Influence of long-term maintenance of physical activity on mental health of patients with occupational lung and respiratory tract diseases for a stationary medical treatment in the BG Clinic for Occupational Diseases Falkenstein

Status:

completed 03/2019

Aims:

Maintaining physical activity (PA) in patients with chronic respiratory diseases is very important for sustainable disease management. Within the project framework, a behaviour-oriented exercise intervention was developed in addition to the standardized rehabilitation program which aimed at a sustainable change of the patient’s PA behaviour in everyday life. The intervention was based on a theoretical framework of different behavioural change models. Motivational strategies (development of goal setting, reinforcement of positive outcome expectancy) as well as volitional strategies (development of action planning and barrier management) were applied. As part of the cooperation with the BG Clinic in Falkenstein, the study aimed to examine the effects of this intervention on maintenance of PA as well as physical and psychosocial determinants in patients with occupational respiratory diseases after an inpatient rehabilitation. In addition, the effects on mental health and quality of life were examined.

Activities/Methods:

The randomized controlled trial (RCT) included patients with occupational respiratory diseases who were not older than 80 years and physically active for less than one hour per week. The effects of behavioural exercise intervention in addition to an inpatient rehabilitation were analysed on the basis of objectively (by ActigraphGT3x+®) and subjectively data of PA measured four weeks prior to rehabilitation and two, six and twelve months after rehabilitation. In addition, behavioural and psychosocial determinants were examined (e.g. self-efficacy, barrier management, action planning etc.) and also health outcomes like anxiety and depression. The participants were randomly assigned to intervention group (IG) and control group (CG). In addition to regular rehabilitation, the IG (n=93) participated in the behavioural exercise intervention over nine sessions. Individuals of the CG (n=101) received only rehabilitation program.

Results:

We found significant effects over the time in both groups in PA, physical and psychological determinants, mental health and quality of life as well as a few interaction effects (time x group). In general effect sizes of the results are small to moderate. Due to age of the participants (M=69.1 years) and the progression of disease these results are of practical relevance. In PA and sedentariness measured by Actigraph descriptive changes could be revealed. In regards to subjectively collected data of the amount of strength and endurance training individuals of the IG showed significant higher improvement twelve months after inpatient rehabilitation (IG +90 min; CG +60 min). Moreover, the participation in an outpatient rehabilitation group increased in IG because of the recommendation during the intervention. Effects over the time in determinants of behavior change and mental health could be shown in both groups with the tendency of maintenance in IG (e.g., self-efficacy (PA), action planning, action control). In contrast, only short-term effects were shown in other determinants of behavior change e. g. outcome expectancy and disease-related quality of life. A behaviour-changed exercise intervention including a specific trainer manual, a workbook for patients and assisting work material could be developed. The intervention was implemented in daily clinical practice and the participants assessed the intervention positively. Both groups showed improvements in different kinds of parameters during the investigation (mostly in form of time effects, only few interaction effects). It has to be noted, that results regarding to PA differ between subjectively and objectively measurements. In general, some hypotheses could be confirmed. Nevertheless, this study contributes to providing important information for the maintenance of PA in patients with occupational lung diseases and will lead to new perspectives for further research.

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