Integrating Physical Activity into COPD Care: From Education to Exercise-Based Interventions

Announcer:
You’re listening to On the Frontlines of COPD on ReachMD. On this episode, we’ll hear from Dr. Patricia Bamonti, who’s a staff psychologist in the Geriatric Mental Health Outpatient Clinic and the track coordinator of the Geropsychology Training Program at VA Boston Healthcare System. She’ll be discussing how we can empower patients with COPD to engage in physical activity. Here’s Dr. Bamonti now.

Dr. Bamonti:
Exercise and physical activity are part of guideline-based care for patients with COPD. Exercise is actually central to pulmonary rehabilitation, which is the gold standard for the management of COPD. But outside of pulmonary rehabilitation, all patients with COPD, regardless of disease stage, should be encouraged to engage in physical activity. Greater physical activity can actually slow disease progression, and individuals with higher levels of physical activity have lower COPD symptoms and better functioning. There’s even one study that suggests that a physical activity intervention could reduce the risk of COPD exacerbations. 

We know that physical activity reduces in even the early stages of COPD. When we talk to patients, it’s often due to attempts to manage dyspnea or shortness of breath. Individuals just begin cutting out different activities or activities that make them short of breath, but this can lead to a really unhealthful cycle of inactivity, which can actually lead to deconditioning and worse dyspnea over time. So a really important first step is providing education on the importance of physical activity in COPD and then teaching patients basic skills, such as how to engage in activity pacing, how to engage in breathing exercises during exercise, and physical activity that can help them manage their shortness of breath.

As a psychologist, it’s also important to address psychological factors, like motivation. When I work with individuals with COPD, I like to link physical activity to something that’s important or meaningful to them so they’re not just trying to walk for walking sake, but they’re walking to be able to maintain independence, to spend time with their grandchildren, or to maintain the activities that bring them meaning in life. It’s also important to remind patients that all activity is helpful. It can range from planned exercise to doing chores and going shopping. Really, every step counts.

Some other skills and ideas that I provide to my patients are finding exercise partners that can help with accountability and provide social support. There can be community exercise programs that you can promote or help connect patients to, like the YMCA, where you’re combining exercise with peer support. And finally, I always encourage my patients to talk to their pulmonary providers or primary care providers about pulmonary rehabilitation. 

Announcer:
That was Dr. Patricia Bamonti sharing insights on encouraging exercise in patients with COPD. To access this and other episodes in our series, visit On the Frontlines of COPD on ReachMD.com, where you can Be Part of the Knowledge. Thanks for listening!