{Reference Type}: Journal Article
{Title}: Interventions with a clear focus on achieving behaviour change are important for maintaining training-related gains in people with chronic obstructive pulmonary disease: a systematic review.
{Author}: Hug S;Cavalheri V;Lawson-Smith H;Gucciardi DF;Hill K;
{Journal}: J Physiother
{Volume}: 70
{Issue}: 3
{Year}: 2024 Jul 24
{Factor}: 10.714
{DOI}: 10.1016/j.jphys.2024.06.003
{Abstract}: <B>OBJECTIVE: </B>In people with chronic obstructive pulmonary disease (COPD) who complete an exercise training program (ETP) offered at a sufficient dose to result in training-related gains, to what extent are these gains maintained 12 months after program completion? Do variables such as the application of behaviour change techniques moderate the maintenance of these training-related gains?<BR><B>METHODS: </B>Systematic review, meta-analysis and meta-regression of randomised controlled trials.<BR><B>METHODS: </B>People with stable COPD.<BR><B>METHODS: </B>Trials were included if they applied ≥ 4 weeks of a whole-body ETP and reported outcome data immediately following program completion and 12 months after initial program completion. The control group received usual care that did not include a formal exercise training component.<BR><B>METHODS: </B>Exercise tolerance, health-related quality of life and dyspnoea during activities of daily living.<BR><B>METHODS: </B>EMBASE, PEDro, PubMed and the Cochrane Library.<BR><B>RESULTS: </B>Nineteen randomised trials with 2,103 participants were found, of which 12 had a sufficiently similar design to be meta-analysed. At 12 months after ETP completion, compared with the control group, the experimental group demonstrated better exercise tolerance (SMD 0.48, 95% CI 0.19 to 0.77) and quality of life (SMD 0.22, 95% CI 0.03 to 0.41) with no clear effect on dyspnoea. Meta-regression using data from all 19 trials demonstrated that the magnitude of between-group differences at the 12-month follow-up was moderated by: behaviour change being a core aim of the strategies implemented following completion of the ETP; the experimental group receiving more behaviour change techniques during the program; and the magnitude of between-group change achieved from the program.<BR><B>CONCLUSIONS: </B>At 12 months after completion of an ETP of ≥ 4 weeks, small gains were maintained in exercise tolerance and health-related quality of life. Applying behaviour change techniques with a clear focus on participants integrating exercise into daily life beyond initial program completion is important to maintain training-related gains.<BR><B>BACKGROUND: </B>CRD42020193833.