Adherence to pulmonary rehabilitation during a 12-month period 93 Figure 3: Change in HRQL from baseline. a: mean score over time; b: change of HRQL per patient over time Post hoc power analysis With an a level of 0.05, a sample size of 196, and a medium effect size of 0.25, achieved power for the study was 0.99. Discussion Main Þndings This study shows that adherence is constant over a period of 12 months in patients with COPD receiving prolonged pulmonary rehabilitation in a primary physiotherapy practice in the Netherlands and Belgium. Also, the health outcomes 6MWD and HRQL were constant in this same period. The boxplots and individual graphs in Figure 1-3, show that there is a small number of patients in whom the measured variables vary over time. Overall, the figures show constant values. Direct comparison of these findings with those published in previous studies of exercise adherence is limited by the use of different units of measurement and different chronic diseases. Nevertheless, a study describing adherence to a home-walking prescription in patients with COPD, found similar results [12]. Participants walked an average of three days per week initially, with a decline to two and a half days per week over one year. On average, participants walked longer than the prescribed duration of 20 minutes per session. They also showed that physical benefits were related to constant adherence [12]. A study concerning adherence to physical activity two years after stroke, found that physical activity levels remained constant, but that adherence to other cardiovascular risk
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