Interventions for promoting physical activity in people with chronic obstructive pulmonary disease (COPD)

• Published in: Cochrane database of systematic reviews 2020-04, Vol.4 (4), p.CD012626-CD012626
• Main Authors: Burge, Angela T, Cox, Narelle S, Abramson, Michael J, Holland, Anne E
• Format: Article
• Language: English
• Subjects: Chronic obstructive pulmonary disease, stable ‐ non‐pharmacotherapy; Exercise; Humans; Lungs & airways; Pulmonary Disease, Chronic Obstructive - rehabilitation; Randomized Controlled Trials as Topic; Telerehabilitation
• ISSN: 1469-493X
• DOI: 10.1002/14651858.CD012626.pub2

Escalating awareness of the magnitude of the challenge posed by low levels of physical activity in people with chronic obstructive pulmonary disease (COPD) highlights the need for interventions to increase physical activity participation. The widely-accepted benefits of physical activity, coupled with the increasing availability of wearable monitoring devices to objectively measure participation, has led to a dramatic rise in the number and variety of studies that aimed to improve the physical activity of people with COPD. However, little was known about the relative efficacy of interventions tested so far. In people with COPD, which interventions are effective at improving objectively-assessed physical activity? We identified trials from the Cochrane Airways Trials Register Register, which contains records identified from bibliographic databases including the Cochrane Central Register of Controlled Trials, MEDLINE, Embase, CINAHL, AMED, and PsycINFO. We also searched PEDro, ClinicalTrials.gov, the World Health Organization International Clinical Trials Registry Platform portal and the Australian New Zealand Clinical Trials Registry (from inception to June 2019). We checked reference lists of all primary studies and review articles for additional references, as well as respiratory journals and respiratory meeting abstracts, to identify relevant studies. We included randomised controlled trials of interventions that used objective measures for the assessment of physical activity in people with COPD. Trials compared an intervention with no intervention or a sham/placebo intervention, an intervention in addition to another standard intervention common to both groups, or two different interventions. We used standard methods recommended by Cochrane. Subgroup analyses were possible for supervised compared to unsupervised pulmonary rehabilitation programmes in clinically-stable COPD for a range of physical activity outcomes. Secondary outcomes were health-related quality of life, exercise capacity, adverse events and adherence. Insufficient data were available to perform prespecified subgroup analyses by duration of intervention or disease severity. We undertook sensitivity analyses by removing studies that were at high or unclear risk of bias for the domains of blinding and incomplete outcome data. We included 76 studies with 8018 participants. Most studies were funded by government bodies, although some were sponsored by equipment or drug manufacturers. Only 38