Increasing activity levels in chronic respiratory disease
Physical activity is increasingly considered important for patients with chronic respiratory disease (CRD), given the beneficial effect of regular physical activity on the prognosis of CRD. Guidelines generally recommend that rehabilitation programs be implemented 2 or 3 times per week. However, it has been observed that elderly populations face several barriers to attending regular supervised rehab programs, because they cannot attend hospitals by themselves. Self-management is an important part of any formalized patient education program that aims to teach the skills needed to implement disease-specific regimens and guide health behaviour changes so that patients can control their disease and improve well-being. As such, there is now a considerable research effort aimed toward promoting self-management strategies in patient groups with chronic diseases.
This recent study explores the use of pedometers and activity diaries to facilitate self-management in this patient population group. The study consisted of 2 groups, one group using a pedometer/ diary and a second, control group which received no intervention. Baseline measurements of 6-minute walk test (6MWT) quality of life (QoL), dyspnoea severity, self-rated activity levels amongst others were taken. Both groups were followed by the researchers for 6 months and outcomes were assessed at the end of the study. No direction was given by the researches to the participants of either group regarding changing or increasing their current activity levels.
The final assessment of the participants showed that the pedometer/ diary group had increased daily activity, 6MWT scores and QoL, while there was no improvement in the control group in these measures. There was no significant difference in dyspnoea severity between the 2 groups over the course of the study. It should be noted that there was a high dropout rate during the study due to disease progression. The results of this study indicate that an activity diary and pedometer combination can significantly increase functional mobility, QoL and activity levels in individuals with medically stable CRD. The authors noted that the increases in outcomes in the pedometer/ diary group were entirely self-motivated and that the act of keeping a diary and being able to objectively monitor their step count via the pedometer, may have led to a long term positive change in health behaviour. As physiotherapists, the use of pedometers and activity diaries should be considered with patients’ chronic diseases who are a medically stable and would benefit from increased activation levels.
> From: Kato et al., J Phys Ther Sci 29 (2017) 807-812. All rights reserved to Journal of Physical Therapy Science. Click here for the online summary.