Physical Activity Beneficial But Poses Challenges in COPD

Nurse helping male patient exercise upper body.
Nurse helping male patient exercise upper body.
In patients with COPD, what attitudes and experiences may affect patient adherence to physical activity programs?

Health care professionals should help patients with chronic obstructive pulmonary disease (COPD) overcome the obstacles to physical activity and develop good activity habits, according to a systematic review and meta-synthesis published in Geriatric Nursing.

Understanding the experiences and attitudes of patients with COPD with respect to physical activity can help clinicians develop individualized physical activity programs that may have higher adherence rates. Toward that end, researchers conducted a systematic review of qualitative studies of patients with COPD regarding their attitudes and experiences with respect to physical activities.

The researchers evaluated multiple databases through March 2022 for relevant primary studies that enrolled adults aged 50 years and older with COPD. A total of 12 articles were identified for analysis.

The studies analyzed had 3 main themes: (1) patients with COPD experience more barriers than facilitating factors while participating in physical activities; (2) patients with COPD experience more positive effects after physical activities than negative effects; and (3) physical activity adherence among patients with COPD may be improved through greater attention to patient safety, goal setting, and the establishment of a professional support group for patients.

Theme 1 addresses obstacles such as symptoms and discomfort, psychological distress, family overprotection, and environmental factors. Fatigue, cough, and dyspnea symptoms prevent patients from engaging in physical activities, which can then worsen the symptoms. Also, weather, transportation, patient economic conditions, and lack of oxygen therapy equipment affect physical activity. Family and friends can help motivate patients to engage in physical activities.

Related to theme 2, physical activity can improve dyspnea, increase muscle strength, and improve stamina, as well as improve patients’ well-being, mental state, and self-confidence. Patients also may have negative experiences during physical activity, including severe dyspnea. Lack of intrinsic motivation and attention are also barriers to engaging in activity.

Subthemes within theme 3 include establishing a professional team to improve patients’ safety. Also, goal setting can help improve initiative among patients, who frequently require motivation to begin and continue physical therapy.

“Health care professionals should educate COPD patients and their families about the necessity and benefits of physical activities,” stated the investigators. “Guidance from health care professionals can effectively reduce patients’ concerns, which gives them a sense of safety and compliance with activities and improves their perception of physical activities.”

This analysis had some notable limitations: (1) the studies analyzed did not differentiate between the patients’ attitudes toward physical activity and their actual experiences; (2) all of the studies selected for inclusion were B grade and did not consider how differences in patients’ age, sex, and cultural/ethnic backgrounds could affect study results.

The researchers concluded that their analysis “adds to our understanding of the impact of physical activity on individual experience of activity and may contribute to improving programs by addressing elderly COPD patients’ needs.”


Tian J, Zhou F, Zhang XG, et al. Experience of physical activity in patients with COPD: a systematic review and qualitative meta-synthesis. Geriatr Nurs. 2022;47:211-219. doi:10.1016/j.gerinurse.2022.07.013