Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland.
Institute of Primary Care, University of Zurich, Zurich, Switzerland.
Int J Chron Obstruct Pulmon Dis. 2020 Nov 6;15:2837-2846. doi: 10.2147/COPD.S279293. eCollection 2020.
Limited evidence on long-term effects of physical activity programs in COPD is available. The aim of the study was to investigate the effects of a three-month program combining physical activity counselling and pedometer-based feedback in addition to usual care, followed by a nine-month unsupervised observation period as compared to usual care in participants with severe to very severe COPD.
Participants were randomized to either a control group receiving usual care or an intervention group receiving motivational support, an activity diary with an individual step count goal (ie, an increase of ≥15% from baseline) and a pedometer in addition to usual care. The intervention ended after three months and an unsupervised observational period followed until twelve months. Primary outcome was daily step count after one year.
Seventy-four participants were included, 61 (82%) completed the study. Linear regression modelling, adjusted for baseline step count, showed no significant difference in change in step count after 12 months between the groups (Β = 547.33, 95% CI = -243.55/1338.20).
A three-month program combining physical activity counselling and pedometer-based feedback in addition to usual care does not attenuate the declining course of physical activity in participants with severe and very severe COPD during a long term follow-up of one year as compared to usual care. This result was primarily determined by the low intervention response rates to the combined program.
www.ClinicalTrials.gov, NCT03114241.
目前关于体力活动方案对慢性阻塞性肺疾病（COPD）长期影响的证据有限。本研究旨在调查与常规护理相比，在严重至极重度 COPD 患者中，除常规护理外，联合使用体力活动咨询和计步器反馈的三个月方案，随后进行九个月的非监督观察期，对患者的影响。
参与者被随机分配到对照组（接受常规护理）或干预组（接受动机支持、带有个人目标步数的活动日记（即比基线增加≥15%）和计步器，除常规护理外）。干预在三个月后结束，随后进行为期九个月的非监督观察期，直到十二个月。主要结局指标为一年后的日常步数。
共纳入 74 名参与者，其中 61 名（82%）完成了研究。经基线步数调整的线性回归模型显示，两组在 12 个月时的步数变化无显著差异（Β=547.33，95%CI=-243.55/1338.20）。
与常规护理相比，除常规护理外，联合使用体力活动咨询和计步器反馈的三个月方案，并不能在一年的长期随访中减缓严重和极重度 COPD 患者的体力活动下降。这一结果主要取决于对联合方案的低干预反应率。
