Impact of meeting behavioral targets in a self-management behaviour-modification program designed to improve physical activity in COPD patients

EUROPEAN RESPIRATORY JOURNAL(2018)

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摘要
Introduction: Critical to changing health behaviors and improving outcomes in COPD patients (pts) is increasing motivation and confidence to engage in those behaviors. Aim: Assess whether a self-management behaviour-modification programme (SMBM) aimed at increasing pt motivation and confidence to engage in daily physical activity (PA) is associated with increases in daily step count among COPD pts in the PHYSACTO ® Trial. Methods: A 12-wk, randomised, partially double-blind, placebo-controlled, parallel-group trial (NCT02085161) of bronchodilators ± exercise training (ExT) (tiotropium [T] 5 µg; T+olodaterol [O] 5/5 µg; T+O 5/5 µg +ExT), all with SMBM, was conducted in COPD pts. Associations between changes in motivation (Treatment Self-Regulation Questionnaire: TSRQ) and confidence (Perceived Competence Scale: PCS) and changes in PA levels (step count, walking time via accelerometer) and health status (SGRQ) from baseline to post-intervention were assessed using multiple regression, adjusting for age, sex, BMI, smoking, FEV 1 , treatment group, baseline endurance time. Results: 304 COPD pts (M age 64.8) were enrolled; 262 pts had complete PA data at 12 wks (M %FEV 1 : 49±13; baseline steps/day: 5423). Every 1-point increase on the TSRQ or PCS was associated with +297 and 202 steps, respectively and increased walking time (+2.9 u0026 +2.1 min); every 1-point increase on the PCS was also associated with less activity limitation (SGRQ activity score: -1.77), p’s Conclusion: A SMBM program designed and able to change mediator variables such as motivation and confidence (to engage in PA) is associated with changes in actual behaviour (i.e., PA).
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