Document Type
Journal Article
Publication Title
Journal of Physiotherapy
Volume
70
Issue
3
First Page
193
Last Page
207
PubMed ID
38918084
Publisher
Elsevier
School
Exercise Medicine Research Institute
RAS ID
71206
Abstract
Questions: In people with chronic obstructive pulmonary disease (COPD) who complete an exercise training program (ETP) offered at a sufficient dose to result in training-related gains, to what extent are these gains maintained 12 months after program completion? Do variables such as the application of behaviour change techniques moderate the maintenance of these training-related gains? Design: Systematic review, meta-analysis and meta-regression of randomised controlled trials. Participants: People with stable COPD. Intervention: Trials were included if they applied ≥ 4 weeks of a whole-body ETP and reported outcome data immediately following program completion and 12 months after initial program completion. The control group received usual care that did not include a formal exercise training component. Outcome measures: Exercise tolerance, health-related quality of life and dyspnoea during activities of daily living. Data sources: EMBASE, PEDro, PubMed and the Cochrane Library. Results: Nineteen randomised trials with 2,103 participants were found, of which 12 had a sufficiently similar design to be meta-analysed. At 12 months after ETP completion, compared with the control group, the experimental group demonstrated better exercise tolerance (SMD 0.48, 95% CI 0.19 to 0.77) and quality of life (SMD 0.22, 95% CI 0.03 to 0.41) with no clear effect on dyspnoea. Meta-regression using data from all 19 trials demonstrated that the magnitude of between-group differences at the 12-month follow-up was moderated by: behaviour change being a core aim of the strategies implemented following completion of the ETP; the experimental group receiving more behaviour change techniques during the program; and the magnitude of between-group change achieved from the program. Conclusion: At 12 months after completion of an ETP of ≥ 4 weeks, small gains were maintained in exercise tolerance and health-related quality of life. Applying behaviour change techniques with a clear focus on participants integrating exercise into daily life beyond initial program completion is important to maintain training-related gains. Registration: CRD42020193833.
DOI
10.1016/j.jphys.2024.06.003
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.
Comments
Hug, S., Cavalheri, V., Lawson-Smith, H., Gucciardi, D. F., & Hill, K. (2024). Interventions with a clear focus on achieving behaviour change are important for maintaining training-related gains in people with chronic obstructive pulmonary disease: a systematic review. Journal of Physiotherapy, 70(3), 193-207. https://doi.org/10.1016/j.jphys.2024.06.003