Enablers, barriers, needs and preferences of physical activity in patients with COPD: does pulmonary rehabilitation play a role?

Abstract

Low physical activity (PA) is associated with reduced survival in patients with chronic obstructive pulmonary disease (COPD). Pulmonary rehabilitation (PR) is essential in COPD management but its influence on patients’ perspectives about PA has been overlooked. This study assessed PA enablers, barriers, needs and preferences of patients attending or not PR. Two focus groups were conducted. One with 6 patients (70.2±8.8yrs; FEV1 55.5±14.4pp) attending a PR programme and another with 6 patients (65±7.6yrs; FEV1 58.2±21.4pp) naïve to PR. Interviews were analysed thematically. Enablers, barriers and needs were similar in both groups. Enablers/barriers fitted in health-related, psychosocial and environmental sub-themes. Identified enablers included: recognising that PA delays the onset of frailty and promotes wellbeing and functionality, being motivated by their family and health professionals, and the availability of green spaces. Main barriers were dyspnoea/fatigue and cough, exacerbations, comorbidities, fear of feeling breathless, frailty, cold/humid weather, smoke, crowded places and not having a current job. Main needs were health professional guidance and self-management education, including training on how to dose PA. Both groups identified (dog) walking as a preferred activity. Other PA preferences differed between groups: patients naïve to PR preferred activities such as playing with grandchildren, gardening and walking in daily tasks (e.g., shopping), whereas the PR group preferred exercise-related activities such as cycling or treadmill. This study provides guidance for future PA-enhancing interventions in those with/without PR previous experience.