The following is a summary of “Beyond Pulmonary Rehabilitation: can the PICk-UP program fill the gap? A Randomized Trial in COPD,” published in the May 2024 issue of Pulmonology by Rebelo et al.
Pulmonary rehabilitation (PR) is pivotal in managing COPD, yet sustaining its benefits remains a challenge. This study aimed to evaluate the efficacy and effectiveness of a personalized community-based physical activity program that aims to prolong PR benefits among individuals with COPD.
Conducted as a multicenter, assessor-blinded, randomized controlled trial, the study enrolled patients with COPD who completed a 12-week PR program. Participants were randomized to either a six-month personalized community-based physical activity program (experimental group) or standard care (control group). Primary outcomes included daily time spent in moderate to vigorous physical activities, steps per day and scores from the brief physical activity assessment tool. Secondary outcomes encompassed sedentary behavior, functional status, peripheral muscle strength, balance, symptoms, emotional state, health-related quality of life, exacerbations, and healthcare utilization. Assessments were conducted immediately post-PR and at three- and six-month intervals. Efficacy and effectiveness were analyzed using intention-to-treat and per-protocol approaches with linear mixed models.
The study included 61 participants (experimental group: n = 32; control group: n = 29), with balanced baseline characteristics (mean age 69.6 ± 8.5 years, 84% male, FEV1 57.1 ± 16.7% predicted). At the six-month follow-up, significant improvements (P < 0.05) favoring the experimental group were observed in all physical activity outcomes and in the one-minute sit-to-stand test. No significant differences between groups were noted in other secondary outcomes.
The community-based physical activity program effectively enhanced physical activity levels and sit-to-stand performance among patients with COPD six months post-PR. However, it did not confer additional benefits across other measured outcomes. These findings underscore the potential of targeted physical activity interventions in sustaining PR benefits in COPD management, highlighting the need for further research to optimize comprehensive care strategies for this patient population.
Source: sciencedirect.com/science/article/pii/S2531043724000473
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