Psychological and cognitive outcomes of a randomized trial of exercise among patients with chronic obstructive pulmonary disease
Abstract
Exercise rehabilitation is recommended increasingly for patients with chronic obstructive pulmonary disease (COPD). This study examined the effect of exercise and education on 79 older adults (M age = 66.6 +/- 6.5 years; 53% female) with COPD, randomly assigned to 10 weeks of (a) exercise, education, and stress management (EXESM; n = 29); (b) education and stress management (ESM; n = 25); or (c) waiting list (WL; n = 25). EXESM included 37 sessions of exercise, 16 educational lectures, and 10 weekly stress management classes. ESM included only the 16 lectures and 10 stress management classes. Before and after the intervention, assessments were conducted of physiological functioning (pulmonary function, exercise endurance), psychological well-being (depression, anxiety, quality of life), and cognitive functioning (attention, motor speed, mental efficiency, verbal processing). Repeated measures multivariate analysis of variance indicated that EXESM participants experienced changes not observed among ESM and WL participants, including improved endurance, reduced anxiety, and improved cognitive performance (verbal fluency).
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Emery and colleagues found reductions in symptoms of anxiety and depression following a 10-week PR intervention.
“Emery and colleagues96 found reductions in symptoms of anxiety and depression following a 10-week PR intervention.”
From Anxiety and Depression in COPD (2008) · cites this paper as [96]
Participation in supervised whole-body exercise training has been shown in several randomized controlled trials to improve symptoms of anxiety and depression as a consequence of training-related gains in functional capacity.
“Subsequent participation in supervised whole-body exercise training has been shown in several randomized controlled trials95–98 to improve symptoms of anxiety and depression as a consequence of training-related gains in functional capacity.”
From Anxiety and Depression in COPD (2008) · cites this paper as [96]
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Can physical activity improve the mental health of older adults?
Lautenschlager, N. T., Almeida, O. P., Flicker, L. A., & Janča, A. (2004) · Annals of General Hospital Psychiatry · doi:10.1186/1475-2832-3-12 · Cited by 83 · see citing works
Rose, C., Wallace, L., Dickson, R., Ayres, J., Lehman, R., Searle, Y., & Sherwood Burge, P. (2002) · Patient Education and Counseling · doi:10.1016/s0738-3991(02)00004-6 · Cited by 82 · see citing works
Greer, T. L., Grannemann, B. D., Chansard, M., Karim, A. I., & Trivedi, M. H. (2015) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2014.10.001 · Cited by 81 · see citing works
“In humans, exercise has been associated with cognitive improvements among patients with other chronic disease states, such as improved verbal fluency/executive function in chronic obstructive pulmonary disease (Emery et al., 1998) and more global improvements in attention, executive function, psychomotor speed, and me…”
BackgroundTrappenburg, J. C., Troosters, T., Spruit, M. A., Vandebrouck, N., Decramer, M., & Gosselink, R. (2005) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2005.03.030 · Cited by 79 · see citing works
Coventry, P. A. (2009) · Current Opinion in Pulmonary Medicine · doi:10.1097/mcp.0b013e3283218318 · Cited by 75 · see citing works
Valenza, M. C., Valenza-Peña, G., Torres‐Sánchez, I., González‐Jiménez, E., Conde-Valero, A., & Valenza‐Demet, G. (2013) · Respiratory Care · doi:10.4187/respcare.02565 · Cited by 75 · see citing works
Cleutjens, F. A. H. M., Janssen, D. J. A., Ponds, R., Dijkstra, J. B., & Wouters, E. F. �. (2014) · BioMed Research International · doi:10.1155/2014/697825 · Cited by 77 · see citing works
“Improvement of cognitive functioning after physical activity has been found using a cognitive test of verbal fluency [66].”
MethodEbrahim, S., Johnston, B. C., Akl, E. A., Mustafa, R. A., Sun, X., Walter, S. D., Heels-Ansdell, D., Alonso-Coello, P., & Guyatt, G. H. (2014) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2013.11.014 · Cited by 72 · see citing works
Effects of medical and psychological treatment of depression in patients with COPD – A review
Fritzsche, A., Clamor, A., & von Leupoldt, A. (2011) · Respiratory Medicine · doi:10.1016/j.rmed.2011.05.014 · Cited by 70 · see citing works
Phan, T., Carter, O. B. J., Adams, C., WATERER, G. W., Chung, L. P., Hawkins, M., Rudd, C. J., Ziman, M. R., & Strobel, N. (2016) · Chronic Respiratory Disease · doi:10.1177/1479972316634604 · Cited by 72 · see citing works
“Another potential limitation is that we did not exclude participation in pulmonary rehabilitation as a possible confounder, which previous evidence suggests can be effective for reducing anxiety and depression in COPD patients.(36,37) Cheung et al.”
Kozora, E., Tran, Z. V., & Make, B. (2002) · Journal of Cardiopulmonary Rehabilitation · doi:10.1097/00008483-200211000-00008 · Cited by 70 · see citing works
“A significant group (F[67,2] 5.”
MethodInfluentialFluid intelligence in an older COPD sample after short- or long-term exercise
ETNIER, J. L., & BERRY, M. (2001) · Medicine & Science in Sports & Exercise · doi:10.1097/00005768-200110000-00002 · Cited by 69 · see citing works
Emery, C. F., Hsiao, E. T., Hill, S. M., & Frid, D. J. (2003) · Heart & Lung · doi:10.1016/s0147-9563(03)00120-1 · Cited by 65 · see citing works
Self-citationHigashimoto, Y., Ando, M., Sano, A., Saeki, S., Nishikawa, Y., Fukuda, K., & Tohda, Y. (2020) · Respiratory Investigation · doi:10.1016/j.resinv.2020.05.010 · Cited by 66 · see citing works
Bernard, P., Romain, A. J., Caudroit, J., Chevance, G., Carayol, M., Gourlan, M., Dancause, K. N., & Moullec, G. (2018) · Health Psychology · doi:10.1037/hea0000578 · Cited by 68 · see citing works
Sohanpal, R., Hooper, R., Hames, R., Priebe, S., & Taylor, S. (2012) · Systematic Reviews · doi:10.1186/2046-4053-1-66 · Cited by 51 · see citing works
The Impact of Cognitive Impairment on Efficacy of Pulmonary Rehabilitation in Patients With COPD
Cleutjens, F. A. H. M., Spruit, M. A., Ponds, R., Vanfleteren, L. E. G. W., Franssen, F. M. E., Dijkstra, J. B., Gijsen, C., Wouters, E. F. �., & Janssen, D. J. A. (2017) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2016.11.016 · Cited by 62 · see citing works
Blumenthal, J. A., Emery, C. F., Smith, P. J., Keefe, F. J., Welty‐Wolf, K. E., Mabe, S., Martinu, T., Johnson, J. J., Babyak, M. A., O’Hayer, V. F., et al. (2014) · Psychosomatic Medicine · doi:10.1097/psy.0000000000000101 · Cited by 62 · see citing works
“Emery and colleagues (79) randomized 79 COPD patients to 10 weeks of exercise, education and stress management; to education and stress management; or to a wait-list control group.”
Self-citationA Proposed Model of Neuroplasticity and Cognitive Reserve in Older Adults
Vance, D. E., & Crowe, M. G. (2006) · Activities Adaptation & Aging · doi:10.1300/j016v30n03_04 · Cited by 61 · see citing works
Thought Speed, Mood, and the Experience of Mental Motion
Pronin, E., & Jacobs, E. (2008) · Perspectives on Psychological Science · doi:10.1111/j.1745-6924.2008.00091.x · Cited by 63 · see citing works
- Authors
- Emery, C. F., Schein, R. L., Hauck, E. R., & MacIntyre, N. R.
- Affiliations
- The Ohio State University (US)
- Venue
- Health Psychology
- Published
- 1998
- Volume
- 17
- Issue
- 3
- Pages
- 232-240
- ISSN
- 0278-6133 (ISSN-L)
- 1930-7810
- OpenAlex
- W2090976943
- Cited by
- 353
- References
- 0
- Citations by year
- 2026: 4 · 2025: 3 · 2024: 5 · 2023: 4 · 2022: 5 · 2021: 9 · 2020: 15 · 2019: 11 · 2018: 8 · 2017: 12 · 2016: 8 · 2015: 18 · 2014: 24 · 2013: 17 · 2012: 15
- FWCI
- 5.56
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Health Psychology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (7r29hl045290-05)
- National Institute on Aging (AG 00029)
- National Heart, Lung, and Blood Institute (HL 45290)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Keywords
- chronic obstructive pulmonary disease, exercise rehabilitation, stress management, patient education, older adults, lung function, exercise endurance, depression, anxiety, quality of life, cognitive performance, verbal fluency, attention, motor speed
- MeSH terms
- Aged, Analysis of Variance, Anxiety, Cognition Disorders, Combined Modality Therapy, Depression, Exercise Therapy, Female, Humans, Health Knowledge, Attitudes, Practice, Lung Diseases, Obstructive, Male, Middle Aged, Neuropsychological Tests, Patient Education as Topic, Physical Fitness, Quality of Life, Regression Analysis, Relaxation Therapy, Respiratory Function Tests, Stress, Psychological, Causality, Treatment Outcome
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