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Silva CG, Santulhão M, Serrado A, Soares M, Morais N. Disability, Physical Activity, and Their Correlates in Patients With Inflammatory Bowel Disease: A Portuguese Cross-Sectional Survey. Gastroenterol Nurs 2024; 47:265-276. [PMID: 39087992 DOI: 10.1097/sga.0000000000000809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Accepted: 12/16/2023] [Indexed: 08/02/2024] Open
Abstract
Knowledge about disability and physical activity is critical for enhancing self- and clinical management of inflammatory bowel disease, but the interplay between the two is unknown. This study aimed to explore the correlates of disability and physical activity in patients with inflammatory bowel disease. A cross-sectional online survey was conducted in 2019 in Portuguese patients (n = 108) capturing disability, clinical factors including disease status and comorbidities, physical activity habits, and barriers. The magnitude of disability was moderate (mean [95% confidence interval] = 41.85 [38.39, 45.31]). Disease activity and comorbidities were the most important predictors of disability (Model 2, F(102) = 20.285, p < .001, R2 = 0.499, R2adj = 0.443). About 62% of the participants engaged in moderate (31.5%) to vigorous (30.6%) physical activities. Perceived effort to engage in physical activities was the sole predictor of total weekly physical activity (R2 = 0.070, R2adj = 0.044, p = .006). The amount of disability and physical activity were poorly associated (ρ = -0.144, p = .068). Findings encourage gastroenterology nurses and other healthcare providers involved in the comprehensive care of patients with gastrointestinal disorders to recommend regular physical activity to these patients as part of an overall health enhancement strategy. Disability and back pain should be given further attention.
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Affiliation(s)
- Cândida G Silva
- Cândida G. Silva, PhD, is Associate Professor, ciTechCare-Center for Innovative Care and Health Technology, Polytechnic of Leiria, Leiria, Portugal; ESSLei-School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal
- Mariana Santulhão, PT, is Clinical Researcher, ESSLei-School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal; Condomínio Residencial Sénior-Montepio Rainha Dona Leonor, Caldas da Rainha, Portugal
- Alícia Serrado, PT, is Clinical Researcher, ESSLei-School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal; ConMeFis-Consultório Médico de Fisiatria, Peniche, Portugal
- Mariana Soares, PT, is Clinical Researcher, ESSLei-School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal; Centro Hospitalar do Oeste, E.P.E.-Unidade de Caldas da Rainha, Caldas da Rainha, Portugal
- Nuno Morais, MSc, PT, is Associate Professor, ciTechCare-Center for Innovative Care and Health Technology, Polytechnic of Leiria, Leiria, Portugal; ESSLei-School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal; CDRSP-Centre for Rapid and Sustainable Product Development, Polytechnic of Leiria, Leiria, Portugal; Saúde Positiva, Clínica de Saúde Física e Mental, Aveiro, Portugal
| | - Mariana Santulhão
- Cândida G. Silva, PhD, is Associate Professor, ciTechCare-Center for Innovative Care and Health Technology, Polytechnic of Leiria, Leiria, Portugal; ESSLei-School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal
- Mariana Santulhão, PT, is Clinical Researcher, ESSLei-School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal; Condomínio Residencial Sénior-Montepio Rainha Dona Leonor, Caldas da Rainha, Portugal
- Alícia Serrado, PT, is Clinical Researcher, ESSLei-School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal; ConMeFis-Consultório Médico de Fisiatria, Peniche, Portugal
- Mariana Soares, PT, is Clinical Researcher, ESSLei-School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal; Centro Hospitalar do Oeste, E.P.E.-Unidade de Caldas da Rainha, Caldas da Rainha, Portugal
- Nuno Morais, MSc, PT, is Associate Professor, ciTechCare-Center for Innovative Care and Health Technology, Polytechnic of Leiria, Leiria, Portugal; ESSLei-School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal; CDRSP-Centre for Rapid and Sustainable Product Development, Polytechnic of Leiria, Leiria, Portugal; Saúde Positiva, Clínica de Saúde Física e Mental, Aveiro, Portugal
| | - Alícia Serrado
- Cândida G. Silva, PhD, is Associate Professor, ciTechCare-Center for Innovative Care and Health Technology, Polytechnic of Leiria, Leiria, Portugal; ESSLei-School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal
- Mariana Santulhão, PT, is Clinical Researcher, ESSLei-School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal; Condomínio Residencial Sénior-Montepio Rainha Dona Leonor, Caldas da Rainha, Portugal
- Alícia Serrado, PT, is Clinical Researcher, ESSLei-School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal; ConMeFis-Consultório Médico de Fisiatria, Peniche, Portugal
- Mariana Soares, PT, is Clinical Researcher, ESSLei-School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal; Centro Hospitalar do Oeste, E.P.E.-Unidade de Caldas da Rainha, Caldas da Rainha, Portugal
- Nuno Morais, MSc, PT, is Associate Professor, ciTechCare-Center for Innovative Care and Health Technology, Polytechnic of Leiria, Leiria, Portugal; ESSLei-School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal; CDRSP-Centre for Rapid and Sustainable Product Development, Polytechnic of Leiria, Leiria, Portugal; Saúde Positiva, Clínica de Saúde Física e Mental, Aveiro, Portugal
| | - Mariana Soares
- Cândida G. Silva, PhD, is Associate Professor, ciTechCare-Center for Innovative Care and Health Technology, Polytechnic of Leiria, Leiria, Portugal; ESSLei-School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal
- Mariana Santulhão, PT, is Clinical Researcher, ESSLei-School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal; Condomínio Residencial Sénior-Montepio Rainha Dona Leonor, Caldas da Rainha, Portugal
- Alícia Serrado, PT, is Clinical Researcher, ESSLei-School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal; ConMeFis-Consultório Médico de Fisiatria, Peniche, Portugal
- Mariana Soares, PT, is Clinical Researcher, ESSLei-School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal; Centro Hospitalar do Oeste, E.P.E.-Unidade de Caldas da Rainha, Caldas da Rainha, Portugal
- Nuno Morais, MSc, PT, is Associate Professor, ciTechCare-Center for Innovative Care and Health Technology, Polytechnic of Leiria, Leiria, Portugal; ESSLei-School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal; CDRSP-Centre for Rapid and Sustainable Product Development, Polytechnic of Leiria, Leiria, Portugal; Saúde Positiva, Clínica de Saúde Física e Mental, Aveiro, Portugal
| | - Nuno Morais
- Cândida G. Silva, PhD, is Associate Professor, ciTechCare-Center for Innovative Care and Health Technology, Polytechnic of Leiria, Leiria, Portugal; ESSLei-School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal
- Mariana Santulhão, PT, is Clinical Researcher, ESSLei-School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal; Condomínio Residencial Sénior-Montepio Rainha Dona Leonor, Caldas da Rainha, Portugal
- Alícia Serrado, PT, is Clinical Researcher, ESSLei-School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal; ConMeFis-Consultório Médico de Fisiatria, Peniche, Portugal
- Mariana Soares, PT, is Clinical Researcher, ESSLei-School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal; Centro Hospitalar do Oeste, E.P.E.-Unidade de Caldas da Rainha, Caldas da Rainha, Portugal
- Nuno Morais, MSc, PT, is Associate Professor, ciTechCare-Center for Innovative Care and Health Technology, Polytechnic of Leiria, Leiria, Portugal; ESSLei-School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal; CDRSP-Centre for Rapid and Sustainable Product Development, Polytechnic of Leiria, Leiria, Portugal; Saúde Positiva, Clínica de Saúde Física e Mental, Aveiro, Portugal
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Hanrahan C, Broderick J, O'Connor TM, McVeigh JG. Behaviour change interventions for physical activity in adults with chronic obstructive pulmonary disease; A systematic review and meta-analysis. Respir Med Res 2024; 85:101068. [PMID: 38154398 DOI: 10.1016/j.resmer.2023.101068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 11/06/2023] [Accepted: 11/06/2023] [Indexed: 12/30/2023]
Abstract
BACKGROUND Physical activity in adults with COPD is poor, but behaviour change interventions could help improve activity. This systematic review aims to examine behaviour change interventions to promote physical activity and health outcomes for adults with COPD. METHODS Eight databases were searched from inception until April 2023: Web of Science, CENTRAL, MEDLINE, EMBASE, APA PsychINFO, CINAHL, PROSPERO, Cochrane Airways Trials Register. Relevant studies were appraised to determine the impact of behaviour change interventions on physical activity outcomes. Interventions were mapped to Michie's Theoretical Domains Framework (TDF) and a meta-analysis and narrative synthesis conducted. The Cochrane risk of bias tool 2 and the GRADE criteria evaluated bias and the quality and certainty of the evidence. RESULTS Twelve randomized controlled trials (RCTs) were included in the review (n = 1211). The most frequently utilized behaviour change interventions included counselling, stepcount monitoring, social support and goal setting. The most commonly measured outcomes across studies were steps-per-day, physical activity levels, exercise capacity and quality of life. A meta-analysis of comparable studies demonstrated there was no difference in stepcount in favour of behaviour change interventions with respect to steps-per-day (SMD 0.16, 95 % CI -0.03, 0.36; p = 0.10). There was some evidence of short-term improvement in physical activity and quality of life, with behaviour change interventions related to goals, behaviour regulation and social influences. CONCLUSIONS People with COPD may benefit from behaviour change interventions to increase physical activity and quality of life in the short-term. The overall certainty and quality of the evidence is low.
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Affiliation(s)
- Ciara Hanrahan
- Discipline of Physiotherapy, School of Clinical Therapies, College of Medicine and Health, University College Cork, Cork T12×70A, Ireland.
| | - Julie Broderick
- Discipline of Physiotherapy, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Terence M O'Connor
- Department of Respiratory Medicine, Mercy University Hospital, Cork, and School of Medicine, College of Medicine and Health, University College Cork, Ireland
| | - Joseph G McVeigh
- Discipline of Physiotherapy, School of Clinical Therapies, College of Medicine and Health, University College Cork, Cork T12×70A, Ireland
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Silva L, Maricoto T, Mota Â, Lemos L, Santos M, Cunha H, Azevedo I, Berger-Estilita J, Costa P, Padilha JM. Effectiveness of a home-based pulmonary rehabilitation maintenance programme: the Rehab2Life study protocol. BMC Nurs 2024; 23:338. [PMID: 38773568 PMCID: PMC11107066 DOI: 10.1186/s12912-024-01999-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 05/07/2024] [Indexed: 05/24/2024] Open
Abstract
Pulmonary rehabilitation (PR) is the bedrock of non-pharmacological treatment for people with COPD. Nonetheless, it is well described in the literature that unless the patient changes his behaviour, the benefits of PR programmes will decline in six to twelve months after finishing the programme. Therefore, maintenance programmes can address the problem of PR programmes' effect loss over time.Community care units can provide multidisciplinary care in the current Portuguese primary health care context. These units have an interdisciplinary team that aims to develop competencies in COPD patients to self-manage the disease.This study aims to test the effectiveness of a 12-month home-based PR programme (Rehab2Life) compared to usual care through a single-blind randomised controlled trial with two parallel groups. The Rehab2Life programme includes two distinct phases. The first is an 8-week PR programme delivered to both groups, and the second is a PR maintenance programme delivered to the intervention group after the initial eight weeks. The control group receive the usual care and regular appointments. The primary outcome is functional capacity, and secondary outcomes are dyspnea, Health-Related Quality of Life (HRQoL), number of exacerbations, symptoms burden, anxiety and depression symptoms, and physical activity.We expect to observe that the home-based PR programme brings clinically relevant benefits to the participants at the end of the first eight weeks and that, at 12 months after the maintenance phase of the programme, benefits are less dissipated than in the control group. We expect to identify the characteristics of the patients who benefit the most from home-based programmes.The trial was registered on 7 April 2022 at ClinicalTrials.gov (NCT05315505).
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Affiliation(s)
- Liliana Silva
- Matosinhos Local Health Unit, Matosinhos, Portugal.
- CINTESIS, Centre for Health Technology and Services Research, Faculty of Medicine, University of Porto, Porto, Portugal.
| | - Tiago Maricoto
- Beira Ria Family Heath Unit/ULS Aveiro, Ílhavo, Portugal
- CICS-UBI - Health Sciences Research Centre & UBIAir - Clinical & Experimental Lung Centre, University of Beira Interior, Covilhã, Portugal
| | - Ângela Mota
- Matosinhos Local Health Unit, Matosinhos, Portugal
| | - Lara Lemos
- Matosinhos Local Health Unit, Matosinhos, Portugal
| | | | - Hélder Cunha
- Matosinhos Local Health Unit, Matosinhos, Portugal
| | - Inês Azevedo
- Matosinhos Local Health Unit, Matosinhos, Portugal
| | - Joana Berger-Estilita
- CINTESIS, Centre for Health Technology and Services Research, Faculty of Medicine, University of Porto, Porto, Portugal
- Institute of Anaesthesiology and Intensive Care, Salemspital, Hirslanden Medical Group, Bern, Switzerland
- Institute for Medical Education, University of Bern, Bern, Switzerland
| | - Patrício Costa
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS'3, PT Government Associate Laboratory, Braga, Guimarães, Portugal
- Faculty of Psychology and Educational Sciences, University of Porto, Porto, Portugal
| | - José Miguel Padilha
- CINTESIS, Centre for Health Technology and Services Research, Faculty of Medicine, University of Porto, Porto, Portugal
- Porto Nursing School, Porto, Portugal
- CINTESIS@RISE, Porto, Portugal
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Younes A, Mandigout S, Robin L, Borel B. What kind of non-pharmacological strategy for reducing sedentary behavior in COPD? Data from a scoping review. Respir Med 2024; 228:107662. [PMID: 38759875 DOI: 10.1016/j.rmed.2024.107662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 05/13/2024] [Accepted: 05/15/2024] [Indexed: 05/19/2024]
Abstract
INTRODUCTION Chronic Obstructive Pulmonary Disease (COPD) is usually associated with sedentary behavior (SB). Literature reports a harmful impact of SB on the physical, mental, and social health of individuals with COPD. However, Pulmonary Rehabilitation (PR) programs seem to have no clear effect on changing SB. Therefore, our study aimed to identify the strategies used in the literature to reduce SB among individuals with COPD. METHOD A scoping review was conducted to summarize the current literature regarding the proposed strategies to reduce SB in individuals with COPD. Searches were conducted in PUBMED; SCOPUS and COCHRANE LIBRARY for studies published from 2010 to march 2024. RESULTS Twenty four articles were retained for our review. Most of the identified strategies in the literature (21/24 articles) are based on behavioral approaches, with various forms: promoting self-efficacy, self-management and self-regulation of one's own behavior (12 articles), goal setting (10 articles), constant feedback (11 articles), therapeutic education (8 articles), motivational strategies (6 articles), re-engagement in meaningful activities (4 articles), promoting light intensity physical activity (LPA) (6 articles) and social support (6 articles). In association with the behavioral strategies, wearable connected technologies have been used in 4 articles, alone or combined with physical exercise programs included or not in a PR program. The home is associated with 83 % of interventions as a place for initial and continuous implementation of behavioral strategies. CONCLUSION It would seem appropriate to focus on combined strategies to reduce SB in individuals with COPD (improvement of physical abilities and behavioral strategies). Further research is needed to only target the reduction of SB and to evaluate the effects of various interventions.
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Affiliation(s)
- A Younes
- Univ. Limoges, ILFOMER - Readaptation Sciences Institute, F-87000 Limoges, France
| | - S Mandigout
- Univ. Limoges, HAVAE, UR 20217, F-87000, Limoges, France; Univ. Limoges, ILFOMER - Readaptation Sciences Institute, F-87000 Limoges, France
| | - L Robin
- Univ. Limoges, HAVAE, UR 20217, F-87000, Limoges, France
| | - B Borel
- Univ. Limoges, HAVAE, UR 20217, F-87000, Limoges, France.
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Rebelo P, Brooks D, Cravo J, Mendes MA, Oliveira AC, Rijo AS, Moura MJ, Marques A. Beyond pulmonary rehabilitation: can the PICk UP programme fill the gap? A randomised trial in COPD. Pulmonology 2024:S2531-0437(24)00047-3. [PMID: 38734564 DOI: 10.1016/j.pulmoe.2024.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 03/11/2024] [Accepted: 04/03/2024] [Indexed: 05/13/2024] Open
Abstract
INTRODUCTION AND OBJECTIVES Pulmonary rehabilitation (PR) is a fundamental intervention to manage COPD, however, maintaining its benefits is challenging. Engaging in physical activity might help to prolong PR benefits. This study assessed the efficacy and effectiveness of a personalised community-based physical activity programme to sustain physical activity and other health-related PR benefits, in people with COPD. MATERIALS AND METHODS This was a multicentre, assessor blinded, randomised controlled trial. Following 12-weeks of PR, people with COPD were assigned to a six-months personalised community-based physical activity programme (experimental group), or to standard care (control group). Physical activity was assessed via: time spent in moderate to vigorous physical activities per day (primary outcome measure), steps/day and the brief physical activity assessment tool. Secondary outcomes included sedentary behaviour, functional status, peripheral muscle strength, balance, symptoms, emotional state, health-related quality of life, exacerbations and healthcare utilization. Assessments were performed immediately post-PR and after three- and six-months. Efficacy and effectiveness were evaluated using intention-to-treat and per-protocol analysis with linear mixed models. RESULTS Sixty-one participants (experimental group: n = 32; control group: n = 29), with balanced baseline characteristics between groups (69.6 ± 8.5 years old, 84 % male, FEV1 57.1 ± 16.7 %predicted) were included. Changes in all physical activity outcomes and in one-minute sit-to-stand were significantly different (P < 0.05) between groups at the six-month follow-up. In the remaining outcomes there were no differences between groups. CONCLUSIONS The community-based physical activity programme resulted in better physical activity levels and sit-to-stand performance, six-months after completing PR, in COPD. No additional benefits were observed for other secondary outcomes.
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Affiliation(s)
- P Rebelo
- Lab3R - Respiratory Research and Rehabilitation Laboratory, School of Health Sciences, University of Aveiro (ESSUA), Aveiro, Portugal; iBiMED - Institute of Biomedicine, University of Aveiro, Aveiro, Portugal
| | - D Brooks
- School of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada; West Park Healthcare Centre, Toronto, ON, Canada
| | - J Cravo
- Pulmonology Service, Centro Hospitalar do Baixo Vouga, Aveiro, Portugal
| | - M A Mendes
- Lab3R - Respiratory Research and Rehabilitation Laboratory, School of Health Sciences, University of Aveiro (ESSUA), Aveiro, Portugal; iBiMED - Institute of Biomedicine, University of Aveiro, Aveiro, Portugal; Pulmonology Service, Centro Hospitalar do Baixo Vouga, Aveiro, Portugal
| | - A C Oliveira
- Agrupamento dos Centros de Saúde do Baixo Vouga, Aveiro, Portugal
| | - A S Rijo
- Agrupamento dos Centros de Saúde do Baixo Vouga, Aveiro, Portugal
| | - M J Moura
- Agrupamento dos Centros de Saúde do Baixo Vouga, Aveiro, Portugal
| | - A Marques
- Lab3R - Respiratory Research and Rehabilitation Laboratory, School of Health Sciences, University of Aveiro (ESSUA), Aveiro, Portugal; iBiMED - Institute of Biomedicine, University of Aveiro, Aveiro, Portugal.
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Llamas-Saez C, Saez-Vaquero T, Jiménez-García R, López-de-Andrés A, Carabantes-Alarcón D, Zamorano-León JJ, Cuadrado-Corrales N, Omaña-Palanco R, de Miguel Diez J, Pérez-Farinos N. Physical activity among adults with chronic obstructive pulmonary disease in Spain (2014-2020): Temporal trends, sex differences, and associated factors. Respir Med 2023; 220:107458. [PMID: 37951312 DOI: 10.1016/j.rmed.2023.107458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 10/07/2023] [Accepted: 11/03/2023] [Indexed: 11/13/2023]
Abstract
OBJECTIVES To evaluate trends in the prevalence of physical activity (PA) from 2014 to 2020; to identify sex differences and sociodemographic and health-related factors associated with PA in individuals with chronic obstructive pulmonary disease (COPD); and to compare PA between individuals with and without COPD. METHODS Cross-sectional and case-control study. SOURCE European Health Interview Surveys for Spain (EHISS) conducted in 2014 and 2020. We included sociodemographic and health-related covariates. We compared individuals with and without COPD after matching for age and sex. RESULTS The number of adults with COPD was 1086 and 910 in EHISS2014 and EHISS2020, respectively. In this population, self-reported "Medium or high frequency of PA" remained stable (42.9% in 2014 and 43.5% in 2020; p = 0.779). However, the percentage who walked on two or more days per week rose significantly over time (63.4%-69.9%; p = 0.004). Men with COPD reported more PA than women with COPD in both surveys. After matching, significantly lower levels of PA were recorded in COPD patients than in adults without COPD. Multivariable logistic regression confirmed this trend in COPD patients and showed that male sex, younger age, higher educational level, very good/good self-perceived health, and absence of comorbidities, obesity, and smoking were associated with more frequent PA. CONCLUSIONS The temporal trend in PA among Spanish adults with COPD is favorable, although there is much room for improvement. Insufficient PA is more prevalent in these patients than in the general population. Sex differences were found, with significantly more frequent PA among males with COPD.
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Affiliation(s)
- Carlos Llamas-Saez
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, 28040, Madrid, Spain
| | | | - Rodrigo Jiménez-García
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, 28040, Madrid, Spain.
| | - Ana López-de-Andrés
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, 28040, Madrid, Spain
| | - David Carabantes-Alarcón
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, 28040, Madrid, Spain
| | - José J Zamorano-León
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, 28040, Madrid, Spain
| | - Natividad Cuadrado-Corrales
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, 28040, Madrid, Spain
| | - Ricardo Omaña-Palanco
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, 28040, Madrid, Spain
| | - Javier de Miguel Diez
- Respiratory Care Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Universidad Complutense de Madrid, 28007, Madrid, Spain
| | - Napoleón Pérez-Farinos
- Epi-PHAAN Research Group, School of Medicine, Universidad de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), 29071, Málaga, Spain
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Tsujimura Y, Akiyama A, Hiramatsu T, Mikawa K, Tabira K. Effects of Pedometer-Based Step-Feedback on Physical Activity of Severe COPD Patients. Int J Chron Obstruct Pulmon Dis 2023; 18:2277-2287. [PMID: 37868622 PMCID: PMC10590114 DOI: 10.2147/copd.s415958] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 09/29/2023] [Indexed: 10/24/2023] Open
Abstract
Purpose This study investigated whether adding step-feedback (step-FB) from a pedometer to pulmonary rehabilitation (PR) programs could increase the physical activity (PA) of low-activity patients with severe chronic obstructive pulmonary disease (COPD). Patients and Methods We included low-activity patients with severe COPD (step-FB group: 14 patients; control group: 17 patients) who underwent PR for the first time. The usual PR program for patients with severe COPD consisted of two 8-week sessions (PR session 1: PR1, PR session 2: PR2). The step-FB group was provided a program with step-FB added to PR2 (PR2+step-FB). Furthermore, all patients were evaluated at pre-intervention (baseline), PR1, and PR2. The primary outcome of this study was the number of daily steps (steps) and energy expenditure from activity (energy expenditure), as measured by a pedometer. The secondary outcomes were dyspnea and exercise tolerance. Results In PR1, dyspnea, exercise tolerance, steps, and energy expenditure were significantly improved as compared to baseline, in both groups. During PR2, dyspnea and exercise tolerance were significantly improved as compared to PR1, in both groups. Steps and energy expenditure were significantly improved in the step-FB group, but not in the control group. Conclusion PR improved PA by improving physical function in severe COPD patients. Adding step-FB improved PA in severe COPD patients by presenting an activity goal for improving PA. Therefore, pedometer-based step-FB is a viable addition to PR and has the potential to improve PA continuously in these patients.
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Affiliation(s)
- Yasuhiko Tsujimura
- Department of Rehabilitation, Hiramatsu Clinic of Internal and Respiratory Medicine, Komaki, Aichi, Japan
- Division of Health Science, Graduate School of Health Science, Kio University, Kitakaturagi, Nara, Japan
| | - Ayumu Akiyama
- Department of Rehabilitation, Hiramatsu Clinic of Internal and Respiratory Medicine, Komaki, Aichi, Japan
| | - Tetsuo Hiramatsu
- Department of Respiratory Medicine, Hiramatsu Clinic of Internal and Respiratory Medicine, Komaki, Aichi, Japan
| | - Kotaro Mikawa
- Department of Physical Therapy Faculty of Nursing and Rehabilitation, Chubu Gakuin University, Seki, Gifu, Japan
| | - Kazuyuki Tabira
- Division of Health Science, Graduate School of Health Science, Kio University, Kitakaturagi, Nara, Japan
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Labeix P, Court Fortune I, Muti D, Berger M, Chomette-Ballereau S, Barthelemy JC, Féasson L, Costes F. The effect of a pressure ventilatory support on quadriceps endurance is maintained after exercise training in severe COPD patients. A longitudinal randomized, cross over study. Front Physiol 2022; 13:1055023. [DOI: 10.3389/fphys.2022.1055023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 11/14/2022] [Indexed: 11/29/2022] Open
Abstract
Purpose: In severe chronic obstructive pulmonary disease (COPD) patients, the application of an inspiratory pressure support (IPS) during exercise increases exercise tolerance and the benefit of exercise training during pulmonary rehabilitation (PR). Moreover, it improves quadriceps endurance after a session of cycling exercise suggesting a reduced muscle fatigue. We looked for the persistence of this effect after PR and sought an association between the improved quadriceps endurance with IPS and the training load during PR.Patients and methods: We studied 20 patients with severe COPD (6 in stage 3and 14 in stage 4 of GOLD) before and after PR. As part of a PR program, patients completed 16 cycling sessions over 6 weeks with the addition of IPS during exercise. As a surrogate of muscular fatigue, quadriceps endurance was measured at 70% of maximal strength in a control condition, after a constant work rate exercise test (CWR) with IPS (TlimQ IPS) or with a sham ventilation (TlimQsham), in a random order. These tests were repeated similarly at the end of PR.Results: PR was associated with a significant increase in maximal power output, cycling endurance, quadriceps strength and endurance. Session training load (power output x duration of the session) increased by 142% during the course of the program. Before PR, CWR duration increases with IPS compared to sham ventilation (Δtime = +244s, p = 0.001). Compared to control condition, post-exercise TlimQ reduction was lower with IPS at isotime than at the end of CWR or than with sham ventilation (−9 ± 21%, −18 ± 16% and −23 ± 18%, respectively, p = 0.09, p < 0.0001 and p < 0.0001). After PR, the post-exercise decrease of TlimQ was reduced after IPS compared to sham (−9 ± 18% vs. −21 ± 17%, respectively, p = 0.004). No relationship was found between the prevention of quadriceps fatigue and the training load.Conclusion: In severe COPD patients, the beneficial effect of a ventilator support on quadriceps endurance persisted after PR with IPS. However, it was not related to the increase in training load, and could not predict the training response to non-invasive ventilation during exercise.
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Koreny M, Arbillaga-Etxarri A, Bosch de Basea M, Foraster M, Carsin AE, Cirach M, Gimeno-Santos E, Barberan-Garcia A, Nieuwenhuijsen M, Vall-Casas P, Rodriguez-Roisín R, Garcia-Aymerich J. Urban environment and physical activity and capacity in patients with chronic obstructive pulmonary disease. ENVIRONMENTAL RESEARCH 2022; 214:113956. [PMID: 35872322 DOI: 10.1016/j.envres.2022.113956] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 07/09/2022] [Accepted: 07/19/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Physical activity and exercise capacity are key prognostic factors in chronic obstructive pulmonary disease (COPD) but their environmental determinants are unknown. OBJECTIVES To test the association between urban environment and objective physical activity, physical activity experience and exercise capacity in COPD. METHODS We studied 404 patients with mild-to-very severe COPD from a multi-city study in Catalonia, Spain. We measured objective physical activity (step count and sedentary time) by the Dynaport MoveMonitor, physical activity experience (difficulty with physical activity) by the Clinical visit-PROactive (C-PPAC) instrument, and exercise capacity by the 6-min walk distance (6MWD). We estimated individually (geocoded to the residential address) population density, pedestrian street length, slope of terrain, and long-term (i.e., annual) exposure to road traffic noise, nitrogen dioxide (NO2) and particulate matter (PM2.5). We built single- and multi-exposure mixed-effects linear regressions with a random intercept for city, adjusting for confounders. RESULTS Patients were 85% male, had mean (SD) age 69 (9) years and walked 7524 (4045) steps/day. In multi-exposure models, higher population density was associated with fewer steps, more sedentary time and worse exercise capacity (-507 [95% CI: 1135, 121] steps, +0.2 [0.0, 0.4] h/day and -13 [-25, 0] m per IQR). Pedestrian street length related with more steps and less sedentary time (156 [9, 304] steps and -0.1 [-0.1, 0.0] h/day per IQR). Steeper slope was associated with better exercise capacity (15 [3, 27] m per IQR). Higher NO2 levels related with more sedentary time and more difficulty in physical activity. PM2.5 and noise were not associated with physical activity or exercise capacity. DISCUSSION Population density, pedestrian street length, slope and NO2 exposure relate to physical activity and capacity of COPD patients living in highly populated areas. These findings support the consideration of neighbourhood environmental factors during COPD management and the attention to patients with chronic diseases when developing urban and transport planning policies.
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Affiliation(s)
- Maria Koreny
- ISGlobal, Barcelona, Spain; Pompeu Fabra University (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
| | - Ane Arbillaga-Etxarri
- Physiotherapy Department, Faculty of Health Sciences, University of Deusto, Donostia-San Sebastián, Spain.
| | - Magda Bosch de Basea
- ISGlobal, Barcelona, Spain; Pompeu Fabra University (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
| | - Maria Foraster
- ISGlobal, Barcelona, Spain; Pompeu Fabra University (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain; PHAGEX Research Group, Blanquerna School of Health Science, Universitat Ramon Llull (URL), Barcelona, Spain.
| | - Anne-Elie Carsin
- ISGlobal, Barcelona, Spain; Pompeu Fabra University (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain; IMIM (Hospital Del Mar Medical Research Institute), Spain.
| | - Marta Cirach
- ISGlobal, Barcelona, Spain; Pompeu Fabra University (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
| | - Elena Gimeno-Santos
- ISGlobal, Barcelona, Spain; Pompeu Fabra University (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain; Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain.
| | - Anael Barberan-Garcia
- University of Barcelona, Institut D'Investigació Biomèdica August Pi I Sunyer (IDIBAPS), CIBER Enfermedades Respiratorias (CIBERES), Hospital Clínic, Barcelona, Spain.
| | - Mark Nieuwenhuijsen
- ISGlobal, Barcelona, Spain; Pompeu Fabra University (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
| | - Pere Vall-Casas
- Universitat Internacional de Catalunya (UIC), Barcelona, Spain.
| | - Robert Rodriguez-Roisín
- University of Barcelona, Institut D'Investigació Biomèdica August Pi I Sunyer (IDIBAPS), CIBER Enfermedades Respiratorias (CIBERES), Hospital Clínic, Barcelona, Spain.
| | - Judith Garcia-Aymerich
- ISGlobal, Barcelona, Spain; Pompeu Fabra University (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
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10
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Rochester CL. Does Telemedicine Promote Physical Activity? Life (Basel) 2022; 12:life12030425. [PMID: 35330176 PMCID: PMC8948765 DOI: 10.3390/life12030425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 02/26/2022] [Accepted: 03/02/2022] [Indexed: 11/16/2022] Open
Abstract
Exercise capacity and physical activity are different concepts: the former refers to what an individual is capable of performing, while the latter refers to what the individual does in daily life. Low levels of physical activity (PA), which are very common in individuals with COPD, are associated with poor health outcomes, including increased symptoms, a more rapid decline in lung function, increased health care utilization and increased mortality risk. Because of these pervasive negative outcomes, attempts have been made to increase physical activity in individuals with COPD, hoping that success in this area will mitigate the negative effects of inactivity. Based on its ability to increase exercise capacity and reduce dyspnea in COPD and other chronic respiratory diseases, pulmonary rehabilitation (PR) would be expected also increase physical activity in these patients. However, accessibility to pulmonary rehabilitation programs is problematic in some areas, and studies testing its effectiveness in this outcome area have had inconsistent results. Using telehealth interventions using technology to provide medical care conveniently over a distance would have the benefit of reaching a larger proportion of individuals with COPD. A systematic review of clinical trials testing telehealth to promote physical activity had mixed results and low-certainty evidence, resulting in the inability to recommend any single type of intervention. Thus, using telehealth interventions to promote physical activity for individuals with chronic respiratory diseases, while promising, remains an area where future investigations are needed to identify its optimal modalities and clarify its benefits.
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Affiliation(s)
- Carolyn L. Rochester
- Section of Pulmonary, Critical Care and Sleep Medicine, Yale University School of Medicine, New Haven, CT 06520, USA; ; Tel.: +1-203-785-4163; Fax: +1-203-785-3627
- VA Connecticut Healthcare System, West Haven, CT 06516, USA
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11
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Hanrahan C, Broderick J, O’Connor TM, McVeigh JG. Behaviour change and physical activity interventions for physical activity engagement in community dwelling adults with chronic obstructive pulmonary disease: protocol for a systematic review. HRB Open Res 2022; 4:110. [PMID: 35079692 PMCID: PMC8753571 DOI: 10.12688/hrbopenres.13399.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2022] [Indexed: 11/20/2022] Open
Abstract
Background: Chronic obstructive pulmonary disease (COPD) is a complex respiratory disease and the third leading cause of death worldwide. Pulmonary rehabilitation is recognised as the gold standard of care in the management of COPD, however engagement with pulmonary rehabilitation is low and maintenance of a physically active lifestyle in community dwelling adults with COPD is poor. Supporting positive behaviour change in people with COPD could help to increase their engagement with physical activity. This systematic review will examine behaviour change and physical activity interventions delivered to community dwelling adults with COPD with the aim of increasing physical activity engagement. Interventions will be mapped against Michie’s theoretical domains framework (TDF) to inform clinical practice and health policy. Methods: The following databases will be searched from inception until December 2021: Web of Science, CENTRAL, MEDLINE (via EBSCO), EMBASE, APA PsychINFO, CINAHL (via EBSCO), AMED, PROSPERO, Cochrane Airways Trials Register. Reference lists of the relevant studies and grey literature will be searched using Grey Literature Report, Open Grey and Google Scholar search engines. Relevant studies will be systematically reviewed and subject to quality appraisal to determine the impact of behaviour change and physical activity interventions on outcomes of community-dwelling adults with COPD. Interventions will be mapped to Michie’s TDF and a narrative synthesis with respect to nature, effectiveness on target population and setting/environment will be provided. Findings will be reported in relation to the generalisability of the primary results and research question, and will include secondary findings on quality of life, self-reported participation in physical activity, exercise capacity, adverse events and intervention adherence. The review will be presented according to the PRISMA guidelines 2020. Conclusions: This systematic review is necessary to explain the impact of behaviour change and physical activity interventions on outcomes of community dwelling people with COPD. PROSPERO registration: CRD42021264965 (29.06.2021)
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Affiliation(s)
- Ciara Hanrahan
- Discipline of Physiotherapy, College of Medicine and Health, University College Cork, Cork, T12 X70A, Ireland
| | - Julie Broderick
- Discipline of Physiotherapy, School of Medicine, Trinity College Dublin, University of Dublin, Dublin, D08 W9RT, Ireland
| | - Terence M. O’Connor
- Department of Respiratory Medicine, Mercy University Hospital, Cork, Ireland
- College of Medicine and Health, University College Cork, Cork, Ireland
| | - Joseph G. McVeigh
- Discipline of Physiotherapy, College of Medicine and Health, University College Cork, Cork, T12 X70A, Ireland
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12
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Uzzaman MN, Chan SC, Shunmugam RH, Engkasan JP, Agarwal D, Habib GMM, Hanafi NS, Jackson T, Jebaraj P, Khoo EM, Liew SM, Mirza FT, Pinnock H, Rabinovich RA. Clinical effectiveness and components of Home-pulmonary rehabilitation for people with chronic respiratory diseases: a systematic review protocol. BMJ Open 2021; 11:e050362. [PMID: 34642195 PMCID: PMC8513265 DOI: 10.1136/bmjopen-2021-050362] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Chronic respiratory diseases (CRDs) are common and disabling conditions that can result in social isolation and economic hardship for patients and their families. Pulmonary rehabilitation (PR) improves functional exercise capacity and health-related quality of life (HRQoL) but practical barriers to attending centre-based sessions or the need for infection control limits accessibility. Home-PR offers a potential solution that may improve access. We aim to systematically review the clinical effectiveness, completion rates and components of Home-PR for people with CRDs compared with Centre-PR or Usual care. METHODS AND ANALYSIS We will search PubMed, CINAHL, Cochrane, EMBASE, PeDRO and PsycInfo from January 1990 to date using a PICOS search strategy (Population: adults with CRDs; Intervention: Home-PR; Comparator: Centre-PR/Usual care; Outcomes: functional exercise capacity and HRQoL; Setting: any setting). The strategy is to search for 'Chronic Respiratory Disease' AND 'Pulmonary Rehabilitation' AND 'Home-PR', and identify relevant randomised controlled trials and controlled clinical trials. Six reviewers working in pairs will independently screen articles for eligibility and extract data from those fulfilling the inclusion criteria. We will use the Cochrane risk-of-bias tool and Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to rate the quality of evidence. We will perform meta-analysis or narrative synthesis as appropriate to answer our three research questions: (1) what is the effectiveness of Home-PR compared with Centre-PR or Usual care? (2) what components are used in effective Home-PR studies? and (3) what is the completion rate of Home-PR compared with Centre-PR? ETHICS AND DISSEMINATION Research ethics approval is not required since the study will review only published data. The findings will be disseminated through publication in a peer-reviewed journal and presentation in conferences. PROSPERO REGISTRATION NUMBER CRD42020220137.
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Affiliation(s)
- Md Nazim Uzzaman
- NIHR Global Health Research Unit on Respiratory Health (RESPIRE), Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - Soo Chin Chan
- Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | | | | | | | - G M Monsur Habib
- NIHR Global Health Research Unit on Respiratory Health (RESPIRE), Usher Institute, The University of Edinburgh, Edinburgh, UK
- Community Respiratory Centre, Bangladesh Primary Care Respiratory Society, Khulna, Bangladesh
| | | | - Tracy Jackson
- NIHR Global Health Research Unit on Respiratory Health (RESPIRE), Usher Institute, The University of Edinburgh, Edinburgh, UK
| | | | - Ee Ming Khoo
- Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Su May Liew
- Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | | | - Hilary Pinnock
- NIHR Global Health Research Unit on Respiratory Health (RESPIRE), Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - Roberto A Rabinovich
- Respiratory Department, Royal Infirmary of Edinburgh, Edinburgh, UK
- Centre for Inflammation Research, QMRI, The University of Edinburgh, Edinburgh, UK
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13
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Hanrahan C, Broderick J, O’Connor TM, McVeigh JG. Behaviour change and physical activity interventions for physical activity engagement in community dwelling adults with chronic obstructive pulmonary disease: protocol for a systematic review. HRB Open Res 2021; 4:110. [DOI: 10.12688/hrbopenres.13399.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/03/2021] [Indexed: 11/20/2022] Open
Abstract
Background: Chronic obstructive pulmonary disease (COPD) is a complex respiratory disease and the third leading cause of death worldwide. Pulmonary rehabilitation is recognised as the gold standard of care in the management of COPD, however engagement with pulmonary rehabilitation is low and maintenance of a physically active lifestyle in community dwelling adults with COPD is poor. Supporting positive behaviour change in people with COPD could help to increase their engagement with physical activity. This systematic review will examine behaviour change and physical activity interventions delivered to community dwelling adults with COPD with the aim of increasing physical activity engagement. Interventions will be mapped against Michie’s theoretical domains framework (TDF) to inform clinical practice and health policy. Methods: The following databases will be searched from inception until December 2021: Web of Science, CENTRAL, MEDLINE (via EBSCO), EMBASE, APA PsychINFO, CINAHL (via EBSCO), AMED, PROSPERO, Cochrane Airways Trials Register. Reference lists of the relevant studies and grey literature will be searched using Grey Literature Report, Open Grey and Google Scholar search engines. Relevant studies will be systematically reviewed and subject to quality appraisal to determine the impact of behaviour change and physical activity interventions on outcomes of community-dwelling adults with COPD. Interventions will be mapped to Michie’s TDF and a narrative synthesis with respect to nature, effectiveness on target population and setting/environment will be provided. Findings will be reported in relation to the generalisability of the primary results and research question, and will include secondary findings on quality of life, self-reported participation in physical activity, exercise capacity, adverse events and intervention adherence. The review will be presented according to the PRISMA guidelines 2020. Conclusions: This systematic review is necessary to explain the impact of behaviour change and physical activity interventions on outcomes of community dwelling people with COPD. PROSPERO registration: CRD42021264965 (29.06.2021)
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14
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Geidl W, Carl J, Schuler M, Mino E, Lehbert N, Wittmann M, Pfeifer K, Schultz K. Long-Term Benefits of Adding a Pedometer to Pulmonary Rehabilitation for COPD: The Randomized Controlled STAR Trial. Int J Chron Obstruct Pulmon Dis 2021; 16:1977-1988. [PMID: 34239299 PMCID: PMC8259733 DOI: 10.2147/copd.s304976] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 05/20/2021] [Indexed: 12/11/2022] Open
Abstract
Purpose This Stay Active after Rehabilitation (STAR) study examined the effects of a pedometer-based behavioral intervention for individuals with COPD during three weeks of inpatient pulmonary rehabilitation (PR) on patients' physical activity levels six weeks and six months after PR, including steps (primary outcome), moderate-intensity physical activity, and sedentary time as well as patient quality of life, symptoms, and other psychological and clinical variables. Patients and Methods Rehabilitation patients with COPD wore a triaxial accelerometer (ActiGraph wGT3X) for seven days two weeks before (T0) as well as six weeks (T3) and six months (T4) after PR. In addition to the three-week inpatient PR (control group, CG), the randomly allocated intervention group (IG) received a brief pedometer-based behavioral intervention with the application of the following behavior-change techniques: performing the behavior, individual goal-setting, self-monitoring, and feedback. The effects were analyzed using analysis of covariance with an intention-to-treat approach. Results A total of 327 patients (69% male, age: 58 years, FEV1 (%): 53.5, six-minute walk distance: 447.8 m) were randomly allocated to either the IG (n = 167) or CG (n = 160). Although both groups increased their daily steps after PR (IG: MT3-T0 = 1152, CG: MT3-T0 = 745; IG: MT4-T0 = 795, CG: MT4-T0 = 300), the slightly higher increases in daily steps in the IG compared to the CG at T3 (Δ388 steps, d = 0.16) and T4 (Δ458 steps, d = 0.15) were not statistically significant (p > 0.05 for all). Patients in both groups showed moderate to high pre-post-changes in terms of secondary outcomes, but no advantage favoring the IG was found. Conclusion The results show that adding a pedometer-based behavioral intervention to standard German three-week inpatient PR for COPD patients did not result in more physical activity in terms of steps and moderate-intensity physical activity or less sedentary time. However, both groups (IG and CG) showed remarkably enhanced physical activity levels six weeks and six months after PR, as well as improvements in other secondary outcomes (eg, quality of life).
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Affiliation(s)
- Wolfgang Geidl
- Department of Sport Science and Sport, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Johannes Carl
- Department of Sport Science and Sport, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Michael Schuler
- Institute for Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany.,Department of Applied Heath Sciences, Hochschule für Gesundheit, University of Applied Sciences, Bochum, Germany
| | - Eriselda Mino
- Department of Sport Science and Sport, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Nicola Lehbert
- Klinik Bad Reichenhall, Centre for Rehabilitation, Pulmonology, and Orthopaedics, Bad Reichenhall, Germany
| | - Michael Wittmann
- Klinik Bad Reichenhall, Centre for Rehabilitation, Pulmonology, and Orthopaedics, Bad Reichenhall, Germany
| | - Klaus Pfeifer
- Department of Sport Science and Sport, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Konrad Schultz
- Klinik Bad Reichenhall, Centre for Rehabilitation, Pulmonology, and Orthopaedics, Bad Reichenhall, Germany
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15
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Abstract
The rehabilitation needs of individuals undergoing thoracic surgery are changing, especially as surgical management is increasingly being offered to patients who are at risk of developing functional limitations during and after hospital discharge. In the past rehabilitative management of these patients was frequently limited to specific respiratory physiotherapy interventions in the immediate postoperative setting with the aim to prevent postoperative pulmonary complications. In the past two decades, this focus has shifted toward pulmonary rehabilitation interventions that aim to improve functional status of individuals, both in the pre- and (longer-term) postoperative period. While there is increased interest in (p)rehabilitation interventions the majority of thoracic surgery patients are however currently on their own with respect to progression of their exercise and physical activity regimens after they have been discharged from hospital. There are also no formal guidelines supporting the referral of these patients to outpatient rehabilitation programs. The current evidence regarding rehabilitation interventions initiated before, during, and after the hospitalization period will be briefly reviewed with special focus on patients undergoing surgery for lung cancer treatment and patients undergoing lung transplantation. More research will be necessary in the coming years to modify or change clinical rehabilitation practice beyond the acute admission phase in patients undergoing thoracic surgery. Tele rehabilitation or web-based activity counseling programs might also be interesting emerging alternatives in the (long-term) postoperative rehabilitative treatment of these patients.
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Affiliation(s)
- Daniel Langer
- Research Group for Rehabilitation in Internal Disorders, Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, KU Leuven, Leuven, Belgium
- Clinical Department of Respiratory Diseases, UZ Leuven, BREATHE Department CHROMETA, KU Leuven, Leuven, Belgium
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16
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Carl JA, Geidl W, Schuler M, Mino E, Lehbert N, Wittmann M, Schultz K, Pfeifer K. Towards a better understanding of physical activity in people with COPD: predicting physical activity after pulmonary rehabilitation using an integrative competence model. Chron Respir Dis 2021; 18:1479973121994781. [PMID: 33703932 PMCID: PMC8718156 DOI: 10.1177/1479973121994781] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 01/20/2021] [Accepted: 01/24/2021] [Indexed: 01/22/2023] Open
Abstract
The integrative Physical Activity-related Health Competence (PAHCO) model specifies competences (movement competence, control competence, and self-regulation competence) that enable people to lead a physically active lifestyle. This longitudinal study analyses the predictive quality of a multidimensional PAHCO assessment for levels of physical activity (PA) and their relevance for quality of life in COPD patients after pulmonary rehabilitation. At the end of an inpatient pulmonary rehabilitation (T2), 350 COPD patients participating in the Stay Active after Rehabilitation (STAR) study underwent assessments, including a six-factor measurement of PAHCO. PA (triaxial accelerometry) and quality of life (Saint George's Respiratory Questionnaire) were recorded 6 weeks (T3) and 6 months (T4) after rehabilitation. Structural equation modelling (SEM) was used to regress the PAHCO assessment on PA, which should, in turn, influence quality of life. In univariable analysis, five and six factors of the PAHCO model were related to PA and quality of life, respectively. Multivariate modelling showed that the predictive analyses for the PA level were dominated by the 6-minute walking test representing movement competence (0.562 ≤ |β| ≤ 0.599). Affect regulation as an indicator of control competence co-predicted quality of life at T3 and levels of PA at T4. The PA level was, in turn, significantly associated with patients' quality of life (0.306 ≤ |β| ≤ 0.388). The integrative PAHCO model may be used as a theoretical framework for predicting PA in COPD patients following pulmonary rehabilitation. The results improve our understanding of PA behaviour in COPD patients and bear implications for person-oriented PA promotion.
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Affiliation(s)
- Johannes Alexander Carl
- Department of Sport Science and Sport, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
- *These authors contributed equally
| | - Wolfgang Geidl
- Department of Sport Science and Sport, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
- *These authors contributed equally
| | - Michael Schuler
- Institute for Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
| | - Eriselda Mino
- Department of Sport Science and Sport, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | - Nicola Lehbert
- Klinik Bad Reichenhall, Centre for Rehabilitation, Pulmonology and Orthopaedics, Bad Reichenhall, Germany
| | - Michael Wittmann
- Klinik Bad Reichenhall, Centre for Rehabilitation, Pulmonology and Orthopaedics, Bad Reichenhall, Germany
| | - Konrad Schultz
- Klinik Bad Reichenhall, Centre for Rehabilitation, Pulmonology and Orthopaedics, Bad Reichenhall, Germany
| | - Klaus Pfeifer
- Department of Sport Science and Sport, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
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17
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Habib GMM, Rabinovich R, Divgi K, Ahmed S, Saha SK, Singh S, Uddin A, Uzzaman MN, Pinnock H. Systematic review of clinical effectiveness, components, and delivery of pulmonary rehabilitation in low-resource settings. NPJ Prim Care Respir Med 2020; 30:52. [PMID: 33214560 PMCID: PMC7677536 DOI: 10.1038/s41533-020-00210-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 10/09/2020] [Indexed: 11/20/2022] Open
Abstract
Pulmonary rehabilitation (PR) is a guideline-recommended multifaceted intervention that improves the physical and psychological well-being of people with chronic respiratory diseases (CRDs), though most of the evidence derives from trials in high-resource settings. In low- and middle-income countries, PR services are under-provided. We aimed to review the effectiveness, components and mode of delivery of PR in low-resource settings. Following Cochrane methodology, we systematically searched (1990 to October 2018; pre-publication update March 2020) MEDLINE, EMBASE, CABI, AMED, PUBMED, and CENTRAL for controlled clinical trials of adults with CRD (including but not restricted to chronic obstructive pulmonary disease) comparing PR with usual care in low-resource settings. After duplicate selection, we extracted data on exercise tolerance, health-related quality of life (HRQoL), breathlessness, included components, and mode of delivery. We used Cochrane risk of bias (RoB) to assess study quality and synthesised data narratively. From 8912 hits, we included 13 studies: 11 were at high RoB; 2 at moderate RoB. PR improved functional exercise capacity in 10 studies, HRQoL in 12, and breathlessness in 9 studies. One of the two studies at moderate RoB showed no benefit. All programmes included exercise training; most provided education, chest physiotherapy, and breathing exercises. Low cost services, adapted to the setting, used limited equipment and typically combined outpatient/centre delivery with a home/community-based service. Multicomponent PR programmes can be delivered in low-resource settings, employing a range of modes of delivery. There is a need for a high-quality trial to confirm the positive findings of these high/moderate RoB studies.
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Affiliation(s)
- G M Monsur Habib
- Bangladesh Primary Care Respiratory Society (BPCRS), Khulna, Bangladesh
- NIHR Global Health Research Unit on Respiratory Health (RESPIRE), Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Roberto Rabinovich
- ELEGI/Colt Laboratory, Centre for Inflammation Research, QMRI, The University of Edinburgh and Respiratory Department, Royal Infirmary Edinburgh, Edinburgh, UK
| | | | - Salahuddin Ahmed
- NIHR Global Health Research Unit on Respiratory Health (RESPIRE), Usher Institute, University of Edinburgh, Edinburgh, UK
- Johns Hopkins University-Bangladesh, Projahnmo, Dhaka, Bangladesh
| | | | - Sally Singh
- Pulmonary and Cardiac Rehabilitation, Department of Respiratory Medicine (Acute Division), University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Aftab Uddin
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Md Nazim Uzzaman
- Bangladesh Primary Care Respiratory Society (BPCRS), Khulna, Bangladesh
- NIHR Global Health Research Unit on Respiratory Health (RESPIRE), Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Hilary Pinnock
- NIHR Global Health Research Unit on Respiratory Health (RESPIRE), Usher Institute, University of Edinburgh, Edinburgh, UK.
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18
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Kohlbrenner D, Sievi NA, Senn O, Kohler M, Clarenbach CF. Long-Term Effects of Pedometer-Based Physical Activity Coaching in Severe COPD: A Randomized Controlled Trial. Int J Chron Obstruct Pulmon Dis 2020; 15:2837-2846. [PMID: 33192057 PMCID: PMC7655791 DOI: 10.2147/copd.s279293] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 10/14/2020] [Indexed: 02/04/2023] Open
Abstract
Background and Objective Limited evidence on long-term effects of physical activity programs in COPD is available. The aim of the study was to investigate the effects of a three-month program combining physical activity counselling and pedometer-based feedback in addition to usual care, followed by a nine-month unsupervised observation period as compared to usual care in participants with severe to very severe COPD. Methods Participants were randomized to either a control group receiving usual care or an intervention group receiving motivational support, an activity diary with an individual step count goal (ie, an increase of ≥15% from baseline) and a pedometer in addition to usual care. The intervention ended after three months and an unsupervised observational period followed until twelve months. Primary outcome was daily step count after one year. Results Seventy-four participants were included, 61 (82%) completed the study. Linear regression modelling, adjusted for baseline step count, showed no significant difference in change in step count after 12 months between the groups (Β = 547.33, 95% CI = -243.55/1338.20). Conclusion A three-month program combining physical activity counselling and pedometer-based feedback in addition to usual care does not attenuate the declining course of physical activity in participants with severe and very severe COPD during a long term follow-up of one year as compared to usual care. This result was primarily determined by the low intervention response rates to the combined program. Clinical Trial Registration www.ClinicalTrials.gov, NCT03114241.
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Affiliation(s)
- Dario Kohlbrenner
- Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland
| | - Noriane A Sievi
- Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland
| | - Oliver Senn
- Institute of Primary Care, University of Zurich, Zurich, Switzerland
| | - Malcolm Kohler
- Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland
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19
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Faizal WM, Ghazali NNN, Khor CY, Badruddin IA, Zainon MZ, Yazid AA, Ibrahim NB, Razi RM. Computational fluid dynamics modelling of human upper airway: A review. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2020; 196:105627. [PMID: 32629222 PMCID: PMC7318976 DOI: 10.1016/j.cmpb.2020.105627] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 06/21/2020] [Indexed: 05/12/2023]
Abstract
BACKGROUND AND OBJECTIVE Human upper airway (HUA) has been widely investigated by many researchers covering various aspects, such as the effects of geometrical parameters on the pressure, velocity and airflow characteristics. Clinically significant obstruction can develop anywhere throughout the upper airway, leading to asphyxia and death; this is where recognition and treatment are essential and lifesaving. The availability of advanced computer, either hardware or software, and rapid development in numerical method have encouraged researchers to simulate the airflow characteristics and properties of HUA by using various patient conditions at different ranges of geometry and operating conditions. Computational fluid dynamics (CFD) has emerged as an efficient alternative tool to understand the airflow of HUA and in preparing patients to undergo surgery. The main objective of this article is to review the literature that deals with the CFD approach and modeling in analyzing HUA. METHODS This review article discusses the experimental and computational methods in the study of HUA. The discussion includes computational fluid dynamics approach and steps involved in the modeling used to investigate the flow characteristics of HUA. From inception to May 2020, databases of PubMed, Embase, Scopus, the Cochrane Library, BioMed Central, and Web of Science have been utilized to conduct a thorough investigation of the literature. There had been no language restrictions in publication and study design of the database searches. A total of 117 articles relevant to the topic under investigation were thoroughly and critically reviewed to give a clear information about the subject. The article summarizes the review in the form of method of studying the HUA, CFD approach in HUA, and the application of CFD for predicting HUA obstacle, including the type of CFD commercial software are used in this research area. RESULTS This review found that the human upper airway was well studied through the application of computational fluid dynamics, which had considerably enhanced the understanding of flow in HUA. In addition, it assisted in making strategic and reasonable decision regarding the adoption of treatment methods in clinical settings. The literature suggests that most studies were related to HUA simulation that considerably focused on the aspects of fluid dynamics. However, there is a literature gap in obtaining information on the effects of fluid-structure interaction (FSI). The application of FSI in HUA is still limited in the literature; as such, this could be a potential area for future researchers. Furthermore, majority of researchers present the findings of their work through the mechanism of airflow, such as that of velocity, pressure, and shear stress. This includes the use of Navier-Stokes equation via CFD to help visualize the actual mechanism of the airflow. The above-mentioned technique expresses the turbulent kinetic energy (TKE) in its result to demonstrate the real mechanism of the airflow. Apart from that, key result such as wall shear stress (WSS) can be revealed via turbulent kinetic energy (TKE) and turbulent energy dissipation (TED), where it can be suggestive of wall injury and collapsibility tissue to the HUA.
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Affiliation(s)
- W M Faizal
- Department of Mechanical Engineering Technology, Faculty of Engineering Technology, University Malaysia Perlis, 02100 Padang Besar, Perlis, Malaysia; Department of Mechanical Engineering, Faculty of Engineering, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - N N N Ghazali
- Department of Mechanical Engineering, Faculty of Engineering, University of Malaya, 50603 Kuala Lumpur, Malaysia.
| | - C Y Khor
- Department of Mechanical Engineering Technology, Faculty of Engineering Technology, University Malaysia Perlis, 02100 Padang Besar, Perlis, Malaysia
| | - Irfan Anjum Badruddin
- Research Center for Advanced Materials Science (RCAMS), King Khalid University, P.O. Box 9004, Abha, 61413, Asir, Kingdom Saudi Arabia; Mechanical Engineering Department, College of Engineering, King Khalid University, PO Box 394, Abha, 61421, Kingdom of Saudi Arabia.
| | - M Z Zainon
- Department of Mechanical Engineering, Faculty of Engineering, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Aznijar Ahmad Yazid
- Department of Mechanical Engineering, Faculty of Engineering, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Norliza Binti Ibrahim
- Department of Oral and Maxillofacial Clinical Science, Faculty of Dentistry, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Roziana Mohd Razi
- Department of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, University of Malaya, 50603, Kuala Lumpur, Malaysia
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20
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Koreny M, Demeyer H, Benet M, Arbillaga-Etxarri A, Balcells E, Barberan-Garcia A, Gimeno-Santos E, Hopkinson NS, De Jong C, Karlsson N, Louvaris Z, Polkey MI, Puhan MA, Rabinovich RA, Rodríguez-Roisin R, Vall-Casas P, Vogiatzis I, Troosters T, Garcia-Aymerich J. Patterns of Physical Activity Progression in Patients With COPD. Arch Bronconeumol 2020; 57:214-223. [PMID: 33041107 DOI: 10.1016/j.arbres.2020.08.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 07/24/2020] [Accepted: 08/06/2020] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Although mean physical activity in COPD patients declines by 400-500steps/day annually, it is unknown whether the natural progression is the same for all patients. We aimed to identify distinct physical activity progression patterns using a hypothesis-free approach and to assess their determinants. METHODS We pooled data from two cohorts (usual care arm of Urban Training [NCT01897298] and PROactive initial validation [NCT01388218] studies) measuring physical activity at baseline and 12 months (Dynaport MoveMonitor). We identified clusters (patterns) of physical activity progression (based on levels and changes of steps/day) using k-means, and compared baseline sociodemographic, interpersonal, environmental, clinical and psychological characteristics across patterns. RESULTS In 291 COPD patients (mean±SD 68±8 years, 81% male, FEV1 59±19%pred) we identified three distinct physical activity progression patterns: Inactive (n=173 [59%], baseline: 4621±1757 steps/day, 12-month change (Δ): -487±1201 steps/day), ActiveImprovers (n=49 [17%], baseline: 7727±3275 steps/day, Δ:+3378±2203 steps/day) and ActiveDecliners (n=69 [24%], baseline: 11 267±3009 steps/day, Δ: -2217±2085 steps/day). After adjustment in a mixed multinomial logistic regression model using Active Decliners as reference pattern, a lower 6-min walking distance (RRR [95% CI] 0.94 [0.90-0.98] per 10m, P=.001) and a higher mMRC dyspnea score (1.71 [1.12-2.60] per 1 point, P=.012) were independently related with being Inactive. No baseline variable was independently associated with being an Active Improver. CONCLUSIONS The natural progression in physical activity over time in COPD patients is heterogeneous. While Inactive patients relate to worse scores for clinical COPD characteristics, Active Improvers and Decliners cannot be predicted at baseline.
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Affiliation(s)
- Maria Koreny
- ISGlobal, Barcelona, Spain; Pompeu Fabra University (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Heleen Demeyer
- Department of Rehabilitation Sciences, KU Leuven - University of Leuven, Leuven, Belgium; Department of Respiratory Diseases, University Hospitals KU Leuven, Leuven, Belgium; Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - Marta Benet
- ISGlobal, Barcelona, Spain; Pompeu Fabra University (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Ane Arbillaga-Etxarri
- Physical Activity and Sports Sciences, Faculty of Psychology and Education, University of Deusto, Donostia-San Sebastián, Spain
| | - Eva Balcells
- Pompeu Fabra University (UPF), Barcelona, Spain; CIBER Enfermedades Respiratorias (CIBERES), Madrid, Spain; Pneumology Department, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Hospital del Mar, Barcelona, Spain
| | - Anael Barberan-Garcia
- University of Barcelona, Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), CIBER Enfermedades Respiratorias (CIBERES), Hospital Clínic, Barcelona, Spain
| | - Elena Gimeno-Santos
- University of Barcelona, Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), CIBER Enfermedades Respiratorias (CIBERES), Hospital Clínic, Barcelona, Spain
| | - Nicholas S Hopkinson
- National Heart and Lung Institute, Imperial College, Royal Brompton Hospital Campus, London UK
| | - Corina De Jong
- Department of General Practice, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; Groningen Research Institute for Asthma and COPD (GRIAC), University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Niklas Karlsson
- Patient Centered Science, BioPharmaceuticals, AstraZeneca R&D, Gothenburg, Sweden
| | - Zafeiris Louvaris
- Department of Rehabilitation Sciences, KU Leuven - University of Leuven, Leuven, Belgium; First Department of Respiratory Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Michael I Polkey
- National Heart and Lung Institute, Imperial College, Royal Brompton Hospital Campus, London UK
| | - Milo A Puhan
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Roberto A Rabinovich
- ELEGI Colt Laboratory, Centre for Inflammation Research, The Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Robert Rodríguez-Roisin
- University of Barcelona, Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), CIBER Enfermedades Respiratorias (CIBERES), Hospital Clínic, Barcelona, Spain
| | - Pere Vall-Casas
- Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - Ioannis Vogiatzis
- First Department of Respiratory Medicine, National and Kapodistrian University of Athens, Athens, Greece; Department of Sport, Exercise and Rehabilitation, Northumbria University Newcastle, Newcastle UK
| | - Thierry Troosters
- Department of Rehabilitation Sciences, KU Leuven - University of Leuven, Leuven, Belgium; Department of Respiratory Diseases, University Hospitals KU Leuven, Leuven, Belgium
| | - Judith Garcia-Aymerich
- ISGlobal, Barcelona, Spain; Pompeu Fabra University (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
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Accuracy of consumer-based activity trackers as measuring tool and coaching device in patients with COPD and healthy controls. PLoS One 2020; 15:e0236676. [PMID: 32750073 PMCID: PMC7402478 DOI: 10.1371/journal.pone.0236676] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 07/09/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Consumer-based activity trackers are used to measure and improve physical activity. However, the accuracy of these devices as clinical endpoint or coaching tool is unclear. We investigated the use of two activity trackers as measuring and coaching tool in patients with Chronic Obstructive Pulmonary Disease (COPD) and healthy age-matched controls. METHODS Daily steps were measured by two consumer-based activity trackers (Fitbit Zip, worn at the hip and Fitbit Alta, worn at the wrist) and a validated activity monitor (Dynaport Movemonitor) in 28 patients with COPD and 14 healthy age-matched controls for 14 consecutive days. To investigate the accuracy of the activity trackers as a clinical endpoint, mean step count per patient were compared with the reference activity monitor and agreement was investigated by Bland-Altman plots. To evaluate the accuracy of activity trackers as coaching tool, day-by-day differences within patients were calculated for all three devices. Additionally, consistency of ranking daily steps between the activity trackers and accelerometer was investigated by Kendall correlation coefficient. RESULTS As a measuring tool, the hip worn activity tracker significantly underestimates daily step count in patients with COPD as compared to DAM (mean±SD Δ-1112±872 steps/day; p<0.0001). This underestimation is less prominent in healthy subjects (p = 0.21). The wrist worn activity tracker showed a non-significant overestimation of step count (p = 0.13) in patients with COPD, and a significant overestimation of daily steps in healthy controls (mean±SD Δ+1907±2147 steps/day; p = 0.006). As a coaching tool, both hip and wrist worn activity tracker were able to pick up the day-by-day variability as measured by Dynaport (consistency of ranking resp. r = 0.80; r = 0.68 in COPD). CONCLUSION Although the accuracy of hip worn consumer-based activity trackers in patients with COPD and wrist worn activity trackers in healthy subjects as clinical endpoints is unsatisfactory, these devices are valid to use as a coaching tool.
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Oliveira A, Rutter M, Quijano-Campos JC, Herrero-Cortina B, Clari M, O'Rourke A, McGowan A, Burtin C, Sajnic A, De Brandt J. ERS International Congress, Madrid, 2019: highlights from the Allied Respiratory Professionals' Assembly. ERJ Open Res 2020; 6:00034-2020. [PMID: 32280669 PMCID: PMC7132037 DOI: 10.1183/23120541.00034-2020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 02/28/2020] [Indexed: 01/29/2023] Open
Abstract
This article provides an overview of outstanding sessions that were (co)organised by the Allied Respiratory Professionals' Assembly during the European Respiratory Society International Congress 2019 in Madrid, Spain. Session content was mainly targeted at allied respiratory professionals such as respiratory physiologists, respiratory physiotherapists and respiratory nurses, and is summarised in this document. Short take-home messages related to pulmonary function testing highlight the importance of quality control. Furthermore, novel findings regarding the assessment of functional status call attention to bodily factors that can affect functional status. Regarding pulmonary rehabilitation, data were presented about the use of equipment and type of exercise training in COPD and lung cancer. Recent developments in physical activity-related research give insight in enablers of physical activity after hospital admission. The importance of integrated respiratory care was also highlighted, with the occupational therapist, nurse, and nutritional and psychological counsellor playing a pivotal role, which relates directly to research in the field of respiratory nursing that formulates the need for more nursing led-interventions in the future. To conclude, this review provides readers with valuable insight into some of the emerging and future areas affecting clinical practice of allied healthcare professionals. A highlights review of selected presentations from #ERSCongress 2019 by @ERS_Assembly9http://bit.ly/2VNFgAj
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Affiliation(s)
- Ana Oliveira
- School of Rehabilitation Science, McMaster University, Hamilton, Canada.,West Park Healthcare Centre, Toronto, Canada.,Lab 3R - Respiratory Research and Rehabilitation Laboratory, School of Health Sciences (ESSUA), University of Aveiro, Aveiro, Portugal.,These authors contributed equally
| | - Matthew Rutter
- Lung Function Dept, Cambridge University Hospitals, Addenbrookes Hospital, Cambridge, UK.,These authors contributed equally
| | - Juan Carlos Quijano-Campos
- Research and Development, Royal Papworth Hospital NHS Foundation Trust, Cambridge Biomedical Campus, Cambridge, UK.,These authors contributed equally
| | - Beatriz Herrero-Cortina
- Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK.,Universidad San Jorge, Zaragoza, Spain.,These authors contributed equally
| | - Marco Clari
- Dept of Public Health and Pediatrics, University of Turin, Turin, Italy.,These authors contributed equally
| | - Aoife O'Rourke
- Respiratory Dept, Cork University Hospital, Cork, Ireland.,These authors contributed equally
| | - Aisling McGowan
- Dept of Respiratory and Sleep Diagnostics, Connolly Hospital, Blanchardstown, Ireland
| | - Chris Burtin
- REVAL - Rehabilitation Research Center, BIOMED - Biomedical Research Institute, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium
| | - Andreja Sajnic
- Dept for Respiratory Diseases Jordanovac, University Hospital Center Rebro, Zagreb, Croatia
| | - Jana De Brandt
- REVAL - Rehabilitation Research Center, BIOMED - Biomedical Research Institute, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium
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