'Do by doing' is the best advice to help COPD patients improve ability to function in daily life

There is no magic bullet to help patients with COPD improve their ability to function in daily life. In fact, the best advice they might get is "do by doing," according to research to be presented at the ATS conference in New Orleans.

The results will be presented at the ATS 2010 International Conference in New Orleans.

Inactivity is known to be associated with a decrease in exercise tolerance, but it was unknown whether the reduced amount of physical activity alone was responsible for the reduction in functional exercise tolerance and maximal exercise capacity, or if the decreased intensity of the performed activities also played a role.

"We looked at the functional exercise tolerance in patients with COPD-that is, the distance they were able to walk during the six-minute walk test-and related it to the amount of daily activity they were able to maintain," said Chris Burtin, P.T., M.Sc. "We found that patients with a higher amount of daily activities also had higher scores on the six-minute walk test."

In contrast, patients' maximal exercise tolerance was unaffected by their daily activity, and more likely to be affected by disease severity, and the intensity, rather than the amount, of performed activities.

"Knowledge of these relationships is of utmost importance when developing interventions aiming at improvement of functional or maximal exercise capacity," explained Mr. Burtin. "These findings confirm that intensity of the performed activities is crucial when the intervention aims at improving physical fitness."

"An optimal long-term functional status should always be a general treatment goal in patients with chronic diseases," he continued. "Without disparaging the importance of formal exercise training in tackling the problem of deconditioning, our results also underline the importance of inducing behavioral changes towards a more active lifestyle in inactive patients. According to our findings, COPD patients who wish to improve their ability to perform daily tasks may be better served by increasing the normal daily activities such as walking to the post office, working in the garden or doing the housekeeping, rather than performing intense exercise once in a while."

As a physical therapist, Mr. Burtin stresses the importance of integrating healthy change into people's lives as seamlessly as possible. "If patients relapse into a sedentary lifestyle after terminating the program, this may negatively influence the long-term effects on functional status," he explained. "The key point in this intervention is to find activities which the patient enjoys to do, in order to increase the chances of long-term adherence."

In future research, Mr. Burtin intends to further investigate the relationship between physical activity and other aspects of disease progression. "It would be interesting to further explore the relationship between levels of physical activity and different aspects of health-related quality of life and moreover whether changes in activity behavior could induce long-term improvements in quality of life," he said.