Open AccessThe Effect of Pulmonary Rehabilitation on Pedometer-Measured Physical Activity
Author(s) -
Corliss McCusker,
Richard ZuWallack
Publication year - 2007
Publication title -
clinical and investigative medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.391
H-Index - 47
eISSN - 1488-2353
pISSN - 0147-958X
DOI - 10.25011/cim.v30i3.1726
Subject(s) - pedometer , medicine , rehabilitation , pulmonary rehabilitation , physical therapy , copd , physical activity
Background: Pulmonary rehabilitation results in favorable outcomes across multiple areas, including exercise capacity, dyspnea, and health status. The effectiveness of this intervention on increasing physical activity levels, however, has received less attention. Accordingly, we tested the potential usefulness of a commercially-available pedometer (NL-2000) as an outcome measure for pulmonary rehabilitation. This instrument, which is a uniaxial accelerometer, accurately detects walking activity in healthy adults.
Methods: Fifty-five patients with COPD who were referred to participating centers in the Northeast Pulmonary Rehabilitation Consortium (mean age 69 yr, FEV1 45%) were studied after informed consent was obtained. All were given usual outpatient pulmonary rehabilitation, with pre- to post-rehabilitation assessments of the six minute walk distance (6MWD), MRC dyspnea, and health status, using a self-administered version of the Chronic Respiratory Disease Questionnaire (CRQ). Pedometer activity was measured over a ~ one-week period early in rehabilitation and again for ~ 1 week at the end of rehabilitation. The device was not worn during rehabilitation sessions. Patients recorded in a diary the exact times they wore the device. Pre- to post-rehabilitation changes in NL-2000 counts per hour worn (NL·hr-1) were evaluated, as well as the standard outcome variables (6 MWD, MRC, and CRQ).
Results: Improvements were observed in the 6MWD (45 m.), MRC dyspnea (- 0.54 units) and the CRQ total score (10 units) (all, P < 0.001). However, there was no change in NL·hr-1 (30 counts, IP. = 0.11). NL·hr-1 were lower on rehabilitation days than on non-rehabilitation days; after adding this as a covariate, changes in activity became statistically significant.
Conclusion: These results suggest that either pedometer activity assessment is relatively insensitive to detecting activity in slow-moving patients with COPD and/or pulmonary rehabilitation has less effect on increasing activity than in improving exercise performance, dyspnea, or health status.