Behavioural interventions targeting physical activity improve psychocognitive outcomes in COPD

Lavoie, Kim L.; Sedeno, Maria; Hamilton, Alan; Li, Peizhi; Sousa, Dorothy De; Troosters, Thierry; Maltais, François; Bourbeau, Jean

doi:10.1183/23120541.00013-2019

Cited by 20 publications

(20 citation statements)

References 48 publications

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“…This may be related to psycho-cognitive factors such as anxiety and depression or even socio-cultural status and educational level [22,23]. There is also a complex interaction between the healthcare professional"s communication and the patient.…”

Section: Discussionmentioning

confidence: 99%

Mechanisms associated with increased physical activity in patients undergoing self-management behaviour modification in the randomised PHYSACTO trial

Bourbeau

Sedeno²,

Li³

et al. 2021

ERJ Open Res

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IntroductionIn this analysis of the PHYSACTO® study, we assessed the efficacy of a self-management behaviour modification (SMBM) programme to improve physical activity (PA) levels, and the extent to which effects were mediated by readiness to change, motivation and confidence.MethodsPHYSACTO® was a randomised, partially double-blind, parallel-group, 12-week trial to evaluate the effects of treatment on exercise capacity and PA. COPD patients received placebo, tiotropium 5 µg or tiotropium/olodaterol 5/5 µg, with or without exercise training, all with an SMBM intervention (the Living Well with COPD programme). Changes were assessed in readiness to change (Stage of Change Visual Analogue Scale [VAS]), motivation (Treatment Self-Regulation Questionnaire [TSRQ]), and confidence (Perceived Competence Scale [PCS]) to engage in PA.ResultsPA was increased in all patients with complete PA data at Week 12 (n=262; +6038 steps·week−1, p<0.001). Significant increases were observed in patients' readiness to change (VAS 0.7 [0.6–0.8]), autonomous regulation (TRSQ 0.2 [0.1–0.3]) and confidence (PCS 0.5 [0.3–0.6]) (all p<0.01). Of note, 23% of the total effect of SMBM on steps·week−1 was found to be mediated by increases in readiness to change, 5% by TSRQ autonomous regulation and 12% by PCS.ConclusionOur study demonstrated that an SMBM programme delivered to COPD patients increased PA, mediated by an improvement of three key hypothesised mechanisms of change: readiness to change, autonomous motivation and confidence. For the first time, this study shows that an SMBM programme can be successful in changing the mechanisms of change targeted by the intervention.

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Section: Discussionmentioning

confidence: 99%

Mechanisms associated with increased physical activity in patients undergoing self-management behaviour modification in the randomised PHYSACTO trial

Bourbeau

Sedeno²,

Li³

et al. 2021

ERJ Open Res

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“…clinically stable settings [48], or with much different 6-minute walking distances. Further studies should clarify the effects of factors leading to a reduction in depression, including medical and psychotherapeutic interventions [56], as well as physical activity, exercise and rehabilitation [57][58][59][60], which may also influence test results and may in parallel improve the quality of life and possibly the outcome of COPD patients [47].…”

Section: Discussionmentioning

confidence: 99%

Does the 6-minute walk test in hospitalized COPD patients exclusively correlate with lung function parameters or should psychological factors also be taken into account?

Borgmann

Ivanda²,

Hadizamani

et al. 2020

PLoS ONE

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The 6-minute walk test is generally considered a standard test for the evaluation of shortterm maximal physical performance. It has not been evaluated whether psychological factors, such as anxiety or depression, affect the performance or the results of the test. The main aim of this study was to investigate whether a correlation exists between psychological factors and the data from the 6-minute walking test. The study cohort consisted of 85 (♀ = 34 and ♂ = 51) 66 ± 10 (mean ± SD) year-old patients with chronic obstructive pulmonary disease (COPD) hospitalized for disease exacerbation. Forced Expiratory Volume in the first second (FEV 1) (% predicted) as predictor for lung function, as well as anxiety and depression symptoms assessed using the Hospital Anxiety and Depression Scale (HADS) as psychological predictors were collected. Bivariate correlations and hierarchical linear regression models were used to analyse the correlations. Walking distance was on average 260m ± 107m and ranged from 64m to 480m. HADS was negatively correlated with 6-min walking distance (r = 0.441, p = .0009, r =-.523, p = 00006). Hierarchical linear regression showed that FEV 1 alone explained 33%, and together with the psychological variables anxiety and depression explained 42% of the variance of results from the 6-minute walking test. These findings demonstrated that 11% of the data correlated with the psychological variables alone (p = .011). The effect size for lung function (f 2 = .717) and psychological variables (f 2 = .352) were high, whereas the socio-demographic variables sex, age, educational level and BMI could not explain any additional variance in our cohort. In conclusion, our

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“…83 Lavoie et al also found that anxiety and depression reduced with increases in either physical activity or exercise capacity, and cognitive function improved with increased exercise capacity in COPD patients. 84 Moreover, exercise Figure 1 The possible mechanism of exercise improving cognitive impairment in the elderly with COPD. Abbreviations: NE, norepinephrine; DA, dopamine; 5-HT, 5-hydroxytryptamine; IL-10, interleukin-10; IL-6, interleukin-6; CRP, C-reactive protein; TNF-α, tumor necrosis factor-α; PaO2, partial arterial blood oxygen pressure; PaCO2, partial arterial carbon dioxide pressure; VEGF, vascular endothelial growth factor; IGF-1, insulin-like growth factor-1.…”

Section: Possible Mechanism Of Exercise On the Improvement Cognitive mentioning

confidence: 99%

<p>Influencing Factors and Exercise Intervention of Cognitive Impairment in Elderly Patients with Chronic Obstructive Pulmonary Disease</p>

Wang¹,

Mao²,

Wang³

et al. 2020

CIA

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Chronic obstructive pulmonary disease (COPD) is a common respiratory condition characterized by airflow limitation in the elderly. Airflow limitation is partially reversible and progressive. COPD not only causes a gradual decline in lung function but also affects the function of other systems throughout the body; it also has adverse effects on the central nervous system that can lead to cognitive impairment, especially in elderly patients. Therefore, understanding the influencing factors of cognitive impairment in elderly patients with COPD and applying early intervention are crucial in improving the quality of life of patients and reducing the burden on their families and society. This article mainly discusses the related factors of cognitive impairment in elderly patients with COPD and expands the possible mechanism of exercise in improving cognitive impairment in patients with COPD to provide a reference for the clinical prevention and treatment of cognitive impairment in elderly patients with COPD.

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Behavioural interventions targeting physical activity improve psychocognitive outcomes in COPD

Cited by 20 publications

References 48 publications

Mechanisms associated with increased physical activity in patients undergoing self-management behaviour modification in the randomised PHYSACTO trial

Mechanisms associated with increased physical activity in patients undergoing self-management behaviour modification in the randomised PHYSACTO trial

Does the 6-minute walk test in hospitalized COPD patients exclusively correlate with lung function parameters or should psychological factors also be taken into account?

<p>Influencing Factors and Exercise Intervention of Cognitive Impairment in Elderly Patients with Chronic Obstructive Pulmonary Disease</p>

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