What are the patient reported facilitators and barriers to physical activity following pulmonary rehabilitation in chronic obstructive pulmonary disease (COPD)? A systematic review of qualitative research

Abstract

Objectives/purpose: This study aimed to determine and understand COPD patients’ perceived facilitators and barriers to physical activity after completion of pulmonary rehabilitation. Pulmonary rehabilitation, a multidisciplinary treatment for COPD incorporating exercise trail. Design: A systematic review of qualitative research. Methods: Electronic databases of published, (MEDLINE, Embase, Web of Science, CINAHL, ASSIA, PsycINFO and SPORTDiscus), non-published data and conference proceedings (DART Europe E theses, EThOS, Open Grey, The New York Academy of Medicine, ProQuest Dissertations and theses), and trial registers (ClinicalTrials.gov and Current Controlled Trials) were searched to identify qualitative studies (interviews, focus groups) including COPD patients following pulmonary rehabilitation. Qualitative data relevant to the research question were synthesised using an inductive, thematic approach. Results: 14 studies (n= 12 published articles, n= 2 theses) including 167 COPD patients (male = 92, female = 75) met the inclusion criteria. Analytical themes were beliefs, motivation and social support, which encapsulated the facilitators and barriers to physical activity following pulmonary rehabilitation. Facilitators included positive intentions, support from health care professionals (HCPs), positive feedback regarding health, access and opportunities to attend physical activity maintenance groups, peer and family interaction. Barriers included negative beliefs, lack of 27 support from HCPs and peers, as well as practical issues surrounding travel and home responsibilities following pulmonary rehabilitation. Conclusions: Our findings reflect the complexity of physical activity behaviour and provide implications regarding the importance of continued social support and feedback in the maintenance of physical activity. These factors should be considered in the development of future interventions that target physical activity following pulmonary rehabilitation in patients with COPD