic patients feel less autonomously motivated to be physically active and reduce their PA as a way of avoiding an increase in symptoms.…”

Section: Discussionsupporting

confidence: 88%

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What Motivates Patients with COPD to Be Physically Active? A Cross-Sectional Study

Pimenta

Silva

Flora

et al. 2021

JCM

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Motivation can be broadly defined as what moves people to act. Low motivation is a frequently reported factor for the reduced physical activity (PA) levels observed in patients with chronic obstructive pulmonary disease (COPD). This study assessed patients’ motives to be physically active, according to three pulmonary rehabilitation (PR) participation groups (Never PR, Previous PR and Current PR) and explored whether these motives were related to the PA levels and clinical characteristics. The motives to be physically active were assessed with the Exercise Motivation Inventory-2 (EMI-2, 14 motivational factors, five dimensions) and PA with accelerometry (PA groups: <5000 steps/day vs. ≥5000 steps/day). The clinical variables included symptoms, impact of the disease, exercise capacity and comorbidities. Ninety-two patients (67.4 ± 8.1 years, 82.6% male, forced expiratory volume in 1s (FEV1) 48.3 ± 18.9% predicted; 30.4% Never PR, 51% Previous PR and 18.5% Current PR) participated. The motivational dimensions related to health/fitness presented the highest scores (3.8 ± 1.1; 3.4 ± 1.3). The motives to be active were not significantly different between PA groups (p > 0.05) but having less symptoms and ≥two comorbidities were associated with higher scores in psychological/health and body-related motives, respectively (p < 0.05). The findings may encourage health professionals to actively explore with patients their motives to be physically active to individualise PA promotion.

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Section: Discussionsupporting

confidence: 88%

“…Low (or lack of) motivation is one of the most frequently reported factors for reduced PA levels in patients with COPD [ 2 , 3 ], in addition to the impact of symptoms such as dyspnoea on exertion and fatigue [ 4 , 5 ]. Motivation can be broadly defined as what moves people to act [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

What Motivates Patients with COPD to Be Physically Active? A Cross-Sectional Study

Pimenta

Silva

Flora

et al. 2021

JCM

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“…The remaining 16 studies were conducted in 12 countries (Germany, Japan, Brazil, Netherlands, Romania, Norway, Sweden, Denmark, China, Indonesia, Portugal, Chile). Among the reviewed articles, study designs ranged from: n = 14 (33.3%) cross-sectional study [32][33][34][35][36][37][38][39][40][41][42][43][44][45]; n = 9 (21.4%) cohort study [8,9,[46][47][48][49][50][51][52]; n = 4 (9.5%) longitudinal study [15,[53][54][55]; n = 3 (7.1%) qualitative study [56][57][58]; n = 12 (28.7%) randomized controlled trials (RCTs) [59][60][61][62][63][64][65][66][67][68][69][70]. Of these, 39 were quantitative studies and 3 were qualitative studies.…”

Section: Article Characteristicsmentioning

confidence: 99%

“…Across all the 42 studies, 27 (64.3%) of studies summarized the barriers to PA in people with COPD, of which 14 used a cross-sectional design [9,[32][33][34][35][36][37][38][39][40][41][42][43][44][45][46], 4 used a longitudinal design [15,[53][54][55], 6 were cohort studies [47][48][49][50][51][52], and 3 used a qualitative design [56][57][58]. We categorized the barriers into four main aspects: sociodemographic variables, physiological factors, psychological factors and social environmental factors (see Regarding the sociodemographic characteristics, studies focused on the effects of age and gender on PA in people with COPD.…”

Section: Barriers Of Physical Activitymentioning

confidence: 99%

Physical activity and chronic obstructive pulmonary disease: a scoping review

Xiang

Fang

et al. 2022

BMC Pulm Med

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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) and three Chinese databases (CNKI, CQVIP and WAN-FANG) in January 2022. Two authors independently screened the literature, extracted the studies characteristics. Results The initial search yielded 4389 results, of which 1954 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. The main barriers identified were older age, women, lung function, comorbidities, COPD symptoms (fear of breathlessness and injury, severe fatigue, anxiety and depression), GOLD stage, frequency of exacerbation, oxygen use, lack of motivation and environment-related (e.g., season and weather). Twelve studies have evaluated the effects of physical exercise (e.g., walking training, pulmonary rehabilitation (PR), pedometer, self-efficacy enhancing intervention and behavioral modification intervention) on PA and showed significant positive effects on the prognosis of patients. However, in real life it is difficult to maintain PA in people with COPD. Conclusions Changing PA 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 PA in people with COPD and conduct randomized, adequately-powered, controlled trials to evaluate the long-term effectiveness of behavioral change interventions in PA.

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“…No one was aware of breathlessness exertion management techniques during exercise or daily physical activity. Previous qualitative and quantitative research revealed that people with COPD have not been informed on physical activity and exercise by their physicians, resulting in low knowledge of the effectiveness of exercise on COPD management 13,26,31,32 . It is not known yet if increased knowledge on exercise and physical activity can enhance engagement in physical activity and exercise, but it might be an enabler 33 .…”

Section: Discussionmentioning

confidence: 99%

Disease management knowledge is poor in Greek patients with chronic obstructive pulmonary disease before entering pulmonary rehabilitation: A qualitative study

Siafaka¹,

Kortianou²,

Mavronasou³

et al. 2022

Pneumon

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INTRODUCTION Patient knowledge on important self-management topics of COPD is low. Education component of pulmonary rehabilitation may increase knowledge, facilitate health behavior change and improve self-efficacy. The aim of the study was to explore specific to disease knowledge in Greek patients with COPD, before entering in a pulmonary rehabilitation program with education component. METHODS Twenty-four patients with COPD (15 males), aged 55-75 years (GOLD I-IV) underwent a semi-structured interview that assessed six important self-management topics and completed the Bristol COPD Knowledge Questionnaire (BCKQ). Qualitative data were analyzed with deductive content analysis and methodological triangulation with the quantitative data was incorporated. RESULTS Qualitative data revealed a low level of knowledge on medication (4-58% of the participants were aware about medication use and any adverse effects), on symptoms and exacerbation management (17% were aware for dyspnea management techniques; 29% used short-acting bronchodilators to manage increased dyspnea). Only 13% of the participants have been informed by their physicians about exacerbation signs. Quantitative data showed total BCKQ score: 45.96% low knowledge shown in medication (inhaled bronchodilators 23.3%, antibiotics 42.5%, oral steroids 29.2%, inhaled steroids 7%), breathlessness 43.4% and infections 36.7%. CONCLUSIONS The knowledge of Greek patients on topics that are important for the self-management of COPD was low. Qualitative methodology efficiently assisted in pointing out knowledge gaps and misconceptions. These data can contribute to the design of a participant-specific education program for knowledge improvement on these topics, which may increase their self-efficacy in self-management.

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Barriers toward Physical Activity in COPD: A Quantitative Cross-Sectional, Questionnaire-Based Study

Cited by 19 publications

References 45 publications

What Motivates Patients with COPD to Be Physically Active? A Cross-Sectional Study

What Motivates Patients with COPD to Be Physically Active? A Cross-Sectional Study

Physical activity and chronic obstructive pulmonary disease: a scoping review

Disease management knowledge is poor in Greek patients with chronic obstructive pulmonary disease before entering pulmonary rehabilitation: A qualitative study

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