Effective Approaches for Improving Physical Activity in Patients with Chronic Obstructive Pulmonary Disease: An umbrella review.

BACKGROUND

Physical inactivity is a significant predictor of hospitalization and all-cause mortality in COPD patients. This study sought to identify the most successful methods for improving physical activity in COPD patients.

METHODS

Systematic reviews with or without meta-analysis from January 2012 to December 2024 according to the PRISMA 2020 guidelines were included. Searches were conducted in MEDLINE, Web of Science, Cochrane Library and other databases. Selected studies had two quality standards required by the Database of Abstracts of Reviews of Effects and focused on improving physical activity in COPD patients.

RESULTS

Ultimately, 20 systematic reviews, with 35,816 participants, were selected for this study. Four main classifications with eleven approaches to improving physical activity were identified. These approaches include: 1. Exercise (Tai Chi, traditional mind-body exercises, walking, and pedometers); 2. Technology-based interventions (Virtual reality-based therapy [VRBT], telerehabilitation [telemonitoring, applications], and smartphone devices, which increased activity by over 18.3% within 6 months and 21% over 12 months, and serious games with a 61.83% adherence rate); 3. Theoretical-behavioral approaches (consultation and coaching, and behavior change interventions); 4. Hybrid approaches.

CONCLUSION

Based on the narrative synthesis, a hybrid approach could be a useful strategy for addressing barriers to physical activity in patients with COPD. Such an approach could include tailoring interventions (e.g., combining tai chi with coaching) and delivering them through technology-based platforms (e.g., VRBT) according to individual patient and health system needs. This approach can improve patients' physical activity levels and support adherence to physical activity, thereby potentially optimizing the treatment process.