Effectiveness of a theory-based behavior change intervention on physical activity in patients with chronic obstructive pulmonary disease

Abstract

Abstract Background:The aim of this study was to evaluate whether a theory-based behavior change intervention could promote changes in physical activity (PA) and sedentary behavior (SB) among patients with chronic obstructive pulmonary disease (COPD), as well as its effects on symptoms of dyspnea, lung function, exercise capacity, self-efficacy, and health-related quality of life (HRQoL). Methods: A quasi-experimental design and convenience sampling were adopted. 92 patients with stable COPD were recruited from two hospitals in Zhejiang province, China. Both the experimental and control groups received usual care provided in the hospital. The control group received usual care only, while the experimental group performed a PA program based on the behavior change wheel theory. Outcomes were measured at baseline (T0), 4 weeks (T1), 8 weeks (T2), and 12 weeks of the intervention (T3). The primary outcome, PA, was measured by the International Physical Activity Questionnaire (IPAQ). Secondary outcomes included: sedentary behavior (SB) measured by the IPAQ, dyspnea measured by the modified Medical Research Council (mMRC) questionnaire, exercise capacity assessed by six minute walking test (6MWT), self-efficacy measured by the Exercise Self-Regulatory Efficacy Scale (EX-SRES), and HRQOL measured by the COPD Assessment Test (CAT). In addition, we measured lung function, using the Spirometer at baseline and 12 weeks. Results: Of the 89 patients included in this study, 64 were male (71.91%); with a mean age of 67.03 ±6.15 years. At 12 weeks, the improvement of PA, SB, mMRC, 6MWT, EX-SRES and CAT were all statistically significant (P<0.05) in the experimental group compared to the control group.There was no difference between groups in lung function. Repeated measures analysis of variance showed that there were group effects and time effects on total PA, SB, mMRC, 6MWT, EX-SRES, and CAT in both groups (P<0.001). Conclusion: PA program based on theoretical significantly improved PA, reduce sedentary time and promote healthy behavior change in patients with COPD. Due to the limited intervention time in this study, lung function in COPD patients may not be reversed in a short period of time, thus further research is necessary. Trial registration: Clinical Trials.gov (ChiCTR2200060590).