Barriers and enablers of physical activity and its association with daily steps after hospitalisation for a COPD exacerbation: what patients say matters

Abstract

Exacerbations of chronic obstructive pulmonary disease (COPD) decrease physical activity (PA). PA interventions after these events are desirable but have had mixed results. Understanding the barriers and enablers of PA may help to improve their results. We aimed to assess the barriers and enablers of PA after COPD exacerbation and its association with daily steps.Cross-sectional analysis of patients with COPD enrolled during a hospitalisation for an exacerbation. PA was measured with an accelerometer for 7 days after discharge. Patients completed an ad-hoc 6-point Likert-scale questionnaire about 13 barriers and 9 enablers of PA. We analysed the association between each item and patients’ daily step counts.46 patients with FEV1%pred (mean (sd)) of 48.6 (15.9) completed the assessments. They were 65 (10) years old, spent 8 (2) days hospitalised, and walked 5633 (3314) steps·day−1after discharge. The patients who reported “breathlessness” (median (p25-p75)) (3813 (2664–5639)versus5549 (3692–9984), p 0.034) and “low mood” (3813 (2456–5471)versus5426 (3612–8942), p 0.047) as barriers(yes (≥2/6) versus no (<2/6) responders, respectively)took statistically fewer daily steps; whereas if they considered “PA as healthy” as an enabler walked statically more (5085 (3538–8703)versus2760 (2271–5298), p 0.031).some barriers and enablers of PA reported by patients after a COPD exacerbation relate to daily steps. Assessing PA barriers and enablers could be useful to improve future PA interventions after these events.