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Canadian Respiratory Journal
Volume 20, Issue 4, Pages 281-284
Original Article

Safe and Effective Prescription of Exercise in Acute Exacerbations of Chronic Obstructive Pulmonary Disease: Rationale and Methods for an Integrated Knowledge Translation Study

Pat G Camp,1,2,3,4 W Darlene Reid,3,4,5 Cristiane Yamabayashi,1,4,5 Dina Brooks,6 Donna Goodridge,7 Frank Chung,8 Darcy D Marciniuk,9 Andrea Neufeld,3 and Alison Hoens2,3

1James Hogg Research Centre, St Paul’s Hospital, University of British Columbia, Vancouver, British Columbia, Canada
2Providence Health Care, University of British Columbia, Vancouver, British Columbia, Canada
3Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
4Institute of Heart and Lung Health, University of British Columbia, Vancouver, British Columbia, Canada
5Vancouver Coastal Health Research Institute, University of British Columbia, Vancouver, British Columbia, Canada
6Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada
7College of Nursing, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
8Department of Physical Therapy, Fraser Health Authority, Burnaby Hospital, Burnaby, British Columbia, Canada
9Division of Respirology, Critical Care and Sleep Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada

Copyright © 2013 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


BACKGROUND: Patients hospitalized with an acute exacerbation of chronic obstructive pulmonary disease (AECOPD) engage in low levels of activity, putting them at risk for relapse and future readmissions. There is little direction for health care providers regarding the parameters for safe exercise during an AECOPD that is effective for increasing activity tolerance before discharge from hospital, especially for patients with associated comorbid conditions.

OBJECTIVE: To report the rationale for and methods of a study to develop evidence-informed care recommendations that guide health care providers in the assessment, prescription, monitoring and progression of exercise for patients hospitalized with AECOPD.

METHODS: The present study was a multicomponent knowledge translation project incorporating evidence from systematic reviews of exercise involving populations with chronic obstructive pulmonary disease and/or common comorbidities. A Delphi process was then used to obtain expert opinion from clinicians, academics and patients to identify the parameters of safe and effective exercise for patients with AECOPD.

RESULTS: Clinical decision-making tool(s) for patients and practitioners supported by a detailed knowledge dissemination, implementation and evaluation framework.

CONCLUSION: The present study addressed an important knowledge gap: the lack of availability of parameters to guide safe and effective exercise prescription for hospitalized patients with AECOPD, with or without comorbid conditions. In the absence of such parameters, health care professionals may adopt an ‘activity as tolerated’ approach, which may not improve physical activity levels in their patients. The present study synthesizes the best available evidence and expert opinion, and will generate decision-making tools for use by patients and their health care providers.