Introduction and objectives Pulmonary rehabilitation (PR) is recommended by the British Thoracic Society for patients that suffer from COPD; it is typically delivered in supervised sessions. Daily physical activity (PA) is often recorded as an outcome following PR, with variable results. National guidelines recommend that older adults should accumulate 150 min of moderate intensity activity in bouts of 10 min or more. We wanted to objectively measure the amount and intensity of PA, which patients actually accumulate during 1 PR session. This is the first study to profile PA during a PR exercise class in this way and could be useful for home training and general PA advice.
Methods We conducted a prospective study on patients diagnosed with COPD that were enrolled for PR at Glenfield Hospital, Leicester. 12 PR sessions include walking [85% speed derived from the incremental shuttle walk test (ISWT)], leg/arm bike, and resistance training. We placed Sense-Wear™ monitors (SWM) on the patients’ arm during session 2 only. Analysis took place on Innerview™ computer software.
Results The patient cohort consisted of 20 patients: 60% female, mean age of 70.1 years (SD – 8.3 years), BMI 28.6 (SD 7.9), FEV1/FVC ratio 60.8 (SD 17.3). 90% of the patients were either smokers or ex-smokers. The baseline ISWT of the group was 199.5 (SD 145.0) metres.
Table 1 shows that in our cohort, patients were exercising in the 0–1.5 METs range for 52% of the time (sedentary activity), 1.5–3 METs – 31% of the time (light activity) and for 17% of the time, they were exercising above 3 METs (moderate activity).
Conclusion The results highlight that, early in the PR programme COPD patients were not achieving 10 min of moderate intensity activity during 1 PR session, as recommended in national guidance. However, documented inaccuracies of the SWM, for instance at slow speeds of walking and when the arm is fixed may account for these results. Future work should aim to discover if the time spent above 3 METS increases later in the programme. In addition, we could use the PA profile of each patient to tailor home and class training progression.
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