Interventions to increase physical activity in people with COPD: systematic review
Abstract
People with chronic obstructive pulmonary disease (COPD) are very sedentary and this contributes to their health problems. The aim of this systematic review was to examine the effects of interventions designed to increase physical activity (PA) in people with COPD. Studies were included when PA was the primary outcome and measured objectively. Six databases were searched and 15 studies with a total of 761 subjects were identified that met inclusion criteria. Nine of the studies were quasi-experimental (QE) and six were randomized controlled trials (RCT). Interventions included pulmonary rehabilitation (n = 7), exercise only (n = 2), behavioral only (n = 2) and a combination of both behavioral and pulmonary rehabilitation/exercise interventions (n = 4). Methodological quality was evaluated using the Downs and Black checklist. The quality of the pulmonary rehabilitation studies was the lowest with a fair rating and the quality of exercise only studies was the highest with a good rating. Eight of the 15 studies demonstrated statistically significant increases in PA: two pulmonary rehabilitation (QE = 2), two exercise only (RCT = 2), two behavioral only (RCT = 1, QE = 1), and two combined behavioral and pulmonary rehabilitation/exercise (RCT = 2). The magnitude of increase was modest in all but one study; and in many studies the increase in PA was not clinically meaningful. Longer interventions demonstrated a higher success rate and only three studies examined longer term effects of the interventions. Existing interventions are promising, but the small number of randomized controlled trials makes it difficult to draw conclusion. Further research is needed to identify a range of interventions that are effective and could be used to promote PA in people with COPD.
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There is a knowledge gap on how to improve physical activity in COPD.
“there is a knowledge gap on how to improve physical activity in COPD.”
From Health Coaching and Chronic Obstructive Pulmonary Disease Rehospitalization: A Randomized Study (2016) · cites this paper as [45]
There is limited and inconsistent evidence on the effectiveness of interventions for improving physical activity.
“There is limited and inconsistent evidence on the effectiveness of interventions for improving physical activity (45, 46).”
From Health Coaching and Chronic Obstructive Pulmonary Disease Rehospitalization: A Randomized Study (2016) · cites this paper as [45]
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Benzo, R., Vickers, K., Novotny, P. J., Tucker, S., Hoult, J., Neuenfeldt, P., Connett, J., Lorig, K., & McEvoy, C. (2016) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.201512-2503oc · Cited by 176 · see citing works
“There is limited and inconsistent evidence on the effectiveness of interventions for improving physical activity (45, 46).”
BackgroundCortés, O., Delgado, S., & Esparza-Bohórquez, M. (2019) · Journal of Advanced Nursing · doi:10.1111/jan.13958 · Cited by 56 · see citing works
Larson, J. L., Covey, M. K., Kapella, M. C., Alex, C. G., & McAuley, E. (2014) · International Journal of COPD · doi:10.2147/copd.s66846 · Cited by 43 · see citing works
“The self-efficacy enhancing intervention produced results that are consistent with other behavioral interventions designed to increase PA.(6) People with COPD increased PA by 1,263 steps/day after 12 weeks of an Internet-based walking program,(39) 785 steps/day after 12 weeks of a customized exercise counseling progra…”
Self-citationClark, D. O., Xu, H., Unverzagt, F. W., & Hendrie, H. C. (2015) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.4395 · Cited by 39 · see citing works
“Evidence of an effect of education on cognitive reserve (Larson et al., 2013; Meng and D’Arcy, 2012; Zahodne et al., 2014) raises the question of what interventions can be offered to the hundreds of millions of adults worldwide who have not achieved upper-level secondary education—an education threshold used in a rece…”
BackgroundDohrn, I., Hagströmer, M., Hellénius, M.-L., & Ståhle, A. (2016) · Journal of Geriatric Physical Therapy · doi:10.1519/jpt.0000000000000077 · Cited by 38 · see citing works
“Physical activity was assessed with pedometers (Yamax) and accelerometers (Actigraph), HRQoL with the Short Form-36 (SF-36), gait with a GAITRite walkway, balance performance with Modified-Figure-Eight test and one-leg stance, fall-related concerns with Falls Efficacy Scale International, and physical function with th…”
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Gore, S., Goldberg, A., Huang, M. H., et al. (2020) · Cardiopulmonary Physical Therapy Journal · doi:10.1097/cpt.0000000000000127 · Cited by 3 · see citing works
“compared to those without the disease.(2,3,5) As compared to healthy older adults, individuals with COPD have 40% to 60% lower activity levels.”
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Gore, S., Chindam, T., Goldberg, A., Huang, M. H., Shoemaker, M. J., & Blackwood, J. (2020) · COPD Journal of Chronic Obstructive Pulmonary Disease · doi:10.1080/15412555.2020.1830963 · Cited by 1 · see citing works
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Physical activity in COPD: a scoping review of methods and behaviour change techniques
Hipólito, N., Pimenta, S., Encantado, J., & Cruz, J. (2026) · ERJ Open Research · doi:10.1183/23120541.01481-2025
“Behavioural change interventions have previously demonstrated potential in improving PA levels in everyday life, while also emphasising the complexity of PA and behaviour change, although the certainty of the evidence remains low [15, 150 – 152].”
- Authors
- Larson, J. L., Vos, C. M., & Fernandez, D.
- Venue
- Annual Review of Nursing Research
- Publisher
- Springer Publishing Company
- Published
- 2013-10
- Volume
- 31
- Issue
- 1
- Pages
- 297-326
- ISSN
- 0739-6686 (ISSN-L)
- 1944-4028
- OpenAlex
- W2334802767
- Cited by
- 12
- References
- 0
- Citations by year
- 2026: 1 · 2023: 1 · 2020: 2 · 2019: 1 · 2018: 1 · 2016: 3 · 2015: 2 · 2014: 1
- FWCI
- 1.63
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Annual Review of Nursing Research (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Keywords
- chronic obstructive pulmonary disease, physical activity, exercise intervention, pulmonary rehabilitation, behavioral interventions, sedentary behavior, physical activity promotion, intervention effectiveness
- MeSH terms
- Humans, Exercise, Pulmonary Disease, Chronic Obstructive
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