Impact of a Primary Care Exercise Program on Physical Activity and Self-Efficacy in Patients with COPD

  • Author / Creator
    Hurley, Kelsey
  • Chronic obstructive pulmonary disease (COPD) is an obstructive lung disease characterized by shortness of breath and is the fourth leading cause of death in Canada. Physical activity is a strong predictor of all-cause mortality in people who have COPD, however long-term adherence to exercise is low. Self-efficacy is the confidence one has for performing a behaviour and has been associated with physical activity behaviours in people with COPD. Currently pulmonary rehabilitation is the primary way exercise programs are provided to COPD patients; however, pulmonary rehabilitation capacity is low. Primary care may be an effective method for delivering exercise programs in this population. The purpose of this study was to examine how supervised and unsupervised exercise programs influence self-efficacy and adherence to exercise in COPD patients. Patients (N=23; mean age=65±9yrs; FEV1=68±20% predicted) were recruited after referral to a Primary Care Network exercise program. Participants chose either a 16-session supervised exercise program or an unsupervised exercise program where they received three visits with an exercise specialist. Physical activity was monitored with an accelerometer and aerobic exercise minutes were tracked by self-report; self-efficacy was assessed by questionnaire; exercise capacity was assessed by six-minute walk test; quality of life was evaluated using the COPD Assessment Test. Data were collected before (T1), immediately after (T2) and 8 weeks following the program (T3). Time spent performing aerobic exercise increased significantly from T1 to T2 in both groups with no further increase at T3. Self-efficacy for managing breathlessness increased in both groups from T1 to T2 with no further increase at T3. Quality of life also improved significantly in both groups from T1 to T2 with no further improvement at T3. Six-minute walk distance was unchanged from T1 to T2, with no change at T3. Task, coping and scheduling self-efficacy was unchanged from T1 to T2 and T2 to T3. Employment status was significantly different between groups at baseline. In the primary analysis of steps per day the difference between groups was approaching significance. Therefore, employment status was controlled for in the analysis which resulted in no significant difference between groups in steps per day, and no change in steps per day from T1 to T2 or T2 to T3. This study suggests that supervised and unsupervised exercise programs delivered in primary care may be effective at increasing aerobic exercise, self-efficacy for managing breathlessness and quality of life in patients who have mild to moderate COPD.

  • Subjects / Keywords
  • Graduation date
    Spring 2019
  • Type of Item
  • Degree
    Master of Science
  • DOI
  • License
    Permission is hereby granted to the University of Alberta Libraries to reproduce single copies of this thesis and to lend or sell such copies for private, scholarly or scientific research purposes only. Where the thesis is converted to, or otherwise made available in digital form, the University of Alberta will advise potential users of the thesis of these terms. The author reserves all other publication and other rights in association with the copyright in the thesis and, except as herein before provided, neither the thesis nor any substantial portion thereof may be printed or otherwise reproduced in any material form whatsoever without the author's prior written permission.