BACKGROUND: We were interested in the effects of a physical activity (PA) counselling programme in three groups of COPD patients from general practice (primary care), outpatient clinic (secondary care) and pulmonary rehabilitation (PR). METHODS: In this randomized controlled trial 155 COPD patients, 102 males, median (IQR) age 62 (54 to 69) y, FEV1predicted 60% (40 to 75) were assigned to a 12-weeks' physical activity counselling programme or usual care. Physical activity (pedometer (Yamax SW200) and metabolic equivalents), exercise capacity (6-min walking distance) and quality of life (Chronic Respiratory Questionnaire and Clinical COPD Questionnaire) were assessed at baseline, after three and 15 months. RESULTS: A significant difference between the counselling and usual care group in daily steps (803 steps, p = 0.001) and daily physical activity (2,214 steps +/- equivalents, p = 0.001)) from 0 to 3 months was found in the total group, as well as in the outpatient (1,816 steps, 2,616 steps +/- equivalents, both p = 0.007) and PR (758 steps, 2,151 steps +/- equivalents, both p = 0.03) subgroups. From 0 to 15 months no differences were found in physical activity. However, when patients with baseline physical activity > 10,000 steps per day (n = 8), who are already sufficiently active, were excluded, a significant long-term effect of the counselling programme on daily physical activity existed in the total group (p = 0.02). Differences in exercise capacity and quality of life were found only from 0 to 3 months, in the outpatient subgroup. CONCLUSION: Our PA counselling programme effectively enhances PA level in COPD patients after three months. Sedentary patients at baseline still benefit after 15 months. ClinicalTrials.gov registration number NCT00614796.

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