Does a program of physical therapy exercises, education and home based walking lead to a change of the activity level at moderate COPD-patients in daily life.

1. There is enough evidence on the territory of physical therapy exercises at
moderate COPD-patients. There are many benefits: increasing quality of life,
less dyspnea and increased functionel walking en exercising capacity.De overall
benefits at COPD-patients are less exacerbaties, less hospitalisatie and mor
life-years.
2. Also there is enough evidence about positive effects by being enough active,
also at COPD-patients.
3. Also has come clear that COPD-patients are less physical active compared to
healthy people.

After the physical therapy program it it important to know if the COPD-patients
are using the positive effects of it and have have become more active in their
daily life. Has the physical therapy program lead to a higher activity level in
their daily life.

The objective of the study is to find out if the COPD-patient how has followed
the physical therapy program has lead to a change in activities in daily life.
In primairy usual care is espected that the patient will follow the advice of
being more active at home.
But with COPD-patients their is no knowledge at this point. Objective is to
research if the factor home-based walking leads to being more active after the
total program. Getting used to the extra- walking schedule could very well make
patients more active during daily life and thereby using the benefits of the
excersises.

Randomised Controlled Trial, singleblinded.

The researcher and the attendant at the filling in of the questionnaires and
the instructions at the activity monitor are blinded.

Referral by the general practitioners with after that the patients are being
screened en by minimization assigned to the therapy or control-group. The
control-group will get no intervention. Both groups will do the spirometrie,
filling in of the questionnaires and one week wearing the activity monitor
before the program. After that there is period of 10 weeks of yes or no therapy
and after that the spirometrie, the filling in of the questionnaires. Also
again the activity monitor will be worn during one week.

The intervention is a program of twice a week during 10 weeks. The program
contains: physical therapy exercises, education ( of the possibiliteits and
problems with the sickness ) and home based walking once a week.

The control-group won't get the program.

The therapy-part is usual care.
The burden is with that evidence based physical therapywhich leads only to
benefits.
Risks are small because patients are being screened by their general
practicioner. When there is a doubt, the patient will do a maximumtest before.
During the therapy, patients are constant under surveylance by using the
saturationmeter and borg-score questions are asked. This are all patients with
mild complaints.

the research-part before and after the program:
Filling in the questionnaires, blowing into the spirometer and wearing a very
small activitymonitor for a week has no higher risk than normal daily life.