Research Needs on Physical Activity and COPD: Bridging the Gap between Knowledge and Behaviour

Maintaining a sufficient amount of physical activity in patients with chronic obstructive pulmonary disease is critical for their prognosis and quality of life. Yet no intervention has been identified that can modify the physical activity behaviour of these patients. The present narrative review discusses, by means of examples, some research habits and paradigms that need to be adapted in order to bridge the gap between knowing that physical activity is good and changing the physical activity behaviour.
First, because effective behavioural interventions are not possible if the causes of the behaviours are unknown, the research base about determinants of physical activity in chronic obstructive pulmonary disease should boost and widen its scope from individual (biological and psychological) to societal, environmental, and policy determinants. Second, research questions should be framed in a direct, actionable manner in order to provide results that are useful for designing interventions and easy to communicate to health professionals, patients, and policy makers. Third, since most existing research on physical activity and chronic obstructive pulmonary disease suffers from serious methodological flaws, a higher concern about epidemiological and statistical methods is essential to provide valid (and consequently, useful) results. Finally, the single-, multi-, or interdisciplinary nature of research needs to be acknowledged and analyzed on a project basis in order to use the best integrative solution that provides top quality, helpful data.
To conclude, this review proposes an integrated research model for the promotion of physical activity in chronic obstructive pulmonary disease patients. It underlines the need for not only (more) experimental research, but also valid information from research on determinants, levels, and effects of physical activity in chronic obstructive pulmonary disease. Additional efforts are required in all areas to define applicable research questions, improve methodology, and finding the precise level of discipline integration. New approaches, like causal inference methods embedded in a multilevel framework, offer complementary guidance.