Physical activity coaching in people with chronic obstructive pulmonary disease: a systematic literature review with meta-analysis.

BACKGROUND

Physical activity (PA) coaching, defined as a structured one-to-one intervention using behavior-change techniques, may increase PA in people with chronic obstructive pulmonary disease (COPD). This systematic review aimed to assess the effects of individual PA coaching components.

METHODS

Randomized clinical trials comparing PA coaching vs usual care in COPD were searched. Effect direction plots synthesized results, and meta-analyses were conducted for selected outcomes, subgroup analyses exploring individual PA coaching components.

RESULTS

Thirty-two studies involving 5483 people with COPD (67 ± 9 years; 55% male; 53 ± 18 FEV1%predicted) were included. PA coaching, mostly delivered remotely, weekly, for 12 weeks, consisted of education, exercise, feedback, goal setting/review, motivational interviews, problem-solving, self-monitoring, and social support. Effect direction plots showed a positive impact of PA coaching on PA (73%, 95%CI 58-89% of studies), with minimal or no effects on emotional, physical, symptoms, and health-related quality of life domains. Meta-analyses revealed a significant increase in steps/day (MD[95%CI] = 806.84[478.99,1134.70]steps/day, I2 = 66, P < 0.01); however, no clinically relevant changes were observed in other outcomes. Compliance rate across studies was 86% 95%CI, 83%-89%.Subgroups analyses for self-monitoring (MD[95%CI] = 861[555 1166]steps/day; I2 = 66, P < 0.01) and goal setting/review (MD[95%CI] = 916[563 1296]steps/day; I2 = 69, P < 0.01) demonstrated significant and clinically relevant improvements in steps/day. Significant between-group differences in whether self-monitoring (χ2 = 9.84, P < 0.01) and goal setting/review (χ2 = 7.59, P < 0.01) were included suggest these components may moderate PA coaching effectiveness.

CONCLUSIONS

PA coaching increases daily steps in people with COPD without significantly affecting emotional, physical, symptoms or health-related quality of life domains. Including self-monitoring and goal setting/review may enhance its effectiveness.