Article

AIM: To investigate the relationship between physical activity (PA) and measures
of health-related quality of life (HRQoL) and hospital admissions in people with
chronic obstructive pulmonary disease (COPD) following pulmonary rehabilitation
(PR). METHOD: CINAHL, Medline, PubMed, AMED, PsycINFO and Cochrane Library
(database inception to July 2014) were searched. Relevant outcomes included
relationships between PA and HRQoL, lung function (forced expiratory volume in
one second, FEV1) and/or hospital admission. Six quantitative and 11 qualitative
studies were included and Harden's method of data synthesis in a mixed-methods
systematic review was applied. RESULTS: Six months following PR, increase
activity levels was associated with improvement of 62m in 6MWD, 2.31 and 15.55
points increase in SGRQ and CRDQ total scores, respectively, 1.3% FEV1 and
reduced dyspnoea. No study reported on hospital admission. Reported relationships
were facilitated by healthcare professionals, social supporters, motivation and
encouragement, reduced fear and seeing benefits and hindered by changing physical
health, environment, lack of motivation, fear and social isolation. CONCLUSION:
The associations between increased levels of PA and quality of life, respiratory
function and dyspnoea are largely based on 6MWD and PA questionnaires. Objective
measurement of free living activity in exercise maintenance phase is required
along with participants' views. Implications for rehabilitation Pulmonary
rehabilitation (PR) is a non-therapeutic intervention in which a team of
multidisciplinary health care professionals use individually tailored supervised
exercise training, self-management education, psychological and social support to
optimize the physical and social performance and autonomy of patients with
chronic respiratory impairment. Initial benefits from PR decline after program
completion. Clinical guidelines advocate increase exercise and activity in
sustaining initial benefits of PR. Following PR, increased levels of physical
activity in people with COPD undertaking exercise maintenance programmes are
positively related with improvements in exercise capacity, quality of life and
dyspnoea. Barriers to activity participation in exercise maintenance programmes,
which need to be overcome,
are fear, lack of motivation, environmental factors,
such as social isolation and changes in physical health. Rehabilitation
professionals and social supporters can make rehabilitation more long-lasting and
facilitate people with COPD to participate in activity by motivating and
encouraging them, reducing their fears and reinforcing the benefits of activity participation.

Langue : ANGLAIS