Exercise maintenance: COPD patients' perception and perspectives on elements of success in sustaining long-term exercise

Abstract

Our goal was to elucidate how patients with COPD who successfully maintain a long-term exercise programme understand concordance with maintenance exercise and see potential solutions. The information, collected from 11 individuals through six in-depth interviews and one focus-group interview, was analysed by means of qualitative content analysis. Four themes were identified: 1) perception and acknowledgement of the disease; 2) the personal manner and empowering skills of the therapist; 3) perception of the exercise programme; and 4) left to myself–a pitfall in maintenance. Motivation to continue long-term exercise was related to how the patient is empowered to come to terms with the situation, the relational skills and expert competence of the physiotherapist, the patient's perceived mastery of the intensity of the exercise programme, and the physiotherapist's ability to individualise the exercise, peer support, and the availability and continuity of the programme. More attention should be paid to the link between PR programs and follow-up programmes. Crucial factors in this context are guidance of a municipal physiotherapist or instructor with extensive knowledge of exercise for patients with COPD, social interaction with peers in the exercise setting, enthusiasm, support, and ongoing communication between patients and practitioners across an entire continuum of care.

Acknowledgement

This study was supported by a grant from The Norwegian Fund for Post-graduate Training in Physiotherapy. The authors thank the participating patients for their time. We also acknowledge the helpful assistance of physiotherapist/doctoral candidate Borghild Lomundal, Norwegian University of Science and Technology (NTNU), and our colleagues at Glittreklinikken and Oslo University Hospital, division in Ski, for establishing the initial contact with the patients.

Declaration of interest: The authors report no conflict of interest, and are solely responsible for the content and writing of this manuscript.