Abstract

Background: Adherence to physical activity (PA) is fundamental in the management of chronic respiratory disease (CRD) and is associated with reduced symptom burden and increased quality of life. At the beginning of the COVID-19 pandemic people living with CRD were advised to shield resulting in changes in daily activities and exercise habits, contributing to reduced PA. However, little is known about the factors affecting PA adherence during the pandemic.

Aim: Explore barriers and facilitators to PA during the COVID-19 pandemic amongst people living with CRD and provide insight into future support required for PA adherence.

Method: A qualitative study using interpretative phenomenological analysis (IPA) was used. Semi-structured interviews were completed with ten people living with CRD (including asthma, bronchiectasis, chronic obstructive pulmonary disease, and interstitial lung disease). Verbatim interview transcripts were analysed using IPA steps: 1) case-by-case review 2) identify emergent themes for each individual 3) identify master themes across all cases 4) theme validation. Trustworthiness was enhanced by researcher triangulation, member checking, and use of a reflexive diary.

Results: Self-reported PA was reduced throughout the pandemic. Five master themes were identified: (1) fear of COVID-19, (2) influence of government restrictions, (3) top priority or on the backburner, (4) reinforcing or reducing motivation, (5) personal context is key. To facilitate future PA adherence, many ideas were suggested including provision of virtual support. Future support should be tailored to underrepresented sub-groups of the CRD population such as those with less prevalent conditions and should consider the impact of the pandemic on mental health.

Conclusion: Fear of COVID-19 and the prolonged effects of shielding reduced self-reported PA adherence in people living with CRD throughout the pandemic. Individualised support addressing physical, mental and social health needs is required to reverse the negative effects of reduced PA adherence and improve wellbeing in this population.