Cognitive behavioural therapy combined with physical activity behavioural modification strategies during pulmonary rehabilitation in patients with COPD

Introduction Patients with COPD who exhibit elevated levels of anxiety and/or depression are typically less able to improve symptoms and physical activity (PA) following a programme pulmonary rehabilitation (PR). Objective To provide proof concept that offering an intervention comprising cognitive behavioural therapy (CBT) alongside PA modification strategies (BPA) during PR is more effective in improving outcomes compared CBT alone. Methods Thirty-two patients (mean± sd : FEV 1 42±14% predicted) were assigned 1:1 receive PR+CBT+BPA or PR+CBT. BPA comprised motivational interviews, step count monitoring, feedback using pedometer goal setting. Assessments included accelerometer-derived steps/day, movement intensity, 6MWD HADS scores. Results The magnitude improvement across was greater for the PR+CBT (by 828 steps/day (p=0.029) by 80±39 vector units (p=0.042), respectively). Compared alone, induced clinically meaningful improvements scores −2 [95% CI −4 units]) 33±20 m). Conclusions Providing anxious depressed combined PR, presents favourable outcome measures alone PR.