Towards a better understanding of physical activity in people with COPD: predicting physical activity after pulmonary rehabilitation using an integrative competence model

Carl, Johannes; Geidl, Wolfgang; Schüler, Michael; Mino, Eriselda; Lehbert, Nicola; Wittmann, Michael; Schultz, Konrad; Pfeifer, Klaus

doi:10.1177/1479973121994781

Cited by 16 publications

(18 citation statements)

References 43 publications

(78 reference statements)

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“…Alongside this person-oriented study, our ndings are partly in agreement with the results of a longitudinal study on PAHCO in chronic obstructive pulmonary patients, which found a positive, bivariate relationship between the subscales of PAAR and PASR after a rehabilitation program and the PA level six months after the program (70). In addition, this study also found a positive, bivariate relationship between the subscales of PASR, PAAR and CCPT after the rehabilitation program and the patients' quality of life after six months.…”

Section: Analysing the Changeability And Temporal Stability Of Pahcosupporting

confidence: 90%

“…However, the ndings regarding the effect of PAHCO on HEPA and HRQOL remain tentative, as most of the research on this model has been cross-sectional (20,37,38,32,34,31) with only few studies employing a longitudinal design in adult populations (40,39). Alongside this, two interventional studies (41,42) yielded initial results concerning the changeability of this model in secondary school students showing improvements in PAHCO.…”

Section: State Of Research On Pahco Hrqol and Hepamentioning

confidence: 99%

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Promotion of Physical Activity-Related Health Competence and the Influence on Leisure-Time Physical Activity and Health-Related Quality of Life in Office Workers

Blaschke

Carl

Pelster

et al. 2022

Preprint

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Background:Office workers (OWs) are at risk of low levels of health-enhancing physical activity (HEPA) and impaired health-related quality of life (HRQOL). Interventions based on physical activity-related health competence (PAHCO) aim to facilitate long-term changes in HEPA and HRQOL. However, these assumptions rely on the changeability and temporal stability of PAHCO and have not been tested empirically. This study therefore aims to test the changeability and temporal stability of PAHCO in OWs within an interventional design and to examine the effect of PAHCO on leisure-time PA and HRQOL. Methods: 328 OWs (34% female, 50.4 ± 6.4 years) completed an in-person, three-week workplace health promotion program (WHPP) focusing on PAHCO and HEPA. The primary outcome of PAHCO as well as the secondary outcomes of leisure-time PA and HRQOL were examined at four measurement points over the course of 18 months in a pre-post design. Results: PAHCO displayed a substantial increase from the baseline to the time point after completion of the WHPP (β = 0.44, p < 0.001). Furthermore, there was no decrease in PAHCO at the first (p = 0.14) and the second follow-up measurement (p= 0.56) compared with the level at the end of the WHPP. In addition, the PAHCO subscale of PA-specific self-regulation (PASR) had a small to moderate, positive effect on leisure-time PA (β = 0.18, p < 0.001) and HRQOL (β = 0.26, p < 0.001). The subscale of control competence for physical training (CCPT) also had a positive small to moderate effect on HRQOL (β = 0.22, p < 0.001). Conclusion: The results substantiate PAHCO’s theoretical characteristics of changeability and temporal stability, and underline the theoretically postulated effects on leisure-time PA and HRQOL. These findings highlight the potential of PAHCO for intervention development, which can be assumed to foster long-term improvements in HEPA and HRQOL in OWs. Trial Registration: The study was retrospectively registered in the German Clinical Trials Register, which is an approved Primary Register in the WHO network, at the 14/10/2022 (DRKS00030514).

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Section: Analysing the Changeability And Temporal Stability Of Pahcosupporting

confidence: 90%

Section: State Of Research On Pahco Hrqol and Hepamentioning

confidence: 99%

Promotion of Physical Activity-Related Health Competence and the Influence on Leisure-Time Physical Activity and Health-Related Quality of Life in Office Workers

Blaschke

Carl

Pelster

et al. 2022

Preprint

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“…First, quality of life plays a prominent role for patients with COPD, and second, we were able to show in a previous analysis of the STAR data that quality of life is directly related to physical activity. 42 The descriptive effects of the pedometer-based intervention on quality of life were even smaller and statistically insignificant. However, the improvement in both groups (IG and CG) indicates a positive effect of the PR program here as well.…”

Section: Discussionmentioning

confidence: 97%

Long-Term Benefits of Adding a Pedometer to Pulmonary Rehabilitation for COPD: The Randomized Controlled STAR Trial

Geidl¹,

Carl²,

Schüler³

et al. 2021

COPD

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Purpose This Stay Active after Rehabilitation (STAR) study examined the effects of a pedometer-based behavioral intervention for individuals with COPD during three weeks of inpatient pulmonary rehabilitation (PR) on patients’ physical activity levels six weeks and six months after PR, including steps (primary outcome), moderate-intensity physical activity, and sedentary time as well as patient quality of life, symptoms, and other psychological and clinical variables. Patients and Methods Rehabilitation patients with COPD wore a triaxial accelerometer (ActiGraph wGT3X) for seven days two weeks before (T0) as well as six weeks (T3) and six months (T4) after PR. In addition to the three-week inpatient PR (control group, CG), the randomly allocated intervention group (IG) received a brief pedometer-based behavioral intervention with the application of the following behavior-change techniques: performing the behavior, individual goal-setting, self-monitoring, and feedback. The effects were analyzed using analysis of covariance with an intention-to-treat approach. Results A total of 327 patients (69% male, age: 58 years, FEV 1 (%): 53.5, six-minute walk distance: 447.8 m) were randomly allocated to either the IG (n = 167) or CG (n = 160). Although both groups increased their daily steps after PR (IG: M T3-T0 = 1152, CG: M T3-T0 = 745; IG: M T4-T0 = 795, CG: M T4-T0 = 300), the slightly higher increases in daily steps in the IG compared to the CG at T3 (Δ388 steps, d = 0.16) and T4 (Δ458 steps, d = 0.15) were not statistically significant (p > 0.05 for all). Patients in both groups showed moderate to high pre-post-changes in terms of secondary outcomes, but no advantage favoring the IG was found. Conclusion The results show that adding a pedometer-based behavioral intervention to standard German three-week inpatient PR for COPD patients did not result in more physical activity in terms of steps and moderate-intensity physical activity or less sedentary time. However, both groups (IG and CG) showed remarkably enhanced physical activity levels six weeks and six months after PR, as well as improvements in other secondary outcomes (eg, quality of life).

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“…Importantly, the STAR study encompasses a combination of physical, psychological, and behavioral assessments, allowing to complement the quadrant concept with further behavioral aspects of PA. In line with the criteria defined in the main analyses of STAR [ 27 , 28 ], the present study included all participants who (a) provided informed consent to participate in the study, (b) were granted inpatient rehabilitation at Bad Reichenhall Clinic, Germany, (c) actually attended pulmonary rehabilitation (PR), and (d) whose COPD diagnosis was confirmed by a lung function test (Tiffeneau index FEV1/VC ≤ 0.70) that was performed at the beginning of the PR (T1). In line with the analytical strategy of the present article, participants (e) had to provide valid accelerometry-measured PA data at T0 and valid PC data at T1.…”

Section: Methodsmentioning

confidence: 99%

The “can do, do do” concept in individuals with chronic obstructive pulmonary disease: an exploration of psychological mechanisms

et al. 2021

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Background The “can do, do do” concept aims at identifying subgroups among persons with chronic obstructive pulmonary disease (COPD). Following a two-dimensional categorization, individuals are binarily classified with respect to their levels of physical capacity (“can’t do” or “can do”) and physical activity (“don’t do” or “do do”), resulting in four disjunct quadrants. The approach has been debated recently and the latest articles have concluded that the quadrants should be specifically examined in terms of psychological aspects of physical activity. Therefore, the goal of the present study was to explore the role of psychological variables in physical activity in the context of the “can do, do do” quadrant concept. Methods Within the scope of secondary data analyses of the “Stay Active After Rehabilitation” (STAR) randomized controlled trial, a total of 298 COPD rehabilitants of an inpatient pulmonary rehabilitation program were grouped into the suggested quadrants. We set fixed cut-offs at 70% of relative 6-min walking test performances for healthy individuals (physical capacity dimension) and 5.000 steps per day (physical activity dimension). Univariate and multivariate logistic regression analyses served to analyze whether depression scores, fear avoidance behaviors, disease-specific anxiety, self-concordance for physical activity, and five indicators of physical activity-related health competence (PAHCO) effectively discriminated between the “don’t do” and “do do” groups. Results Among persons with lower relative physical capacity, depression scores, fear avoidance behaviors, and disease-specific anxiety (univariate case) significantly differentiated between the more and the less active. Among persons with higher relative physical capacity, fear avoidance behaviors, disease-specific anxiety, as well as three PAHCO indicators (physical activity-specific self-efficacy, self-control, and affect regulation) significantly separated the more and the less active. In multivariate analyses, only fear avoidance behaviors and affect regulation discriminated among individuals with better relative physical capacity. Conclusion The findings identified important psychological and competence-oriented variables that explain discrepancies in the quadrant concept. Based on this, we discuss implications for physical activity promotion in individuals with COPD. Respiratory research can benefit from future studies complementing the quadrant concept through further behavioral analyses. Trial registration Clinicaltrials.gov, ID: NCT02966561. Registered 17 November, 2016, https://clinicaltrials.gov/ct2/show/NCT02966561.

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Towards a better understanding of physical activity in people with COPD: predicting physical activity after pulmonary rehabilitation using an integrative competence model

Cited by 16 publications

References 43 publications

Promotion of Physical Activity-Related Health Competence and the Influence on Leisure-Time Physical Activity and Health-Related Quality of Life in Office Workers

Promotion of Physical Activity-Related Health Competence and the Influence on Leisure-Time Physical Activity and Health-Related Quality of Life in Office Workers

Long-Term Benefits of Adding a Pedometer to Pulmonary Rehabilitation for COPD: The Randomized Controlled STAR Trial

The “can do, do do” concept in individuals with chronic obstructive pulmonary disease: an exploration of psychological mechanisms

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