title: Activity levels after pulmonary rehabilitation - what really happens?
abstract: OBJECTIVE
  To assess the changes in physical activity in subjects with chronic obstructive pulmonary disease over 6months after pulmonary rehabilitation.
  
  
  METHODS
  Prospective, observational study. Activity was measured over 2-day periods at the end of rehabilitation, and repeated every 6weeks for 6months using the ActivPAL uni-axial accelerometer. These results were compared with the shuttle walking test (SWT) and the St. George's Respiratory Disease Questionnaire (SGRDQ).
  
  
  METHODS
  UK community hospital.
  
  
  METHODS
  Adults completing a community rehabilitation programme.
  
  
  METHODS
  Time spent standing and mobilising ('uptime').
  
  
  RESULTS
  Of 34 subjects recruited, 28 completed the 6-month study period (mean age 69years, mean forced expiratory volume in 1second 1.3l). Participants wore the monitor for 13.8 to 14.2hours/day. At baseline (post-rehabilitation), participants spent 1.7 [standard deviation (SD) 1.3]hours/day walking and 3.5 (SD 2.6)hours/day standing. Taking the group as a whole, mean uptime decreased marginally by 13.6minutes after 24weeks compared with baseline, with significant individual variability. In all but one subject who showed decreased activity, this was apparent after 6weeks. There were no significant changes in the mean SWT or SGRDQ. Significant associations between total uptime and the SWT were found, but coefficients were weak. It was not possible to predict individual responses from baseline data.
  
  
  CONCLUSIONS
  The accelerometer provides useful supplementary data in patients completing rehabilitation programmes, and the results reveal wide variation. The weak associations between activity data and the SWT suggest that monitors provide additional information. More work is required to determine the factors associated with early deterioration in activity in order to design appropriate interventions.
authors.affiliation: Bath University School for Health, Bath, UK. chris.dyer1@nhs.net
authors.forename: C A E
authors.initials: CA
authors.lastname: Dyer
authors.forename: N D
authors.initials: ND
authors.lastname: Harris
authors.forename: E
authors.initials: E
authors.lastname: Jenkin
authors.forename: C
authors.initials: C
authors.lastname: Langley-Johnson
authors.forename: R
authors.initials: R
authors.lastname: Lewis
authors.forename: G J
authors.initials: GJ
authors.lastname: Taylor
authors.forename: K
authors.initials: K
authors.lastname: Gruffydd-Jones
mesh_terms: D061725:Accelerometry; D000203:Activities of Daily Living; D000368:Aged; D003153:Community Health Services; D005260:Female; D005500:Follow-Up Studies; D005541:Forced Expiratory Volume; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D026741:Physical Therapy Modalities; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology* / Q000534:rehabilitation*