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Abstract
Introduction and objectives There is a relationship between Physical Activity (PA) and both readmissions and mortality.1 PA in COPD in the immediate period following hospital admission and discharge has not received much attention. This study aimed to investigate the profile of PA in the 7 days following discharge from a respiratory-related admission. Additionally, we explored whether brief PA advice (given as part of a self-management (SM) manual) would improve the rate of recovery, compared to usual care.
Methods The study was a Randomised Controlled Trial. Those randomised to UC were discharged with standard treatment and follow-upon addition, those allocated to the SM group received brief advice PA advice in the form of a SM manual (SPACE FOR COPD). All patients wore the ‘Sensewear’ armband (SWA) monitor for 7 days post-discharge for 12 waking hours/day. Outcomes collected were: Total Energy Expenditure (TEE), Steps, Physical Activity Level (PAL) and time spent in light, moderate and vigorous activity.
Results Activity data was collected on 25 patients with COPD, UC = 10, SM = 15. Mean (SD) Age-67.7(7.2) years, FEV-1.01(0.43) L, MRC grade-3.8(1. X), 14 Females, 11 Males. Figure 1 shows the serial measures of steps over 7 days. There were no significant differences in physical activity at baseline between the groups. There was little fluctuation in steps over 7 days and the change was not significant from Day 1–Day 7, within in each group. Furthermore, there was no significant difference between the groups. This was the same for all of the other activity monitor data.
Conclusion We found there was no improvement in steps in the 7 days post-discharge, despite PA advice given in the SM group. It may be that the advice was too brief or that 7 days was not long enough to witness an effect. Further research is required to investigate the effects of an exacerbation and SM interventions on PA; capturing PA data prior to, during and after an admission would be of value.
Reference 1 Puhan MA, Scharplatz M, Troosters T, Steurer J. Respiratory rehabilitation after acute exacerbation of COPD may reduce risk for readmission and mortality – a systematic review. Respir Res. 2005;6:54