Physical Inactivity, Self-Management, and Living Well With COPD.

Physical inactivity is an underrecognized and undertreated lifestyle behavior among patients with chronic obstructive pulmonary disease and is independently associated with a number of adverse health-related outcomes. Pulmonary rehabilitation with exercise training provides an efficacious intervention with short-term improvements, but it is an infrequently used modality and does not consistently result in longer term increases in physical activity. Similarly, pedometer self-monitoring with coaching has demonstrated short-term increases in physical activity. However, further research is needed to determine the optimal method to support long-term behavior change that will have the greatest benefit. While available evidence suggests that reversing physical inactivity is an essential component of self-management to optimize health, it is only one component of a complex set of interventions needed to support patients in adapting to their chronic condition. In the future, this support will ideally start with identification of specific patient phenotypes, which describes their adaptation to the condition based on patients' knowledge, skills, confidence, symptoms, and impairments. This information will then be used to tailor education and behavior change strategies over the long term to promote sustainable physical activity and other healthy lifestyles.