Counseling During Pulmonary Rehabilitation

Effect of Counseling During Pulmonary Rehabilitation on Self-determined Motivation Towards Physical Activity in Patients With Chronic Obstructive Pulmonary Disease

The purpose of this study is to investigate if a physical activity counseling program during pulmonary rehabilitation increases the physical activity level in daily life in patients with Chronic Obstructive Pulmonary Disease.

Participants performed a 12 weeks outpatient pulmonary rehab (PR) according to guidelines. Participants allocated to intervention received PR plus physical activity (PA) counselling. PA counselling was performed using "motivational interviewing" techniques and was provided by two experiences physiotherapists independant to the rehab team. After PR and three months follow-up was evaluated if PA counselling during PR increases PA elvel (primary outcome: steps per day) in daily life.

Furthermore, individual, semi-structured interviews were performed in a subgroup of participants in order to gain more detailed information about barriers and enablers of participation in daily-life activities. Participants were invited to two interviews, one right after PR the other after 3 months follow up. A content analysis was performed.

Inclusion Criteria:

• confirmed COPD (GOLD stages B-D) according to GOLD-guidelines

Exclusion Criteria:

• Mental or physical disability (mini-mental score <20) precluding informed consent or compliance with the protocol
• morphine medication
• Primary diagnosis of heart failure
• Uncontrolled arrhythmias causing symptoms or hemodynamic compromise
• Severe co-morbidity (acute coronary syndrome, unstable angina terminal renal failure, concomitant pulmonary embolism, very severe pneumonia: CURB65>3)
• Severe untreated arterial hypertension at rest (> 200 mm Hg systolic, > 120 mm Hg diastolic)