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Increasing physical activity in people with COPD

02 November 2020
Volume 31 · Issue 11


Levels of physical activity tend to be reduced in people with COPD. Matthew Armstrong discusses the benefits of improving activity levels in this group of patients

It is well acknowledged that levels of physical activity in patients with chronic obstructive pulmonary disease (COPD) are considerably lower than healthy-age matched individuals, with physical inactivity recognised as a key predictor of hospitalisation and mortality. Pulmonary rehabilitation (PR) has become a major tool for managing symptoms of COPD and the associated extra-pulmonary effects. However, inconsistencies surrounding its effectiveness in terms of improving physical activity remain due to the complex nature of physical activity. To overcome these inconsistencies, both pharmacological and behavioural interventions have been documented to aid improvements in physical activity, with behavioural interventions alongside PR found to be the most effective tool to promote levels of physical activity. Health professionals must therefore look to incorporate an interdisciplinary approach in order to best achieve improvements in physical activity levels in patients with COPD.

Chronic obstructive pulmonary disease (COPD) is a highly prevalent respiratory disease that is characterised by persistent respiratory symptoms and airflow limitation, primarily affecting individuals with a history of exposure to cigarette smoke and/or other noxious particles and gases (Global Initiative for Chronic Obstructive Lung Disease [GOLD], 2020). The most common respiratory symptoms include dyspnea (breathlessness), cough and/or sputum production (GOLD, 2020). In addition to progressive chronic airflow limitation and the associated levels of dyspnea, many patients also suffer extra-pulmonary effects, including skeletal muscle dysfunction/wasting and weight loss, leading to reductions in functional capacity and physical activity (Watz et al, 2014). Although regular physical activity is recommended by the European Respiratory Society (ERS) statement on physical activity, it remains well acknowledged that levels of activity are significantly lower in patients with COPD compared to healthy age-matched individuals (Troosters et al, 2010; Watz et al, 2014). Furthermore, physical activity levels have been recognised as a key predictor of mortality and hospitalisation in patients with COPD, making physical inactivity a key risk factor that health professionals must consider when prescribing management goals to patients with COPD (Garcia-Aymerich et al, 2006).

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