Physical activity, exercise capacity and psycho-social factors during and after pulmonary rehabilitation in COPD

Physical activity (PA) has shown several beneficial effects on COPD patients. Our aim was to examine the relationship between psychological determinants and PA in COPD patients during and after an inpatient pulmonary rehabilitation (PR) program. We recruited 27 COPD patients (age 65.4±5.8 yrs;17 M, 10 F) at the CIRO+ expertise center(Horn, Netherlands). Active energy expenditure (AEE) was monitored daily by an activity monitor (DirectLife, Philips) for 3 months: 8 weeks in PR and 4 weeks at home. 6MWT was assessed at the beginning and end of PR. The exercise self-efficacy scale (ESES) was used monthly to assess patients9 beliefs in their own ability to perform PA. Patients9 responses to PA were evaluated by means of the Physical Activity Affect Scale(PAAS). 6MWD improved at the end of PR compared to the beginning (445.0±88.3 m and 490.7±98 m;p=0.006). Patients reached an average daily AEE of 647.7±189.3 kcal during PR, which decreased at home (512.5±169.7 kcal;p This study shows that PR helps COPD patients improve their exercise capacity. In addition, self-efficacy and positive affect towards PA improve and are maintained at home. These results and the loss in tranquility suggest that psycho-social factors, rather than exercise capacity, contribute to lower PA when returning home. Close psycho-social support may be needed in maintaining PA at higher levels at home.