https://doi.org/10.4081/monaldi.2021.1891
Factors associated with physical activity among COPD patients with mild or moderate airflow obstruction
Submitted: April 25, 2021
Accepted: June 29, 2021
Published: September 14, 2021
Accepted: June 29, 2021
Abstract Views: 1420
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Physical inactivity is already present among patients with chronic obstructive pulmonary disease (COPD) of mild or moderate airflow obstruction. Most previous studies that reported on determinants of physical activity in COPD included patients with severe COPD. Therefore, the aim of this study was to explore which patient characteristics were related with physical activity in COPD patients with mild or moderate airflow obstruction. Cross-sectional analyses were performed on patients selected from the population-based Netherlands Epidemiology of Obesity study. Patients were included if they had a physician-diagnosed COPD GOLD 0-2 or had newly diagnosed COPD GOLD 1-2. Physical activity was evaluated using the Short Questionnaire to Assess Health-Enhancing Physical Activity (SQUASH) questionnaire and reported in hours per week of metabolic equivalents (MET-h/week). Associations between sociodemographic, lifestyle, clinical and functional characteristics were examined using regression analysis. 323 patients were included in research (77 with physician-diagnosed and 246 with newly diagnosed COPD). We found that physical activity was positively associated with pulmonary function: FEV1 (regression coefficient 0.40 (95% CI 0.09,0.71)) and FVC (regression coefficient 0.34 (95% CI 0.06,0.61)). Physical activity was associated with anxiety (regression coefficient =0.9 (95% CI 0.3,1.6)) only for physician-diagnosed patients. Lung function and anxiety level determine level of physical activity among COPD patients with mild or moderate airflow obstruction. Thus, integrating it into the physical activity plans could help to increase physical activity level of the patients.
Brawner CA, Churilla JR, Keteyian SJ. Prevalence of Physical activity is lower among individuals with chronic disease. Med Sci Sports Exerc 2016;48:1062-7.
DOI: https://doi.org/10.1249/MSS.0000000000000861
Garcia-Aymerich J, Lange P, Benet M, et al. Regular physical activity reduces hospital admission and mortality in chronic obstructive pulmonary disease: a population based cohort study. Thorax 2006;61:772-8.
DOI: https://doi.org/10.1136/thx.2006.060145
Watz H, Pitta F, Rochester CL, et al. An official European Respiratory Society statement on physical activity in COPD. Eur Respir J 2014;44:1521-37.
DOI: https://doi.org/10.1183/09031936.00046814
ZuWallack R, Esteban C. Understanding the impact of physical activity in COPD outcomes: moving forward. Eur Respir J 2014;44:1107-9.
DOI: https://doi.org/10.1183/09031936.00151014
Watz H, Waschki B, Meyer T, et al. Physical activity in patients with COPD. Eur Respir J 2009;33:262-72.
DOI: https://doi.org/10.1183/09031936.00024608
Van Remoortel H, Hornikx M, Demeyer H, et al. Daily physical activity in subjects with newly diagnosed COPD. Thorax 2013;68:962-3.
DOI: https://doi.org/10.1136/thoraxjnl-2013-203534
Fastenau A, van Schayck OC, Gosselink R, et al. Discrepancy between functional exercise capacity and daily physical activity: a cross-sectional study in patients with mild to moderate COPD. Prim Care Respir J 2013;22:425-30.
DOI: https://doi.org/10.4104/pcrj.2013.00090
Troosters T, Sciurba F, Battaglia S, et al. Physical inactivity in patients with COPD, a controlled multi-center pilot-study. Respir Med 2010;104:1005-11.
DOI: https://doi.org/10.1016/j.rmed.2010.01.012
Mapel DW, Dalal AA, Blanchette CM, et al. Severity of COPD at initial spirometry-confirmed diagnosis: data from medical charts and administrative claims. Int J Chron Obstruct Pulmon Dis 2011;6:573-81.
DOI: https://doi.org/10.2147/COPD.S16975
Gimeno-Santos E, Frei A, Steurer-Stey C, et al. Determinants and outcomes of physical activity in patients with COPD: a systematic review. Thorax 2014;69:731-9.
DOI: https://doi.org/10.1136/thoraxjnl-2013-204763
Watz H, Waschki B, Boehme C, et al. Extrapulmonary effects of chronic obstructive pulmonary disease on physical activity: a cross-sectional study. Am J Respir Crit Care Med 2008;177:743-51.
DOI: https://doi.org/10.1164/rccm.200707-1011OC
Hartman JE, Boezen HM, de Greef MH, et al. Physical and psychosocial factors associated with physical activity in patients with chronic obstructive pulmonary disease. Arch Phys Med Rehabil 2013;94:2396-402.
DOI: https://doi.org/10.1016/j.apmr.2013.06.029
Moy ML, Matthess K, Stolzmann K, et al. Free-living physical activity in COPD: assessment with accelerometer and activity checklist. J Rehabil Res Dev 2009;46:277-86.
DOI: https://doi.org/10.1682/JRRD.2008.07.0083
Watz H, Waschki B, Kirsten A, et al. The metabolic syndrome in patients with chronic bronchitis and COPD: frequency and associated consequences for systemic inflammation and physical inactivity. Chest 2009;136:1039-46.
DOI: https://doi.org/10.1378/chest.09-0393
Garcia-Aymerich J, Felez MA, Escarrabill J, et al. Physical activity and its determinants in severe chronic obstructive pulmonary disease. Med Sci Sports Exerc 2004;36:1667-73.
DOI: https://doi.org/10.1249/01.MSS.0000142378.98039.58
Garcia-Rio F, Lores V, Mediano O, et al. Daily physical activity in patients with chronic obstructive pulmonary disease is mainly associated with dynamic hyperinflation. Am J Respir Crit Care Med 2009;180:506-12.
DOI: https://doi.org/10.1164/rccm.200812-1873OC
Pitta F, Troosters T, Probst VS, et al. Potential consequences for stable chronic obstructive pulmonary disease patients who do not get the recommended minimum daily amount of physical activity. J Bras Pneumol 2006;32:301-8.
DOI: https://doi.org/10.1590/S1806-37132006001100008
Monteiro F, Camillo CA, Vitorasso R, et al. Obesity and physical activity in the daily life of patients with COPD. Lung 2012;190:403-10.
DOI: https://doi.org/10.1007/s00408-012-9381-0
Nguyen HQ, Fan VS, Herting J, et al. Patients with COPD with higher levels of anxiety are more physically active. Chest 2013;144:145-51.
DOI: https://doi.org/10.1378/chest.12-1873
Bourbeau J, Ford G, Zackon H, et al. Impact on patients' health status following early identification of a COPD exacerbation. Eur Respir J 2007;30:907-13.
DOI: https://doi.org/10.1183/09031936.00166606
Lahaije AJ, van Helvoort HA, Dekhuijzen PN, et al. Resting and ADL-induced dynamic hyperinflation explain physical inactivity in COPD better than FEV1. Respir Med 2013;107:834-40.
DOI: https://doi.org/10.1016/j.rmed.2013.02.017
de Mutsert R, den Heijer M, Rabelink TJ, et al. The Netherlands Epidemiology of Obesity (NEO) study: study design and data collection. Eur J Epidemiol 2013;28:513-23.
DOI: https://doi.org/10.1007/s10654-013-9801-3
COPD standards of the Dutch College of General Practitioners [Internet]. Nederlands Huisartsengenootschap (NHG). 2021. Accessed: 2021 Jun 14. Available from: https://richtlijnen.nhg.org/standaarden/copd
Global Initiative for Chronic Obstructive Lung Disease [Internet]. Global Strategy for the Diagnosis, Management and prevention of Chronic Obstructive Pulmonary Disease 2021 Report 2020 Accessed: 2021 Jun 14]. Available from: http://www.goldcopd.org/
Wendel-Vos GC, Schuit AJ, Saris WH, et al. Reproducibility and relative validity of the short questionnaire to assess health-enhancing physical activity. J Clin Epidemiol 2003;56:1163-9.
DOI: https://doi.org/10.1016/S0895-4356(03)00220-8
Beck AT, Epstein N, Brown G, et al. An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol 1988;56:893-7.
DOI: https://doi.org/10.1037/0022-006X.56.6.893
Rush AJ, Gullion CM, Basco MR, et al. The inventory of depressive symptomatology (IDS): psychometric properties. Psychol Med 1996;26:477-86.
DOI: https://doi.org/10.1017/S0033291700035558
Miller MR, Hankinson J, Brusasco V, et al. Standardisation of spirometry. Eur Respir J 2005;26:319-38.
DOI: https://doi.org/10.1183/09031936.05.00034805
Koeneman MA, Verheijden MW, Chinapaw MJ, et al. Determinants of physical activity and exercise in healthy older adults: a systematic review. Int J Behav Nutr Phys Act 2011;8:142.
DOI: https://doi.org/10.1186/1479-5868-8-142
Durstine JL, Gordon B, Wang Z, Luo X. Chronic disease and the link to physical activity. J Sport Health Sci 2013;2:3–11.
DOI: https://doi.org/10.1016/j.jshs.2012.07.009
Korn EL, Graubard BI. Epidemiologic studies utilizing surveys: accounting for the sampling design. Am J Public Health 1991;81:1166-73.
DOI: https://doi.org/10.2105/AJPH.81.9.1166
Garcia-Aymerich J, Serra I, Gomez FP, et al. Physical activity and clinical and functional status in COPD. Chest 2009;136:62-70.
DOI: https://doi.org/10.1378/chest.08-2532
Katajisto M, Koskela J, Lindqvist A, et al. Physical activity in COPD patients decreases short-acting bronchodilator use and the number of exacerbations. Respir Med 2015;109:1320-5.
DOI: https://doi.org/10.1016/j.rmed.2015.08.001
Cindy Ng LW, Mackney J, Jenkins S, et al. Does exercise training change physical activity in people with COPD? A systematic review and meta-analysis. Chron Respir Dis 2012;9:17-26.
DOI: https://doi.org/10.1177/1479972311430335
van Helvoort HA, Willems LM, Dekhuijzen PR, et al. Respiratory constraints during activities in daily life and the impact on health status in patients with early-stage COPD: a cross-sectional study. NPJ Prim Care Respir Med 2016;26:16054.
DOI: https://doi.org/10.1038/npjpcrm.2016.54
Ofir D, Laveneziana P, Webb KA, et al. Mechanisms of dyspnea during cycle exercise in symptomatic patients with GOLD stage I chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2008;177:622-9.
DOI: https://doi.org/10.1164/rccm.200707-1064OC
MedScape [Internet]. Pulmonary function testing; 2018. Available from: https://emedicine.medscape.com/article/303239-overview
Jerning C, Martinander E, Bjerg A, et al. Asthma and physical activity--a population based study results from the Swedish GA(2)LEN survey. Respir Med 2013;107:1651-8.
DOI: https://doi.org/10.1016/j.rmed.2013.08.040
Watz H, Krippner F, Kirsten A, et al. Indacaterol improves lung hyperinflation and physical activity in patients with moderate chronic obstructive pulmonary disease--a randomized, multicenter, double-blind, placebo-controlled study. BMC Pulm Med 2014;14:158.
DOI: https://doi.org/10.1186/1471-2466-14-158
Hataji O, Naito M, Ito K, et al. Indacaterol improves daily physical activity in patients with chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis 2013;8:1-5.
DOI: https://doi.org/10.2147/COPD.S38548
Watz H, Mailander C, Baier M, et al. Effects of indacaterol/glycopyrronium (QVA149) on lung hyperinflation and physical activity in patients with moderate to severe COPD: a randomised, placebo-controlled, crossover study (The MOVE Study). BMC Pulm Med 2016;16:95.
DOI: https://doi.org/10.1186/s12890-016-0256-7
Bossenbroek L, ten Hacken NH, van der Bij W, et al. Cross-sectional assessment of daily physical activity in chronic obstructive pulmonary disease lung transplant patients. J Heart Lung Transplant 2009;28:149-55.
DOI: https://doi.org/10.1016/j.healun.2008.11.905
Thyregod M, Bodtger U. Coherence between self-reported and objectively measured physical activity in patients with chronic obstructive lung disease: a systematic review. Int J Chron Obstruct Pulmon Dis 2016;11:2931-8.
DOI: https://doi.org/10.2147/COPD.S116422
Supporting Agencies
Leiden University Medical Center, National Pirogov Memorial Medical University, Vinnytsya, University Hospital Essen, Ruhrlandklinik, University Duisburg-EssenHow to Cite
R. van Buul, Amanda, Marise J. Kasteleyn, Vitalii Poberezhets, Tobias N. Bonten, Renée de Mutsert, Pieter S. Hiemstra, Saskia le Cessie, Frits R. Rosendaal, Niels H. Chavannes, and Christian Taube. 2021. “Factors Associated With Physical Activity Among COPD Patients With Mild or Moderate Airflow Obstruction”. Monaldi Archives for Chest Disease 92 (1). https://doi.org/10.4081/monaldi.2021.1891.
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