Walking football for people with chronic breathlessness: A mixed-methods proof of concept study.

Abstract

IntroductionPulmonary rehabilitation (PR) provides substantial benefits, but these are rarely sustained. Walking football (WF), with its slower pace and widespread availability, may offer an exercise-maintenance option. This proof-of-concept study aimed to understand the potential of WF as an exercise-maintenance intervention following PR.MethodsA mixed-methods, prospective observational design was used. Patients completing PR at two NHS trusts were invited to attend weekly 2-hour WF sessions for 6 weeks. Feasibility outcomes included recruitment, adherence, and safety. An ethnographic approach observed participant experiences and engagement. Health outcomes were assessed at baseline and post-intervention, and the intensity of a single WF session was analysed.Results160 individuals were approached; 36 expressed interest and 6 enrolled (5 male; mean age 71 years). Travel difficulties were the most common reason for declining. Five participants attended at least 4 sessions, and all continued WF after the study. One minor, unrelated adverse event occurred. Qualitative analysis of 18-hours of observations and 6 interviews generated 6 themes. The most notable finding highlighted the importance of WF sessions being exclusive to people with breathlessness. At least 3 participants achieved the minimal clinically important difference in functional exercise capacity, strength, health-related quality of life, and symptom burden. During a single session, group mean heart rate reached 66% of estimated HRmax, with a mean distance of 3.23 km covered.ConclusionsWF appears to be a promising, engaging, and potentially sustainable exercise-maintenance option following PR, though travel barriers limited uptake. Future interventions should prioritise accessible locations and consider transport support.