The effects of a brief physiotherapist-led intervention in primary care on physical activity levels in people with COPD

Introduction/Aim: The aim of this study was to determine if a brief intervention delivered by physiotherapists in primary care can increase physical activity (PA) levels in people with chronic obstructive pulmonary disease (COPD).

Methods: Four general practices participated. ‘At risk’ participants (aged >40 years, current/ex-smoker) and people with ‘existing’ COPD were invited to attend an assessment with a cardiorespiratory physiotherapist at the practice. Pre/post-bronchodilator spirometry was performed to identify or confirm a diagnosis of COPD (FEV1/FVC < 0.7). At baseline, those with confirmed obstruction received one-off PA advice, a pedometer and diary to monitor daily steps. Participants were reviewed at 1 month to set step goals and a progression plan. A final review was completed at 3 months. Self-reported PA levels were obtained from the Active Australia Questionnaire at baseline and 3 months. Average daily step count and goal compliance were assessed.

Results: 31 participants with airflow obstruction (mean age 75 yrs (SD 9.3), mean FEV1% pred = 74% (SD 7.9), 61% female) received the intervention. At baseline, the majority of participants indicated they were meeting PA guidelines (n = 21, 87%) which decreased to 19 participants (79%) at 3 months. There was no significant change in average daily step count at 3 months compared to baseline (6180 (±3785) to 5916 (±3203) steps (95%CI: −767 to 1549, p = 0.50) however, participants recorded a higher ‘optimal’ daily step count (mean change 319 steps (95%CI: −196 to 835, p = 0.21). Participant compliance with weekly step goals decreased from 90% at Week 5 to 50% at 3 months.

Conclusion: A brief PA intervention in people with COPD identified in a primary care setting was insufficient to increase PA levels. Alternative methods of improving PA in people with COPD in primary care need to be explored.