This study aimed to clarify the effects of low-frequency self-management interventions on motor function, activities of daily living (ADL), and quality of life (QOL) in patients with chronic respiratory disease.
Fourteen patients with chronic respiratory disease who regularly attended our hospital were included in the study. The intervention consisted of self-exercise instruction and recommendations to increase daily steps at least once a month. The recommended daily steps increased by 5% each month, based on the first month. Participants tracked their daily steps, self-exercise, and self-rated activity in a diary.
Outcomes were evaluated at baseline, 3 months, and 6 months using measures of quadriceps muscle strength, the 30-second chair stand test (CS-30), the 6-minute walk test (6MWT), the modified Medical Research Council (mMRC) dyspnea scale, the COPD Assessment Test (CAT), the Nagasaki University Respiratory ADL questionnaire (NRADL), and the St. George's Respiratory Questionnaire (SGRQ).
The rate of missing data was 2.1%, classified as missing completely at random; therefore, multiple imputation was used to handle it. A linear mixed-effects model was applied for analysis, with fixed effects designated as time and random effects designated as individuals. The statistical software used was R, and the significance level was set at 5%.
The percentage change in steps, based on the first month's data, showed a significant increase from the fourth month onward (4 months: estimate=0.165, SE=0.072; 5 months: estimate=0.205, SE=0.074; 6 months: estimate=0.256, SE=0.070). The SGRQ symptom score increased significantly at the 3 months (estimate=10.07, SE=4.39), while there was no significant increase at the 6 months (estimate=6.84, SE=4.20). Meanwhile, the CS-30 score showed significant improvement at both 3 months (estimate=2.36, SE=0.83) and 6 months (estimate=2.70, SE=0.88).
Low-frequency self-management interventions, conducted at least once a month, may initially increase symptoms in patients with chronic respiratory disease within the first 3 months. However, this effect is temporary and secondary to increased activity, and it is no longer apparent by the sixth month. When continued for 4 months or longer, these interventions are effective in improving physical activity and lower extremity muscle strength.
Low-frequency self-management interventions are offered to patients with chronic respiratory disease, there may be a temporary increase in symptoms as physical activity is encouraged. However, it is important to ensure that patients understand the interventions, as continued participation can lead to improvements in physical function and activity levels.
Self-management
Low-frequency intervention
