Exercise training alone or with the addition of activity counseling improves physical activity levels in COPD: a systematic review and meta-analysis of randomized controlled trials.

While PA counseling alone 31 , 32 , 34 – 36 and the addition of nocturnal noninvasive ventilation (NNIV) 50 to PR achieved a mean difference in steps that exceeded MID, the ES was small and did not reach statistical significance (PA counseling [n=5 studies]: 930 [293–1,566], NNIV + PR [n=1 study]: 906 [−655 to 2,467]; Figure 5 ).

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