BACKGROUND: Even after a rehabilitation program, levels of physical activity in COPD progressively decrease unless strategies to encourage activity are implemented. We analyzed the effects of the implementation of urban walking circuits on levels of physical activity and exercise capacity of patients with severe and very severe COPD after a rehabilitation program. METHOD: A total of 83 patients were randomized to either urban circuits group (UCG) or usual care in the non-circuit group (NCG), after completing a 2-week rehabilitation program. Results were evaluated 9 months after completion of the rehabilitation program and were compared with a control group of 54 patients not enrolled in the rehabilitation program. RESULTS: At the end of follow-up, UCG patients increased their physical activity by a mean of 32.4 (SE 5.9) min per day and 1.09 (SE 0.22) days walked per week; 33.9 (SE 5.6) min per day and 1.12 (SE 0.24) days per week more compared to the NCG (p < 0.001). There was a significant positive correlation between the results of the 6-min walking test and minutes walked per day in the UCG (r2 = 0.52, p < 0.05) but not in the NCG (r2 = 0.094, p > 0.05). Controls showed a significant decrease in exercise capacity and physical activity over the follow-up. CONCLUSIONS: Urban circuits are an easy, inexpensive strategy, which demonstrated to be useful to stimulate physical activity in our population of severe and very severe COPD patients andresulted in increased exercise capacity even 9 months after completion of a rehabilitation program. ClinicalTrials.gov, identifier NCT01854008.

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