Interventions to promote physical activity and reduce sedentary behaviour in COPD: systematic review of methodologies

Physical activity (PA) promotion and sedentary behaviour (SB) reduction are major goals in COPD, but long-term maintenance is challenging. Reasons may include uncertainty of the best mode/timing of the intervention or its implementation with/without pulmonary rehabilitation (PR). This review (PROSPERO CRD42023410363) characterised methodologies used in community-based interventions aiming to promote PA/reduce SB in people with COPD. Studies were searched on PubMed, Scopus, Web of Science and PsycNET until December 2023. Two reviewers independently screened articles and extracted data. The search retrieved 12533 results. From these, 106 studies were included comprising 71 interventions (67 targeting PA, 3 SB, 1 both). Walking was the most common form of PA (n=10), followed by home-based exercise (n=7) and a combination of both (n=11). 39 interventions aimed to improve daily/lifestyle PA. PA prescription was mainly personalised (n=34), fixed/based on guidelines (n=11) or mixed (n=5). Steps were the only prescription measure in 23 interventions, while 21 did not report it. 21 interventions reported progression criteria, in which 11 were personalised. Professional supervision was mainly made by phone (n=22), with 12 interventions having none. PA/SB monitoring was mostly conducted with pedometers (n=30), diaries (n=22) or mobile apps (n=16). Interventions lasted 21±19 weeks, with 16 implementing it during/after PR. Accelerometery (n=34) and questionnaires (n=20) were frequently used to assess PA/SB. Interventions promoting PA/reducing SB are heterogeneous and not always described in detail. Guidelines could facilitate comparison, replication and interpretation of results.