A community-based exercise programme in COPD self-management:Two years follow-up of the COPE-II study

Introduction: It is still unknown how best to maintain effects of exercise programmes in COPD in the long-term. We present the long-term effects of a community-based exercise programme incorporated in a self-management programme, compared to a self-management programme only in patients with COPD.Methods: All included patients participated in four self-management sessions. Additionally, patients in the intervention group participated in an 11-month community-based exercise programme led by physiotherapists. Patients trained three times/week for six months and two times/week during the subsequent five months. To encourage a behavioural change towards exercise, one of these weekly training sessions was home-based (unsupervised). No formal exercise training was offered to intervention patients in the second year.Results: The intervention was assigned to 80 patients, and the control condition to 79 patients. 82.5% and 78.5% of the intervention and control group, respectively, completed 24 months follow-up. Modified intention-to-treat analyses were performed. Although statistically significant after 12 months (35.1 m (95%Cl: 8.4-61.8)), the between-group difference on maximal exercise capacity was not statistically significant after 24 months (12.2 m (95%Cl: -16.6 to 41.0). Nevertheless, the between-group difference in daily physical activity was maintained after 24 months (1193 steps/day (95%Cl: 203-2182)). A beneficial effect was also found on CRQ dyspnoea score but not on other CRQ domains, CCQ and HADS.Conclusions: Our intervention was effective in achieving a behavioural change reflected by a sustained increase in daily physical activity, not accompanied by a sustained increase in maximal exercise capacity after two years of follow-up (ISRCTN81447311). (C) 2014 Elsevier Ltd. All rights reserved.