Barriers and Enablers to Physical Activity Participation in Patients With COPD

Thorpe, Olivia; Johnston, Kylie; Kumar, Saravana

doi:10.1097/hcr.0b013e318262d7df

Cited by 94 publications

(116 citation statements)

References 25 publications

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“…However, in spite of strong evidence, it appears to be very difficult to recruit people with COPD to attend pulmonary rehabilitation [11], and participation in pulmonary rehabilitation is reported to be uniformly low all over the world [12]. A systematic review underlines that physical activity is not widely implemented in clinical practice [13]. Two questions appears: ‘Why do people with COPD not participate in pulmonary rehabilitation and why is physical activity not widely implemented in clinical practice?’…”

Section: Introductionmentioning

confidence: 99%

Barriers and motivational factors towards physical activity in daily life living with COPD – an interview based pilot study

Østergaard

Sritharan

Kristiansen

et al. 2018

European Clinical Respiratory Journal

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Background: In Denmark, few people with Chronic Obstructive Pulmonary Disease (COPD) engage in physical activity although it is evident that pulmonary rehabilitation has positive effects on physical activity, dyspnoea, anxiety, fatigue and quality of life. Objective: The purpose of this pilot study was to explore why people with COPD do not engage in physical activity and to explore motivational factors and barriers towards physical activity. Furthermore, to explore the role general practitioners have in this matter. Design: We conducted fieldwork among five people with COPD and three general practitioners using qualitative semi-structured interviews. We made a thematic analysis and our analytical perspective was based on The Health Belief Model and Self Determination Theory. Results: Findings revealed that people with COPD was not active because they did not receive the necessary information from the general practitioners about the benefits of physical activity neither about the negative consequences of an inactive lifestyle. Motivational factors were knowledge about COPD and benefits of physical activity. Experiencing the benefits on their own bodies, feeling that it was not dangerous to feel breathless and being successful coping with breathlessness were motivational. Functional tests like walking tests were very important and motivational for the participants because they outlined the progress achieved during activity and provided evidence of progress that was easy to comprehend compared with spirometry tests. General practitioners did not inform about the benefits of physical activity because they felt that medication was more important than physical activity and that people with COPD would not be motivated to be active. Conclusions: The main reason for people with COPD not being physically active in our study was lack of sufficient information from their general practitioners. This study described some barriers, enablers and motivational factors for a physically active lifestyle and the general practitioners’ role in this. Thus, it is important that people with COPD receive early information about physical activity - and it should start with the general practitioners, who are the gate keepers in the health care system. We recommend that lung function test results are never used as a single indicator of disease progression and that more focus should be paid to functional tests like The Shuttle Walking Test or The Six Minute Walking Test.Further studies to identify barriers to, and facilitators for referral people with COPD to physical activity in daily life from the perspective of Danish general practitioners are required.

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Section: Introductionmentioning

confidence: 99%

Barriers and motivational factors towards physical activity in daily life living with COPD – an interview based pilot study

Østergaard

Sritharan

Kristiansen

et al. 2018

European Clinical Respiratory Journal

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“…Pulmonary rehabilitation can provide an environment that reinforces the social contacts and support. Those who participate in pulmonary rehabilitation report enjoying the social aspect of training together [104], and people can interact, receive and provide emotional support, which serves to encourage and motivate one another [104]. Furthermore, exercising in a peer group and opportunities for social interaction are important components for a long-term physically active lifestyle [105].…”

Section: Establishing Social Support Networkmentioning

confidence: 99%

The importance of components of pulmonary rehabilitation, other than exercise training, in COPD

Hill¹,

Vogiatzis²,

Burtin³

2013

European Respiratory Review

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Comprehensive pulmonary rehabilitation is an important component in the clinical management of people with chronic obstructive pulmonary disease (COPD). Although supervised exercise training is considered the cornerstone of effective pulmonary rehabilitation, there are many other components that should be considered to manage the impairments and symptom burden, as well as the psychosocial and lifestyle changes imposed by COPD. These include approaches designed to: 1) facilitate smoking cessation; 2) optimise pharmacotherapy; 3) assist with early identification and treatment of acute exacerbations; 4) manage acute dyspnoea; 5) increase physical activity; 6) improve body composition; 7) promote mental health; 8) facilitate advance care planning; and 9) establish social support networks. This article will describe these approaches, which may be incorporated within pulmonary rehabilitation, to optimise effective chronic disease self-management. @ERSpublications This paper describes several components of comprehensive pulmonary rehabilitation, other than simply exercise training http://ow.ly/mMNRp Pulmonary rehabilitation for chronic obstructive pulmonary diseaseChronic obstructive pulmonary disease (COPD) is characterised by persistent airflow limitation due to chronic inflammation within the airways and lung in response to noxious particles or gases [1]. People with this condition are limited by dyspnoea and have impaired exercise capacity and health-related quality of life [1]. The prevalence of COPD amongst adults aged o40 years is ,10% [2], and increases to 21% in those with a significant smoking history who are visiting their family physician for any reason [3]. The natural course of COPD is punctuated with episodes of acute worsening, known as exacerbations, which contribute

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“…13 Salient factors that impede exercise participation include other commitments, health problems, exacerbation of COPD symptoms, perception of exercise as too strenuous, inclement weather, and lack of social support. 12 Additionally, higher levels of task self-efficacy (ie, confidence that one can manage breathlessness while participating in activities) have been associated with an increase in exercise participation among individuals diagnosed with COPD. 14 The evidence cited indicates that the knowledge base with respect to exercise by those diagnosed with COPD is growing.…”

Section: Introductionmentioning

confidence: 99%

“…Factors that may facilitate exercise participation among individuals diagnosed with COPD include personal drivers (eg, self-motivation, desire to improve COPD symptoms) and various personal and professional supports 12 , such as support from peers with a COPD diagnosis. 13 Salient factors that impede exercise participation include other commitments, health problems, exacerbation of COPD symptoms, perception of exercise as too strenuous, inclement weather, and lack of social support.…”

Section: Introductionmentioning

confidence: 99%

A Qualitative Exploration of Exercise Among Pulmonary Rehabilitation Participants: Insight From Multiple Sources of Social Influence

Witcher

McGannon

Hernández³

et al. 2015

Respir Care

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BACKGROUND: Exercise training within the pulmonary rehabilitation (PR) context is considered the most effective strategy to reduce COPD symptoms. However, participation in PR and continued exercise training following program completion are low. Previous research examined factors related to attendance and adherence, but the knowledge base to date has been limited to quantitative findings that focus solely on participants diagnosed with COPD. In addition to quantitative research, exploring multiple perspectives (eg, PR participants, significant others, staff, and stakeholders) using qualitative research methods opens a window of additional understanding. The goal of this study was to obtain multiple perspectives on PR to gain insight into factors that affect exercise participation among individuals diagnosed with COPD. METHODS: A total of 26 participants were interviewed via telephone, including 8 individuals diagnosed with COPD (4 men and 4 women, mean age of 67 [range of 58 -77] y), 4 family members, 11 PR staff, and 3 community stakeholders. RESULTS: Analysis revealed 3 themes: task self-efficacy for exercise, provision of support and encouragement, and perceptions of gender differences. Despite initial concerns, individuals diagnosed with COPD reported becoming more confident during PR and emphasized the importance of being supported by staff. PR staff perceived that men tended to approach exercise in a more eager and aggressive manner compared with women, who were more cautious and hesitant. CONCLUSIONS: In addition to enhancing task self-efficacy, findings suggest that exercise participation and adherence within the PR environment may be improved by adopting a gender-tailored approach.

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Barriers and Enablers to Physical Activity Participation in Patients With COPD

Abstract: The findings from this review may assist health professionals, patients, care givers and the wider community to develop effective strategies to promote participation in PA and PR among people with COPD.

Cited by 94 publications

References 25 publications

Barriers and motivational factors towards physical activity in daily life living with COPD – an interview based pilot study

Barriers and motivational factors towards physical activity in daily life living with COPD – an interview based pilot study

The importance of components of pulmonary rehabilitation, other than exercise training, in COPD

A Qualitative Exploration of Exercise Among Pulmonary Rehabilitation Participants: Insight From Multiple Sources of Social Influence

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