Donesky-Cuenco Doranne, Janson Susan, Neuhaus John, Neilands Torsten B, Carrieri-Kohlman Virginia
Department of Physiological Nursing, School of Nursing, University of California, San Francisco, USA.
Heart Lung. 2007 Sep-Oct;36(5):348-63. doi: 10.1016/j.hrtlng.2006.11.004.
We know little about long-term exercise behavior and adherence in patients with chronic obstructive pulmonary disease (COPD).
The study's purpose was (1) to describe exercise behavior and adherence to a home-walking exercise prescription over 12 months in a sample of patients with COPD; and (2) to validate categories of exercise adherence over time in this population.
This was a secondary analysis of a randomized controlled trial.
A total of 103 participants with COPD who were randomly assigned to one of three versions of a dyspnea self-management program participated.
The components of exercise frequency, duration, and intensity were measured by exercise/dyspnea daily logs, and participants were classified into categories on the basis of their pattern of exercise adherence over the year.
Participants walked an average of 3 days per week initially, with a decline to 2.5 days per week over the year. On average, participants walked longer than the prescribed duration of 20 minutes per session. Dyspnea intensity at the end of the walk tended to remain stable at a mean level of 4 over the year. Classification by adherence category distinguished differences in 6-minute walk distance, endurance treadmill test time, Short Form-36 physical function, and Short Form-36 mental health, with endurance treadmill test time and physical function improvements mirroring increases in exercise adherence, and mental health highest among occasional lapse and lowest among relapser and recycle categories.
This investigation provides a description of long-term exercise behavior and adherence in a sample of patients with COPD. The categories suggest that physical benefits are related to consistent adherence, whereas mental health improvements are related to regular exercise with some flexibility in the schedule. Future research should test interventions to improve exercise adherence in patients with COPD and identify characteristics of patients who are most likely and least likely to adhere over time.
我们对慢性阻塞性肺疾病（COPD）患者的长期运动行为和依从性了解甚少。
本研究的目的是（1）描述COPD患者样本在12个月内的运动行为以及对家庭步行运动处方的依从性；（2）验证该人群随时间推移的运动依从性类别。
这是一项随机对照试验的二次分析。
共有103名COPD参与者，他们被随机分配到呼吸困难自我管理计划的三个版本之一。
通过运动/呼吸困难每日日志测量运动频率、持续时间和强度等组成部分，并根据参与者一年中的运动依从模式将其分类。
参与者最初平均每周步行3天，一年后降至每周2.5天。平均而言，参与者步行时间长于规定的每次20分钟。一年中，步行结束时的呼吸困难强度往往稳定在平均4级水平。根据依从性类别分类可区分6分钟步行距离、耐力跑步机测试时间、简短健康调查问卷36项身体功能和简短健康调查问卷36项心理健康方面的差异，耐力跑步机测试时间和身体功能的改善反映了运动依从性的提高，心理健康在偶尔中断组中最高，在复发和循环组中最低。
本调查描述了COPD患者样本的长期运动行为和依从性。这些类别表明身体益处与持续依从性相关，而心理健康改善与定期运动且日程安排有一定灵活性相关。未来的研究应测试改善COPD患者运动依从性的干预措施，并确定随着时间推移最有可能和最不可能依从的患者特征。
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