Intervention by phone calls raises domiciliary activity and exercise capacity in patients with severe COPD.
BACKGROUND
Patients with severe COPD suffer from impairments of exercise capacity which affects daily activity. Conversely, activity might exert effects on the functional state. We studied whether a short-term intervention by regular phone calls caused an increase in activity at home and whether this resulted in a gain in exercise capacity.


METHODS
Over a 2-week period (P1) normal daily activity was assessed in 21 patients with stable severe COPD (GOLD III/IV). After this, the individual setting was explored in a short home visit. The subsequent 2-week period (P2) involved phone calls every other day to raise home-based activity (target: 3x15 min daily at 75% of maximum dyspnea). During the study, patients wore an actograph plus pedometer and kept a diary. Before P1 and after P2, 6-min walking distance (6MWD), lung function, the Borg score and quality of life (SF-36, SGRQ) were determined.


RESULTS
Compared to P1, actograph counts (p<0.05) were higher in P2. There was also an increase in 6MWD (p<0.05) and quality of life scores (SF-36, p<0.05) between initial and final visit, whereby improvements in 6MWD correlated with changes in activity (p<0.01). Conversely, four patients who experienced an exacerbation in P2 showed no increase in activity or 6MWD.


CONCLUSIONS
In patients with stable severe COPD, it was possible to increase activity by regular phone calls without performing previous rehabilitation. Increased activity resulted in increased exercise capacity and quality of life within 2 weeks, underlining the effectiveness of continued motivational support in patients with severe COPD.
Wewel
Alexandra R
AR
Hospital Grosshansdorf, Center for Pneumology and Thoracic Surgery, Grosshansdorf, Germany.
Gellermann
Iska
I
Schwertfeger
Ingrid
I
Morfeld
Matthias
M
Magnussen
Helgo
H
Jörres
Rudolf A
RA
D000203:Activities of Daily Living; D000704:Analysis of Variance; D005081:Exercise Therapy; D017079:Exercise Tolerance; D006801:Humans; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000534:rehabilitation*; D017010:Reminder Systems; D013689:Telephone; D016896:Treatment Outcome