title: Self-efficacy enhancing intervention increases light physical activity in people with chronic obstructive pulmonary disease.
abstract: BACKGROUND
  People with chronic obstructive pulmonary disease lead sedentary lives and could benefit from increasing their physical activity. The purpose of this study was to determine if an exercise-specific self-efficacy enhancing intervention could increase physical activity and functional performance when delivered in the context of 4 months of upper body resistance training with a 12-month follow-up.
  
  
  METHODS
  IN THIS RANDOMIZED CONTROLLED TRIAL, SUBJECTS WERE ASSIGNED TO: exercise-specific self-efficacy enhancing intervention with upper body resistance training (SE-UBR), health education with upper body resistance training (ED-UBR), or health education with gentle chair exercises (ED-Chair). Physical activity was measured with an accelerometer and functional performance was measured with the Functional Performance Inventory. Forty-nine people with moderate to severe chronic obstructive pulmonary disease completed 4 months of training and provided valid accelerometry data, and 34 also provided accelerometry data at 12 months of follow-up. The self-efficacy enhancing intervention emphasized meeting physical activity guidelines and increasing moderate-to-vigorous physical activity.
  
  
  RESULTS
  Differences were observed in light physical activity (LPA) after 4 months of training, time by group interaction effect (P=0.045). The SE-UBR group increased time spent in LPA by +20.68±29.30 minutes/day and the other groups decreased time spent in LPA by -22.43±47.88 minutes/day and -25.73±51.76 minutes/day. Changes in LPA were not sustained at 12-month follow-up. There were no significant changes in moderate-to-vigorous physical activity, sedentary time, or functional performance. Subjects spent most of their waking hours sedentary: 72%±9% for SE-UBR, 68%±10% for ED-UBR, and 74%±9% for ED-Chair.
  
  
  CONCLUSIONS
  The self-efficacy enhancing intervention produced a modest short-term increase in LPA. Further work is needed to increase the magnitude and duration of effect, possibly by targeting LPA.
authors.affiliation: Division of Acute, Critical and Long-Term Care Programs, School of Nursing, University of Michigan, Ann Arbor, MI, USA ; Department of Biobehavioral Health Science, College of Nursing, University of Illinois at Chicago, Chicago, IL, USA.
authors.forename: Janet L
authors.initials: JL
authors.lastname: Larson
authors.affiliation: Department of Biobehavioral Health Science, College of Nursing, University of Illinois at Chicago, Chicago, IL, USA.
authors.forename: Margaret K
authors.initials: MK
authors.lastname: Covey
authors.affiliation: Department of Biobehavioral Health Science, College of Nursing, University of Illinois at Chicago, Chicago, IL, USA.
authors.forename: Mary C
authors.initials: MC
authors.lastname: Kapella
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Edward Hines Jr VA Hospital, Hines, IL, USA ; Advocate Christ Medical Center, Oaklawn, IL, USA.
authors.forename: Charles G
authors.initials: CG
authors.lastname: Alex
authors.affiliation: Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois Urbana-Champagne, Urbana, IL, USA.
authors.forename: Edward
authors.initials: E
authors.lastname: McAuley
mesh_terms: D056044:Actigraphy; D000368:Aged; D000369:Aged, 80 and over; D017079:Exercise Tolerance; D005260:Female; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008168:Lung / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D010353:Patient Education as Topic; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D055070:Resistance Training; D020377:Self Efficacy; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome
keywords: behavioral intervention; chronic bronchitis; emphysema; physical activity