Interventions to modify physical activity in patients with COPD: A systematic review

Background: The broad range of interventions to increase physical activity (PA) in patients with COPD has not been systematically assessed. Objectives: We aimed to perform a systematic review of the interventional studies that have assessed PA as an outcome in patients with COPD. Methods: A systematic search in five different databases (Medline, Embase, PsycINFO, CINAHL and Web of Science) was performed in March/2015. Two independent reviewers analysed the studies against the inclusion criteria (COPD defined by spirometry; prospective, randomised/non-randomised studies, cohort and experimental studies with interventions using PA as an outcome), extracted the data and assessed the quality of evidence. Results: 60 studies were included. Seven intervention groups were identified. PA counselling increased PA levels in COPD, especially when combined with coaching. Thirteen studies showed positive effects of pulmonary rehabilitation (PR) on PA, while 7 studies showed no changes. All (n=3) PR programmes > 12 weeks in duration increased PA. Overall, the quality of evidence was graded as very low. Conclusions: Interventions focussing specifically on increasing PA and longer PR programmes may have greater impacts on PA in COPD. Well-designed clinical trials with objective assessment of PA in COPD patients are needed.