THE PERCEIVED BENEFITS AND BARRIERS TO PHYSICAL ACTIVITY IN INDIVIDUALS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE ON LONG-TERM OXYGEN THERAPY

C. C. Oliveira¹, L. A. S. Jesus², L. A. Sena³, H. H. Oliveira³, L. B. Dorásio³, M.R. Santos⁴, A. José², C. Malaguti²

¹Federal University of Juiz de Fora / Federal University of Minas Gerais, Physiotherapy, Governador Valadares, Brazil, ²Federal University of Juiz de Fora, Physiotherapy, Juiz de Fora, Brazil, ³Federal University of Juiz de Fora, Physiotherapy, Governador Valadares, Brazil, ⁴Federal University of Minas Gerais, Physiotherapy, Belo Horizonte, Brazil

Background: Individuals with Chronic Obstructive Pulmonary Disease (COPD) may develop chronic hypoxemia requiring long-term home oxygen therapy (LTOT). Reduced physical activity (PA) may have harmful consequences in this population, including muscle weakness, increased dyspnoea, and reduced quality of life. The individual´s perceived benefits and barriers to PA may influence the daily PA performed.

Purpose: To investigate the correlations between the perception of benefits and barriers to PA and the daily PA performed by individuals with stable COPD on LTOT.

Methods: This cross-sectional study was approved by the institutional ethics committee of the Federal University of Juiz de Fora, Brazil (#3.046.585/2018). Participants were consecutively recruited from two public health oxygen therapy dispensation services and provided a signed informed consent form before participating. The inclusion criteria were COPD diagnosis, LTOT use for at least three months, and on a clinically stable term with no acute exacerbation in the last three months. The exclusion criteria were refusal to use the accelerometer, contraindications to spirometry testing, or inability to understand the study procedures. The perceived benefits and barriers to PA were assessed using the Exercise Benefits/Barriers Scale (EBBS), a questionnaire that evaluates the individual´s perceived Benefits (range 29-116) and Barriers (range 14-56) domains to PA. Objectively PA was assessed using accelerometry based on five days of recording with a valid data set (>10 hours of daily use). The objective PA variables studied were the average daily time spent in Sedentary, Light (LPA), Moderate-to-vigorous PA (MVPA) and the average number of daily steps. Descriptive statistics are shown in frequency, mean and standard deviation. Pearson correlation coefficient was used to test associations between EBBS and the PA variables. A significance level was set at 0.05.

Results: Thirty-four participants were included [21 (62%) male, 71±9 (mean±SD) years, BMI: 26.7±7.7Kg/m², FEV₁: 37.7±13.0% predicted and FEV₁/FVC: 51.6±10.6. The mean Benefits score was 86±12, and the Barriers score was 36±10. The time(min)/day spent on Sedentary, LPA and MVPA were 691±138, 107±59, and 4±4, respectively. The number of steps/day was 1932±1418. There was a positive correlation between the EBBS total score and steps/day (r=0.36, p=0.04). There was no correlation between the EBBS Benefits and Barriers domains and the PA accelerometry variables. The EBBS Benefits were correlated with the Barries domain (r=-0.56, p≤0,01).

Conclusions: A higher score on perceived benefits and barriers to PA on the EBBS is correlated with a better PA level based on the daily number of steps in individuals with stable COPD on LTOT.

Implications: Evaluating the perceived benefits and barriers to PA may be a straightforward approach to identifying individuals with COPD on LTOT with reduced daily PA levels. Strategies in clinical practice aimed at improving the perception of PA benefits and overcoming restrictions on PA may improve the daily PA level performed in this population.

Funding acknowledgements: This work was supported by CAPES [code 001], FAPEMIG / PPSUS [code APQ-03921-17], and CNPq, Brazil [424542/2018-8].

Keywords:
chronic obstructive pulmonary disease
physical activity
oxygen therapy

Topics:
Cardiorespiratory
Disability & rehabilitation

Did this work require ethics approval? Yes

Institution: Federal University of Juiz de Fora

Committee: Federal University of Juiz de Fora Ethics Committee

Ethics number: 3.046.585/2018