PURPOSE: We evaluated the effects of low-intensity and home-based pulmonary rehabilitation (PR) on physical activity (PA) and the feedback provided by a pedometer in stable elderly patients with chronic obstructive pulmonary disease (COPD). METHODS: We assessed PA using a newly developed triaxial accelerometer (A-MES, Kumamoto, Japan), which measures the time spent walking, standing, sitting and lying down. Twenty-seven elderly patients with COPD (age 74 +/- 8 yrs; %FEV1 56.6 +/- 18.7%) participated. They were randomly selected to undergo PR (pulmonary rehabilitation only) or PR+P (PR plus the feedback from using a pedometer). Their PA and pulmonary function, exercise capacity (6-min walking distance; 6MWD), quadriceps femoris muscle force (QF) were evaluated before the PR began (baseline) and at 1 year later. We compared the patients' changes in PA and other factors between the baseline values and those obtained 1 year later and analyzed the relationships between the changes in PA and other factors in the both groups. RESULTS: The increase in the time spent walking in the PR+P group (51.3 +/- 63.7 min/day) was significantly greater than that of PR group (12.3 +/- 25.5 min/day) after the PR. The improvement rate of daily walking time after PR was significantly correlated with that of the 6MWD and QF in all subjects. CONCLUSIONS: These data suggest that low-intensity and home-based PR with the feedback from using pedometer was effective in improving PA, and the improvements of physiological factors were correlated with increased walking time in stable elderly patients with COPD.

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