Aim: Despite extensive knowledge about positive effects of exercise training (ExT) in Chronic Obstructive Pulmonary Disease (COPD) patients, there are few available health-care ExT programs and a considerable proportion of eligible patients decline participation or drop out. Reasons for decline and drop-out from an ExT program have seldom been investigated. The aim of the study is to outline motivations and barriers towards ExT in COPD patients. Methods: From the Respiratory Division’s archive we identified males patients with mild to severe COPD to be involved in a 6 months of ExT trial. Participants were randomized in a Fitness Center (FC), Educational and Control groups. Steps of recruitment and drop out motives were recorded. Moreover, motivation EMI-2 questionnaire was administrated at baseline, after 3 and 6 months. One way ANOVA was used to detect significant differences between groups and variables. Results: 132 COPD patients were considered eligible, 92 were contacted and 38 were involved into the trial. Reasons of decline (n = 54) concerned ‘‘no interest’’ (n = 21), ‘‘lack of time’’ (n = 16), ‘‘clinical conditions’’ (n = 13) and ‘‘transport difficulties’’ (n = 4). After 6 months of trial, 4 patients dropped out caused clinical conditions. EMI-2 baseline analysis showed no significant differences between groups. During the trial, EMI-2 significant modifications were found in FC. After 3 months, significant improvements were observed in EMI-2 total score (p\0.05), socio/emotional (p\0.01), weight management (p\0.05) and enjoyment items (p\0.01). After 6 months, EMI-2 total score (p\0.05), socio/emotional (p\0.01) and enjoyment items (p\0.05) significantly improved. Conclusion: Mismatched inclusion criteria (65.5 %), no-interest in ExT (8.9 %), lack of time (6.8 %) and transport difficulties (1.7 %) were the main causes to decline participation. The high recruitment’s rate (25.7 %), ExT adherence (89.5 %) and the significant motivation’s improvement suggest a positive influence of a structured and high-supervised ExT program to increase patients’ intrinsic and selfdetermined extrinsic motives towards ExT. References GOLD (2013) Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease UPDATED 2013 Valero C et al (2009) Evaluation of a combined strategy direct towards health-care professionals and patients with chronic obstructive pulmonary disease (COPD): information and health education feedback for improving clinical monitoring and quality-of-life. BMC Public Health 14(9):442–456 Faulkner J et al (2010) The feasibility of recruiting patients with early COPD to a pilot trial assessing the effects of a physical activity intervention. Primary Care Resp J 19:1–7
Motivations and barriers towards exercise training program in mild to severe COPD patients
RINALDO, Nicoletta;ROSSI, ANDREA;SCHENA, Federico;LANZA, Massimo;BRUSTIO, Paolo Riccardo
2013-01-01
Abstract
Aim: Despite extensive knowledge about positive effects of exercise training (ExT) in Chronic Obstructive Pulmonary Disease (COPD) patients, there are few available health-care ExT programs and a considerable proportion of eligible patients decline participation or drop out. Reasons for decline and drop-out from an ExT program have seldom been investigated. The aim of the study is to outline motivations and barriers towards ExT in COPD patients. Methods: From the Respiratory Division’s archive we identified males patients with mild to severe COPD to be involved in a 6 months of ExT trial. Participants were randomized in a Fitness Center (FC), Educational and Control groups. Steps of recruitment and drop out motives were recorded. Moreover, motivation EMI-2 questionnaire was administrated at baseline, after 3 and 6 months. One way ANOVA was used to detect significant differences between groups and variables. Results: 132 COPD patients were considered eligible, 92 were contacted and 38 were involved into the trial. Reasons of decline (n = 54) concerned ‘‘no interest’’ (n = 21), ‘‘lack of time’’ (n = 16), ‘‘clinical conditions’’ (n = 13) and ‘‘transport difficulties’’ (n = 4). After 6 months of trial, 4 patients dropped out caused clinical conditions. EMI-2 baseline analysis showed no significant differences between groups. During the trial, EMI-2 significant modifications were found in FC. After 3 months, significant improvements were observed in EMI-2 total score (p\0.05), socio/emotional (p\0.01), weight management (p\0.05) and enjoyment items (p\0.01). After 6 months, EMI-2 total score (p\0.05), socio/emotional (p\0.01) and enjoyment items (p\0.05) significantly improved. Conclusion: Mismatched inclusion criteria (65.5 %), no-interest in ExT (8.9 %), lack of time (6.8 %) and transport difficulties (1.7 %) were the main causes to decline participation. The high recruitment’s rate (25.7 %), ExT adherence (89.5 %) and the significant motivation’s improvement suggest a positive influence of a structured and high-supervised ExT program to increase patients’ intrinsic and selfdetermined extrinsic motives towards ExT. References GOLD (2013) Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease UPDATED 2013 Valero C et al (2009) Evaluation of a combined strategy direct towards health-care professionals and patients with chronic obstructive pulmonary disease (COPD): information and health education feedback for improving clinical monitoring and quality-of-life. BMC Public Health 14(9):442–456 Faulkner J et al (2010) The feasibility of recruiting patients with early COPD to a pilot trial assessing the effects of a physical activity intervention. Primary Care Resp J 19:1–7
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