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Gao Y, Li C, Li J, Li L. Causal relationships of physical activity and leisure sedentary behaviors with COPD: A Mendelian randomization study. Arch Gerontol Geriatr 2024; 121:105364. [PMID: 38430688 DOI: 10.1016/j.archger.2024.105364] [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: 12/15/2023] [Revised: 01/26/2024] [Accepted: 02/04/2024] [Indexed: 03/05/2024]
Abstract
BACKGROUND Chronic diseases such as chronic obstructive pulmonary disease (COPD) have been linked to low levels of physical activity (PA) and higher frequency of leisure sedentary behavior (LSB). The main causes of COPD include respiratory and peripheral muscle dysfunction, low levels of PA, and LSB which are associated with a higher risk of developing COPD. The attribution relationship between PA or LSB and COPD risk or COPD respiratory insufficiency is unclear. To explore this further, we conducted a Mendelian randomization (MR) study using a genotype-simulated randomized trial group to systematically evaluate the causal relationships of PA/LSB on COPD risk and respiratory insufficiency. METHODS The exposure data were obtained from large-scale genome-wide association studies (GWAS), including the PA dataset (N = 729,373) and LSB dataset (N = 1,109,337). The outcome data were derived from the Finn-Gen COPD dataset (N = 381,392). The causal effects were estimated with IVW1, MR-Egger, and WM2. Sensitivity analysis was conducted using Cochran's Q test, MR-Egger intercept test, MR-PRESSO3, leave-one-out analysis, and funnel plot to estimate the robustness of our findings. RESULTS Genetically predicted leisure television (TV) watching significantly increased the risk of COPD (OR = 2.4895, 95 % CI: 1.85259 to 3.34536; P = 1.44 × 10-9) and COPD respiratory insufficiency (OR = 2.55, 95 % CI: 1.53 to 4.27; P = 3.54 × 10-4). No casual effect of other PA or LSB phenotypes on COPD risk or respiratory insufficiency was observed. CONCLUSION Our study provides evidence that TV watching may increase the risk of COPD and its related respiratory insufficiency. These findings emphasized the importance of promoting regular physical exercise and reducing leisure sedentary behavior to prevent COPD.
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Affiliation(s)
- Yixuan Gao
- School of Sport Science, Beijing Sport University, 48 Xinxi Road, Beijing 100084, China; Laboratory of Sports Stress and Adaptation of General Administration of Sports, 48 Xinxi Road, Beijing 100084, China
| | - Conghui Li
- School of Sport Science, Beijing Sport University, 48 Xinxi Road, Beijing 100084, China
| | - Junping Li
- School of Sport Science, Beijing Sport University, 48 Xinxi Road, Beijing 100084, China; Laboratory of Sports Stress and Adaptation of General Administration of Sports, 48 Xinxi Road, Beijing 100084, China.
| | - Ling Li
- Physical and Military Education, Jingdezhen Ceramic University, Jiangxi Province 333403, China
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2
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Harding S, Richardson A, Glynn A, Hodgson L. Influencing factors of sedentary behaviour in people with chronic obstructive pulmonary disease: a systematic review. BMJ Open Respir Res 2024; 11:e002261. [PMID: 38789283 PMCID: PMC11129033 DOI: 10.1136/bmjresp-2023-002261] [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: 12/18/2023] [Accepted: 05/10/2024] [Indexed: 05/26/2024] Open
Abstract
BACKGROUND People with chronic obstructive pulmonary disease (COPD) are more likely to adopt a sedentary lifestyle. Increased sedentary behaviour is associated with adverse health consequences and reduced life expectancy. AIM This mixed-methods systematic review aimed to report the factors contributing to sedentary behaviour in people with COPD. METHODS A systematic search of electronic databases (Medline, CINAHL, PsycINFO and Cochrane Library) was conducted and supported by a clinician librarian in March 2023. Papers were identified and screened by two independent researchers against the inclusion and exclusion criteria, followed by data extraction and analysis of quality. Quantitative and qualitative data synthesis was performed. RESULTS 1037 records were identified, 29 studies were included (26 quantitative and 3 qualitative studies) and most studies were conducted in high-income countries. The most common influencers of sedentary behaviour were associated with disease severity, dyspnoea, comorbidities, exercise capacity, use of supplemental oxygen and walking aids, and environmental factors. In-depth findings from qualitative studies included a lack of knowledge, self-perception and motivation. However, sedentarism in some was also a conscious approach, enabling enjoyment when participating in hobbies or activities. CONCLUSIONS Influencers of sedentary behaviour in people living with COPD are multifactorial. Identifying and understanding these factors should inform the design of future interventions and guidelines. A tailored, multimodal approach could have the potential to address sedentary behaviour. PROSPERO REGISTRATION NUMBER CRD42023387335.
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Affiliation(s)
| | | | | | - Luke Hodgson
- University Hospitals Sussex NHS Foundation Trust, Worthing, UK
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3
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Cheng SWM, Guan C, Dennis S, Alison J, Stamatakis E, McKeough Z. A behaviour change intervention to reduce sedentary behaviour in chronic obstructive pulmonary disease: a qualitative study. Physiotherapy 2024; 124:9-20. [PMID: 38795529 DOI: 10.1016/j.physio.2024.04.347] [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: 05/06/2023] [Revised: 03/06/2024] [Accepted: 04/16/2024] [Indexed: 05/28/2024]
Abstract
OBJECTIVES To document the experiences of people with chronic obstructive pulmonary disease (COPD) who underwent a behaviour change intervention to reduce sedentary behaviour (SB) in a clinical trial. DESIGN AND PARTICIPANTS Qualitative study using semi-structured interviews to explore perspectives of the behaviour change intervention and specific intervention components in people with stable COPD on the waitlist for pulmonary rehabilitation. SETTING Three outpatient pulmonary rehabilitation programmes in Sydney, Australia. INTERVENTIONS The six-week behaviour change intervention with once weekly contact with a physiotherapist aimed to reduce SB by replacing it with light-intensity physical activity (PA) and by breaking up prolonged SB. MAIN OUTCOME MEASURES Of 30 participants who completed the behaviour change intervention, interviews were conducted with 13 participants and analysed using the 'capability, opportunity, motivation, behaviour (COM-B)' framework of behaviour change. RESULTS Intervention components regarded as most helpful by participants were verbal education on health consequences on SB, goal setting, and self-monitoring of, and feedback on, step count using activity trackers. There was a clear preference during goal setting to increase PA rather than to reduce SB. Physical limitations and enjoyment of SB were the most reported barriers to reducing SB. CONCLUSIONS Goal setting, verbal education, and self-monitoring of, and feedback on step count, were viewed positively by people with COPD and may show promise for reducing SB and increasing PA based on individual preference. CONTRIBUTION OF THE PAPER.
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Affiliation(s)
- Sonia Wing Mei Cheng
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
| | - Catherine Guan
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia; Department of Physiotherapy, Concord Repatriation General Hospital, Sydney Local Health District, Sydney, Australia
| | - Sarah Dennis
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia; Ingham Institute for Applied Medical Research, Sydney, Australia; South West Sydney Allied Health Research Collaboration, South Western Sydney Local Health District, Sydney, Australia
| | - Jennifer Alison
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia; Allied Health Professorial Unit, Sydney Local Health District, Sydney, Australia
| | - Emmanuel Stamatakis
- Charles Perkins Centre, School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Zoe McKeough
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
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Webster-Dekker KE, Zhou W, Woo S, Son JY, Ploutz-Snyder R, Larson JL. Prolonged bouts of sedentary behavior in people with chronic obstructive pulmonary disease and associated factors. Heart Lung 2023; 62:129-134. [PMID: 37499548 DOI: 10.1016/j.hrtlng.2023.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 06/22/2023] [Accepted: 07/15/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND Increased sedentary behavior (SB), especially in prolonged bouts, is associated with adverse health outcomes, but little is known about patterns of SB in people with chronic obstructive pulmonary disease (COPD). OBJECTIVES The purpose of this study was to describe SB and patterns of SB and to examine factors associated with prolonged bouts of SB in inactive community-dwelling adults with COPD. METHODS This cross-sectional analysis used data from inactive adults with COPD who were enrolled in an exercise program but had not started exercising. Participants were ≥ 50 years old with a diagnosis of COPD, had a forced expiratory volume in one second < 80% predicted, and were inactive. Participants wore an activPAL device for seven days to measure their SB and completed surveys and physical measures. Data were analyzed with multiple regression. RESULTS The sample included 160 participants with a mean age (± SD) of 69 ± 8, and a mean total sedentary time of 742 ± 150 min/day, with 254 ± 146 min/day in SB bouts ≥ 60 min. DURATION Time spent in bouts of SB ≥ 60-min. was negatively associated with self-efficacy for overcoming barriers to light physical activity (P<0.05), balance (P<0.05), chair stand test (P<0.05), FEV1% predicted (P<0.05) and positively associated with BMI (P<0.001). CONCLUSIONS Inactive people with COPD engage in extensive SB, much of it in prolonged bouts. Self-efficacy, balance, and lower body strength are modifiable variables associated with SB and potential targets for future interventions to reduce time in prolonged sedentary behavior.
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Affiliation(s)
- Katelyn E Webster-Dekker
- University of Michigan School of Nursing, Ann Arbor, 400 North Ingalls Building, Ann Arbor, MI 48109, USA; Indiana University School of Nursing, 600 Barnhill Dr, Indianapolis, IN 46202, USA.
| | - Weijiao Zhou
- University of Michigan School of Nursing, Ann Arbor, 400 North Ingalls Building, Ann Arbor, MI 48109, USA; Peking University School of Nursing, 38 Xueyuan Rd, Haidian District, Beijing 100191, China.
| | - Seoyoon Woo
- University of Michigan School of Nursing, Ann Arbor, 400 North Ingalls Building, Ann Arbor, MI 48109, USA; University of North Carolina Wilmington School of Nursing, McNeill Hall 3089, Wilmington, NC 28403, USA.
| | - Jung Yoen Son
- University of Michigan School of Nursing, Ann Arbor, 400 North Ingalls Building, Ann Arbor, MI 48109, USA.
| | - Robert Ploutz-Snyder
- University of Michigan School of Nursing, Ann Arbor, 400 North Ingalls Building, Ann Arbor, MI 48109, USA.
| | - Janet L Larson
- University of Michigan School of Nursing, Ann Arbor, 400 North Ingalls Building, Ann Arbor, MI 48109, USA.
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Urroz Guerrero PD, Oliveira JM, Lewthwaite H, Gibson PG, McDonald VM. Key Considerations When Addressing Physical Inactivity and Sedentary Behaviour in People with Asthma. J Clin Med 2023; 12:5998. [PMID: 37762938 PMCID: PMC10531510 DOI: 10.3390/jcm12185998] [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: 08/02/2023] [Revised: 09/06/2023] [Accepted: 09/13/2023] [Indexed: 09/29/2023] Open
Abstract
People with asthma tend to be less physically active and more sedentary than people without asthma. This narrative review aimed to present key considerations when addressing physical inactivity and sedentary behaviour in people with asthma by identifying barriers and facilitators, determinants and correlates, and intervention approaches. Using a search strategy, electronic databases were searched for relevant studies. Data extracted from studies were qualitatively synthesised. A total of 26 studies were included in the review. Six studies reported asthma symptoms as a barrier to physical activity, while four studies reported having a supportive network as a physical activity facilitator. Across studies, physical activity correlates/determinants were pulmonary function, exercise capacity, body mass index, dyspnoea, psychological health, and asthma control. Interventions that effectively improved physical activity in the short term were a step-based prescription programme, a weight loss programme incorporating aerobic and resistance training, and a weight loss lifestyle intervention, while a high-intensity interval training pulmonary rehabilitation program was effective in the long term. The collective findings suggest that a personalised physical activity programme incorporating different strategies is needed. There was minimal evidence to provide recommendations to optimise sedentary behaviour in asthma, and more research is needed on the topic.
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Affiliation(s)
- Paola D. Urroz Guerrero
- National Health and Medical Research Council, Centre of Excellence in Treatable Traits, Newcastle, NSW 2305, Australia; (P.D.U.G.); (H.L.); (P.G.G.)
- Asthma and Breathing Program, Hunter Medical Research Institute, Newcastle, NSW 2305, Australia;
- School of Nursing and Midwifery, University of Newcastle, Newcastle, NSW 2308, Australia
| | - Joice M. Oliveira
- Asthma and Breathing Program, Hunter Medical Research Institute, Newcastle, NSW 2305, Australia;
- School of Nursing and Midwifery, University of Newcastle, Newcastle, NSW 2308, Australia
- Graduate Program in Rehabilitation Sciences, Pitagoras Unopar University, Londrina 86041-140, PR, Brazil
- Laboratory of Research in Respiratory Physiotherapy, Department of Physiotherapy, State University of Londrina, Londrina 86038-350, PR, Brazil
| | - Hayley Lewthwaite
- National Health and Medical Research Council, Centre of Excellence in Treatable Traits, Newcastle, NSW 2305, Australia; (P.D.U.G.); (H.L.); (P.G.G.)
- Asthma and Breathing Program, Hunter Medical Research Institute, Newcastle, NSW 2305, Australia;
- School of Nursing and Midwifery, University of Newcastle, Newcastle, NSW 2308, Australia
| | - Peter G. Gibson
- National Health and Medical Research Council, Centre of Excellence in Treatable Traits, Newcastle, NSW 2305, Australia; (P.D.U.G.); (H.L.); (P.G.G.)
- Asthma and Breathing Program, Hunter Medical Research Institute, Newcastle, NSW 2305, Australia;
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW 2308, Australia
- Department of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle, NSW 2305, Australia
| | - Vanessa M. McDonald
- National Health and Medical Research Council, Centre of Excellence in Treatable Traits, Newcastle, NSW 2305, Australia; (P.D.U.G.); (H.L.); (P.G.G.)
- Asthma and Breathing Program, Hunter Medical Research Institute, Newcastle, NSW 2305, Australia;
- School of Nursing and Midwifery, University of Newcastle, Newcastle, NSW 2308, Australia
- Department of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle, NSW 2305, Australia
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Byron C, Osadnik CR. Physical Activity Profiles among Patients Admitted with Acute Exacerbations of Chronic Obstructive Pulmonary Disease. J Clin Med 2023; 12:4914. [PMID: 37568317 PMCID: PMC10419862 DOI: 10.3390/jcm12154914] [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: 06/08/2023] [Revised: 07/21/2023] [Accepted: 07/25/2023] [Indexed: 08/13/2023] Open
Abstract
People with hospitalised acute exacerbations of chronic obstructive pulmonary disease (AECOPD) exhibit low levels of physical activity (PA) and increased risks of future exacerbations. While methods to objectively measure and express PA are established for people with stable COPD, less clarity exists for people during AECOPD. Further, the relationship between PA during AECOPD and clinically relevant outcomes remains uncertain. The purpose of the study was to evaluate how much PA (step count and intensity) people accumulate during hospitalised AECOPDs, and the effect of accumulated inpatient PA (expressed via differing metrics) on length of stay (LOS), PA recovery, and readmission risk. This study was a secondary analysis of prospective observational cohort data collected with Actigraph wActiSleep-BT devices from patients with AECOPD in a Melbourne hospital from 2016 to 2018. Step counts and PA intensity throughout the hospital admission and at one-month follow-up were collected and analysed. Sixty-eight participants were recruited for inpatient measurement, and 51 were retained for follow-up. There were no significant changes in step count or intensity across the inpatient days, but 33/51 (65%) of participants demonstrated a clinically meaningful improvement in steps per day from 3817.0 to 6173.7 at follow-up. Participants spent most time sedentary and in light PA, with both PA metrics demonstrating significant influences on LOS and follow-up PA intensity, but with generally low explanatory power (R2 value range 7-22%). Those who had LOS < 5 days spent significantly less time sedentary and more time in light PA than those with LOS ≥ 5 days (p < 0.001 for both). Time spent sedentary or in light PA appears to be the most promising metric to associate with clinically relevant outcomes related to recovery following AECOPD. These findings can inform future clinical practice for the evaluation of inpatient PA to better establish its role in the clinical management of patients with AECOPD.
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Affiliation(s)
- Christopher Byron
- Department of Physiotherapy, Monash University, Melbourne 3199, Australia;
| | - Christian R. Osadnik
- Department of Physiotherapy, Monash University, Melbourne 3199, Australia;
- Monash Lung Sleep Allergy Immunology, Monash Health, Melbourne 3168, Australia
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7
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Bertoche MP, Furlanetto KC, Hirata RP, Sartori L, Schneider LP, Mantoani LC, Brito I, Dala Pola DC, Hernandes NA, Pitta F. Assessment of sedentary behaviour in individuals with COPD: how many days are necessary? ERJ Open Res 2023; 9:00732-2022. [PMID: 37650084 PMCID: PMC10463027 DOI: 10.1183/23120541.00732-2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 06/09/2023] [Indexed: 09/01/2023] Open
Abstract
Objective The objective of the present study was to define the minimum number of monitoring days required for the adequate cross-sectional assessment of sedentary behaviour in individuals with chronic obstructive pulmonary disease (COPD). Methods In this cross-sectional study, the sedentary behaviour of individuals with COPD was assessed using two physical activity monitors during awake time for seven consecutive days. Time spent per day in activities requiring ≤1.5 metabolic equivalents (METs) and in sitting, lying and sitting+lying positions was calculated taking into account the average of 7 days (as a reference in all analyses) and of all 119 possible combinations of 2---6 days. Intraclass correlation coefficients (ICCs) and linear regression analyses were performed for all combinations. Results 91 individuals were analysed (47 female, 66±9 years, forced expiratory volume in 1 s 50±15% predicted). For the variables time spent per day in activities ≤1.5METs and sitting, the average of any combination of at least four assessment days was sufficient to adequately reflect the average of 7 days (adjusted R2≥0.929, ICC≥0.962, p<0.0001 for all). For time spent per day lying and sitting+lying, only two assessment days were enough (adjusted R2≥0.937, ICC≥0.968, p<0.0001 for all). Results were maintained independently of patient sex, disease severity, day of the week, daylight time or daytime naps. Conclusions The average of 4 days of objective monitoring was sufficient to adequately reflect the results of a 1-week assessment of the main outcomes related to sedentary behaviour in individuals with moderate to very severe COPD, regardless of sex, disease severity, day of the week, daylight time and occurrence of daytime naps.
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Affiliation(s)
- Mariana Pereira Bertoche
- Laboratory of Research in Respiratory Physiotherapy, Department of Physiotherapy, Universidade Estadual de Londrina, Londrina, Paraná, Brazil
| | - Karina Couto Furlanetto
- Laboratory of Research in Respiratory Physiotherapy, Department of Physiotherapy, Universidade Estadual de Londrina, Londrina, Paraná, Brazil
- Biological and Health Sciences Research Center, Stricto Sensu Graduate Program in Rehabilitation Sciences, Universidade Pitagoras – UNOPAR, Londrina, Paraná, Brazil
| | - Raquel Pastrello Hirata
- Laboratory of Research in Respiratory Physiotherapy, Department of Physiotherapy, Universidade Estadual de Londrina, Londrina, Paraná, Brazil
| | - Larissa Sartori
- Laboratory of Research in Respiratory Physiotherapy, Department of Physiotherapy, Universidade Estadual de Londrina, Londrina, Paraná, Brazil
| | - Lorena Paltanin Schneider
- Laboratory of Research in Respiratory Physiotherapy, Department of Physiotherapy, Universidade Estadual de Londrina, Londrina, Paraná, Brazil
| | - Leandro Cruz Mantoani
- Laboratory of Research in Respiratory Physiotherapy, Department of Physiotherapy, Universidade Estadual de Londrina, Londrina, Paraná, Brazil
| | - Igor Brito
- Laboratory of Research in Respiratory Physiotherapy, Department of Physiotherapy, Universidade Estadual de Londrina, Londrina, Paraná, Brazil
| | - Daniele Caroline Dala Pola
- Laboratory of Research in Respiratory Physiotherapy, Department of Physiotherapy, Universidade Estadual de Londrina, Londrina, Paraná, Brazil
| | - Nidia Aparecida Hernandes
- Laboratory of Research in Respiratory Physiotherapy, Department of Physiotherapy, Universidade Estadual de Londrina, Londrina, Paraná, Brazil
| | - Fabio Pitta
- Laboratory of Research in Respiratory Physiotherapy, Department of Physiotherapy, Universidade Estadual de Londrina, Londrina, Paraná, Brazil
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8
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Cheng SWM, Alison JA, Stamatakis E, Dennis SM, McKeough ZJ. Validity and Accuracy of Step Count as an Indicator of a Sedentary Lifestyle in People With Chronic Obstructive Pulmonary Disease. Arch Phys Med Rehabil 2023:S0003-9993(23)00097-7. [PMID: 36775005 DOI: 10.1016/j.apmr.2023.01.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 01/04/2023] [Accepted: 01/25/2023] [Indexed: 02/12/2023]
Abstract
OBJECTIVE To determine the validity and accuracy of <5000 steps/day as a sedentary lifestyle indicator, and the optimal step count cut point value for indicating a sedentary lifestyle in people with chronic obstructive pulmonary disease (COPD). DESIGN Analysis of baseline data from a randomized clinical trial. SETTING Sydney, Australia. PARTICIPANTS Stable COPD on the waitlist for pulmonary rehabilitation. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Step count and time in sedentary behavior (SB) were assessed using thigh-worn accelerometry. A sedentary lifestyle was defined as <5000 steps/day. Pearson correlation coefficients were analyzed between step count and time spent in SB. Sensitivity, specificity, and accuracy were calculated for the <5000 steps/day threshold. Receiver operating characteristic curves with the area under the curve were computed for step count in identifying a sedentary lifestyle. RESULTS 69 people with COPD (mean age=74 years, SD=9; forced expiratory volume in 1 second, mean=55%, SD=19 predicted) had sufficient wear data for analysis. There was a moderate inverse correlation between step count and time spent in SB (r=-0.58, P<.001). Step count had a fair discriminative ability for identifying a sedentary lifestyle (area under the curve=0.80, 95% confidence interval [CI], 0.68-0.91). The <5000 steps/day threshold had a sensitivity, specificity, and accuracy of 82% (95% CI, 70-94), 70% (95% CI, 54-86), and 78%, respectively. A lower threshold of <4300 steps/day was more accurate for ruling in a sedentary lifestyle. CONCLUSIONS Compared with thigh-worn accelerometry, <5000 steps/day is a valid and reasonably accurate indicator of a sedentary lifestyle in this population.
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Affiliation(s)
- Sonia W M Cheng
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
| | - Jennifer A Alison
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia; Allied Health Professorial Unit, Sydney Local Health District, Sydney, Australia
| | - Emmanuel Stamatakis
- Charles Perkins Centre, School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Sarah M Dennis
- Allied Health Professorial Unit, Sydney Local Health District, Sydney, Australia; Ingham Institute for Applied Medical Research, Sydney, Australia; Allied Health Professorial Unit, South Western Sydney Local Health District, Sydney, Australia
| | - Zoe J McKeough
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
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Valeiro B, Rodríguez E, Pérez P, Gómez A, Mayer AI, Pasarín A, Ibañez J, Ferrer J, Ramon MA. Promotion of physical activity after hospitalization for COPD exacerbation: A randomized control trial. Respirology 2022; 28:357-365. [PMID: 36270673 DOI: 10.1111/resp.14394] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 10/06/2022] [Indexed: 01/21/2023]
Abstract
BACKGROUND AND OBJECTIVE Physical activity worsens during exacerbations of chronic obstructive pulmonary disease (COPD) and notably after hospitalizations. Pedometer-based interventions are useful to increase physical activity in stable patients with COPD. However, there is little information concerning the implementation of such programs following severe exacerbation. This study assessed the efficacy of a physical activity program after hospitalization for a COPD exacerbation. METHODS We performed a prospective, 12-week, parallel group, assessor-blinded, randomized control trial in COPD patients hospitalized for an exacerbation. After discharge, physical activity and other secondary variables were assessed. Patients were allocated (1:1) to a physical activity promotion program (intervention group, IG) or usual care (control group, CG). Based on a motivational interview and accelerometer physical activity assessment, a patient-tailored, pedometer-based, progressive and target-driven program was designed. Linear mixed effect models were used to analyse between-group differences. RESULTS Forty-six out of 61 patients recruited were randomized and 43 (IG = 20, CG = 23) completed the study. In-hospital and baseline characteristics were similar in both groups. After 12 weeks of intervention, the mean steps difference between groups was 2093 steps/day, p = 0.018, 95% CI 376-4012, favouring the IG. Only the IG significantly increased the number of steps/day compared to baseline (mean difference [95% CI] 2932 [1069-4795] steps; p = 0.004). There were no other between-group differences. CONCLUSION After hospitalization for a COPD exacerbation, a patient-tailored physical activity program based on a motivational interview and the use of pedometers, with progressive and customized targets, improved the number of steps/day.
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Affiliation(s)
- Beatriz Valeiro
- Servicio de Neumología, Hospital Universitari Vall d'Hebron, Departamento de Medicina, Universidad Autónoma de Barcelona (UAB), Barcelona, Spain
| | - Esther Rodríguez
- Servicio de Neumología, Hospital Universitari Vall d'Hebron, Departamento de Medicina, Universidad Autónoma de Barcelona (UAB), Barcelona, Spain.,CIBER Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Paula Pérez
- Servicio de Neumología, Hospital Universitari Vall d'Hebron, Departamento de Medicina, Instituto de Investigación Vall d'Hebron (VHIR), Barcelona, Spain
| | - Alba Gómez
- Servicio de Rehabilitación, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Ana Isabel Mayer
- Servicio de Rehabilitación, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Alejandro Pasarín
- Servicio de Rehabilitación, Sant Rafael Hospital, Germanes Hospitalaries, Barcelona, Spain
| | - Jordi Ibañez
- Servicio de Medicina Interna, Sant Rafael Hospital, Germanes Hospitalaries, Barcelona, Spain
| | - Jaume Ferrer
- Servicio de Neumología, Hospital Universitari Vall d'Hebron, Departamento de Medicina, Universidad Autónoma de Barcelona (UAB), Barcelona, Spain.,CIBER Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Maria Antonia Ramon
- Servicio de Neumología, Hospital Universitari Vall d'Hebron, Departamento de Medicina, Universidad Autónoma de Barcelona (UAB), Barcelona, Spain.,CIBER Enfermedades Respiratorias (CIBERES), Madrid, Spain
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10
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Xiang X, Huang L, Fang Y, Cai S, Zhang M. Physical activity and chronic obstructive pulmonary disease: a scoping review. BMC Pulm Med 2022; 22:301. [PMID: 35932050 PMCID: PMC9354440 DOI: 10.1186/s12890-022-02099-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 07/31/2022] [Indexed: 11/25/2022] Open
Abstract
Background Reduced physical activity (PA) was the strongest predictor of all-cause mortality in patients with chronic obstructive pulmonary disease (COPD). This scoping review aimed to map the evidence on the current landscape of physical activity, barriers and facilitators, and assessment tools across COPD patients. Methods Arksey and O’Malley’s scoping review methodology framework guided the conduct of this review. An electronic search was conducted on five English databases (PubMed, Cochrane Library, PsycINFO, CINAHL and Web of Science) and three Chinese databases (CNKI, CQVIP and WAN-FANG) in January 2022. Two authors independently screened the literature, extracted the studies characteristics. Results The initial search yielded 4389 results, of which 1954 were duplicates. Of the remaining 135 articles, 42 studies met the inclusion criteria. Among the reviewed articles, there were 14 (33.3%) cross-sectional study, 9 (21.4%) cohort study, 4 (9.5%) longitudinal study, 3 qualitative study, 12 (28.7%) randomized control trials. The main barriers identified were older age, women, lung function, comorbidities, COPD symptoms (fear of breathlessness and injury, severe fatigue, anxiety and depression), GOLD stage, frequency of exacerbation, oxygen use, lack of motivation and environment-related (e.g., season and weather). Twelve studies have evaluated the effects of physical exercise (e.g., walking training, pulmonary rehabilitation (PR), pedometer, self-efficacy enhancing intervention and behavioral modification intervention) on PA and showed significant positive effects on the prognosis of patients. However, in real life it is difficult to maintain PA in people with COPD. Conclusions Changing PA behavior in patients with COPD requires multidisciplinary collaboration. Future studies need to identify the best instruments to measure physical activity in clinical practice. Future studies should focus on the effects of different types, time and intensity of PA in people with COPD and conduct randomized, adequately-powered, controlled trials to evaluate the long-term effectiveness of behavioral change interventions in PA. Supplementary Information The online version contains supplementary material available at 10.1186/s12890-022-02099-4.
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Affiliation(s)
- Xinyue Xiang
- Department of Nursing, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Lihua Huang
- Department of Nursing, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China.
| | - Yong Fang
- Department of Nursing, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Shasha Cai
- Department of Nursing, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Mingyue Zhang
- Department of Nursing, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
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11
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Coll F, Cavalheri V, Gucciardi DF, Wulff S, Hill K. Quantifying the Effect of Monitor Wear Time and Monitor Type on the Estimate of Sedentary Time in People with COPD: Systematic Review and Meta-Analysis. J Clin Med 2022; 11:jcm11071980. [PMID: 35407588 PMCID: PMC8999633 DOI: 10.3390/jcm11071980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 03/24/2022] [Accepted: 03/30/2022] [Indexed: 01/25/2023] Open
Abstract
In studies that have reported device-based measures of sedentary time (ST) in people with chronic obstructive pulmonary disease (COPD), we explored if the monitor type and monitor wear time moderated the estimate of this measure. Five electronic databases were searched in January 2021. Studies were included if >70% of participants had stable COPD, and measures of ST (min/day) were collected using wearable technology. Meta-regression was used to examine the influence of moderators on ST, monitor type, and wear time. The studies identified were a total of 1153, and 36 had usable data for meta-analyses. The overall pooled estimate of ST (mean [95% CI]) was 524 min/day [482 to 566] with moderate heterogeneity among effect sizes (I2 = 42%). Monitor wear time, as well as the interaction of monitor wear time and monitor type, were moderators of ST (p < 0.001). The largest difference (−318 min; 95% CI [−212 to −424]) was seen between studies where participants wore a device without a thigh inclinometer for 24 h (and removed sleep during analysis) (675 min, 95% CI [589 to 752]) and studies where participants wore a device with a thigh inclinometer for 12 h only (356 min; 95% CI [284 to 430]). In people with COPD, the monitor wear time and the interaction of the monitor wear time and the monitor type moderated the estimate of ST.
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Affiliation(s)
- Fiona Coll
- Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, WA 6102, Australia; (F.C.); (V.C.); (D.F.G.)
- Physiotherapy Department, Royal Perth Hospital, Perth, WA 6000, Australia;
| | - Vinicius Cavalheri
- Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, WA 6102, Australia; (F.C.); (V.C.); (D.F.G.)
- Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, WA 6102, Australia
- Allied Health, South Metropolitan Health Service, Perth, WA 6150, Australia
- Exercise Medicine Research Institute, Edith Cowan University, Perth, WA 6027, Australia
| | - Daniel F. Gucciardi
- Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, WA 6102, Australia; (F.C.); (V.C.); (D.F.G.)
- Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, WA 6102, Australia
| | - Sheldon Wulff
- Physiotherapy Department, Royal Perth Hospital, Perth, WA 6000, Australia;
| | - Kylie Hill
- Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, WA 6102, Australia; (F.C.); (V.C.); (D.F.G.)
- Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, WA 6102, Australia
- Institute for Respiratory Health, Sir Charles Gairdner Hospital, Nedlands, WA 6009, Australia
- Correspondence: ; Tel.: +61-8-9226-2774
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12
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Chang C, Wong J, Kamari AI, Hui Cheah SC, Chan MA, Zainuldin R. Understanding perspectives and choices for sedentary behaviour and physical activity in older adults’ post-acute exacerbation of chronic obstructive pulmonary disease. PROCEEDINGS OF SINGAPORE HEALTHCARE 2021. [DOI: 10.1177/20101058211066418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Individuals recovering from acute exacerbation of chronic obstructive pulmonary disease (AECOPD) are most likely to exhibit sedentary behaviour (SB) and low levels of physical activity (PA). This study seeks to explore their choices for adopting current patterns of SB and PA post AECOPD and add to current literature on stable COPD. Method A semi-structured interview, based on the broad framework of the Behaviour Change Wheel, was conducted on patients post AECOPD. A phenomenological approach was utilised inductively. Results Six participants were interviewed at their homes. Four major themes were identified: (1) low perceived capabilities for engaging in PA; (2) limited understanding on COPD and PA; (3) lack of translation of health knowledge and intentions into actions; and (4) poor adherence to movement-advice from physiotherapist. Conclusion Our findings revealed largely psychological and behavioural deficits influencing SB and PA in people post AECOPD, similar to those in stable COPD.
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Affiliation(s)
- Chevonne Chang
- Physiotherapy, Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore
| | - John Wong
- Physiotherapy, Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore
| | - Ahmad Iqbal Kamari
- Physiotherapy, Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore
| | | | - Mark A Chan
- Physiotherapy, Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore
| | - Rahizan Zainuldin
- Physiotherapy, Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore
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Wshah A, Selzler AM, Hill K, Brooks D, Goldstein R. Embedding a Behavior Change Program Designed to Reduce Sedentary Time Within a Pulmonary Rehabilitation Program Is Feasible in People With COPD. J Cardiopulm Rehabil Prev 2021; 42:45-51. [PMID: 34520411 DOI: 10.1097/hcr.0000000000000624] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE This study examined the feasibility of embedding a 4-wk intervention, which sought to reduce sedentary time (SED), into a pulmonary rehabilitation program (PRP) in people with chronic obstructive pulmonary disease. METHODS This was an intervention study that comprised one face-to-face session and three follow-up visits. Primary outcomes related to feasibility and included adherence to data completion undertaken before and during the intervention period, participant satisfaction with the intervention (out of 100%), and participant achievement of intervention goals. Secondary outcomes, collected before and after the intervention period, included SED and daily step count. RESULTS Of 28 eligible individuals approached to participate, 21 (75%) were enrolled and 19 (90%) completed the program (13 females; age 69.1 ± 8.7 yr). Sixteen participants (84%) were adherent to wearing a physical activity monitor before and during the intervention period. The satisfaction score was 90 ± 12%. Over the intervention period, a total of 73 intervention goals were set, of which 41 (56%) were achieved. The effect of the intervention on SED was unclear. CONCLUSIONS Embedding this intervention in a PRP appears to be feasible; however, its impact on SED should be further evaluated.
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Affiliation(s)
- Adnan Wshah
- Respiratory Medicine, West Park Healthcare Centre, Toronto, Ontario, Canada (Drs Wshah, Selzler, Brooks, and Goldstein); Rehabilitation Sciences Institute (Drs Wshah, Brooks, and Goldstein) and Department of Medicine (Drs Brooks and Goldstein), University of Toronto, Toronto, Ontario, Canada; Department of Physical and Occupational Therapy, Hashemite University, Zarqa, Jordan (Dr Wshah); School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia (Dr Hill); and School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada (Dr Brooks)
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14
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Prediction framework for upper body sedentary working behaviour by using deep learning and machine learning techniques. Soft comput 2021; 26:12969-12984. [PMID: 34456620 PMCID: PMC8385485 DOI: 10.1007/s00500-021-06156-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/13/2021] [Indexed: 11/19/2022]
Abstract
Public health experts and healthcare professionals are gradually identifying sedentary activity as a population-wide, pervasive health risk. The purpose of this paper is to propose a method to identify the changes in posture during sedentary work and to give feedback by analysing the identified posture of the upper body, i.e. hands, shoulder, and head positioning. After capturing the image of the human pose, pre-processing of the image takes place with a bandpass filter, which helps to reduce the noise and morphological operation, which is used to carry out the process of dilation, erosion and opening of an image. To predict the results easily with the use of texture feature extraction, it helps to extract the image’s feature. Then, accuracy is predicted by using the deep neural network techniques, to predict the result accurately. After prediction and analysis, the feedback system is developed to alert individuals through the alarm system. The proposed method is formulated by using DNN for prediction in the MATLAB software tool. The results show accuracy, sensitivity and specificity of the prediction using a deep neural network are 97.2%, 88.7% and 99.1%. The proposed method is compared with the existing methods SVM, Random Forest and KNN algorithms. The accuracy, sensitivity and specificity of the existing algorithms are SVM with 77.6%, 57.4 and 97.8%; Random Forest with 80.6%, 63.7% and 97.5%; and KNN with 65.8%, 61.2%, and 95.1%. This concept helps to prevent the impact of sedentary activity on fatal and non-fatal cardiovascular and musculoskeletal diseases, respectively.
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15
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Cheng SWM, Alison J, Stamatakis E, Dennis S, McNamara R, Spencer L, McKeough Z. Six-week behaviour change intervention to reduce sedentary behaviour in people with chronic obstructive pulmonary disease: a randomised controlled trial. Thorax 2021; 77:231-238. [PMID: 34226203 DOI: 10.1136/thoraxjnl-2020-214885] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 06/02/2021] [Indexed: 11/03/2022]
Abstract
INTRODUCTION This study aimed to determine whether a 6-week behaviour change intervention was more effective than a sham intervention for reducing sedentary behaviour (SB) in people with chronic obstructive pulmonary disease (COPD). METHODS People with stable COPD on the waitlist for entry into pulmonary rehabilitation were recruited to this multicentre trial with randomisation (independent, concealed allocation) to either an intervention group or sham group, assessor blinding and intention-to-treat (ITT) analysis. The behaviour change intervention consisted of once weekly sessions for 6 weeks with a physiotherapist to reduce SB through education, guided goals setting and real-time feedback on SB. The sham intervention consisted of once weekly phone calls for 6 weeks to monitor health status. SB was measured continuously over 7 days using thigh-worn accelerometry (activPAL3 micro). The primary outcome was time spent in SB. Participants with at least 4 days of ≥10 hours waking wear time were included in the ITT analysis and those who reported achieving ≥70% of goals to reduce SB or who completed all sham calls were included in a per-protocol analysis. RESULTS 70 participants were recruited and 65 completed the study (mean±SD age 74±9 years, mean FEV1 55%±19% predicted, 49% male). At 6 weeks, no between-group differences in time spent in SB were observed in the ITT analysis (mean difference 5 min/day, 95% CI -38 to 48) or per-protocol analysis (-16 min/day, 95% CI -80 to 48). DISCUSSION A 6-week behaviour change intervention did not reduce time in SB compared with a sham intervention in people with stable moderate-to-severe COPD prior to pulmonary rehabilitation.
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Affiliation(s)
- Sonia Wing Mei Cheng
- Discipline of Physiotherapy, The University of Sydney, Sydney, New South Wales, Australia .,Department of Physiotherapy, Macquarie University Hospital, Sydney, New South Wales, Australia
| | - Jennifer Alison
- Discipline of Physiotherapy, The University of Sydney, Sydney, New South Wales, Australia.,Allied Health Professorial Unit, Sydney Local Health District, Sydney, New South Wales, Australia
| | - Emmanuel Stamatakis
- Charles Perkins Centre, School of Public Health, Prevention Research Collaboration, The University of Sydney, Sydney, New South Wales, Australia
| | - Sarah Dennis
- Discipline of Physiotherapy, The University of Sydney, Sydney, New South Wales, Australia.,Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia
| | - Renae McNamara
- Department of Physiotherapy, Prince of Wales Hospital and Community Health Services, Randwick, New South Wales, Australia.,Woolcock Emphysema Centre, Woolcock Institute of Medical Research, Sydney, New South Wales, Australia
| | - Lissa Spencer
- Department of Physiotherapy, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - Zoe McKeough
- Discipline of Physiotherapy, The University of Sydney, Sydney, New South Wales, Australia
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Mendoza L, de Oca MM, López Varela MV, Casas A, Ramírez-Venegas A, López A, Ugalde L, Wehrmeister FC, Surmonti F, Menezes AMB, Miravitlles M. Physical Activity Levels and Associated Factors in a Latin American COPD Population of Patients. The LASSYC Study. COPD 2021; 18:393-400. [PMID: 34180756 DOI: 10.1080/15412555.2021.1937090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Reduced physical activity (PA) is an independent risk factor for lung function decline, hospitalization and mortality in chronic obstructive pulmonary disease (COPD) and affects a large proportion of patients from Europe and the United States. However, little is known of the level of PA of COPD patients in Latin America. The aim of this study was to provide information of the level of PA and its determinants in COPD patients in Latin America. This is an observational, cross-sectional study on patients with COPD in seven Latin American countries. PA level was evaluated with the short version of the International Physical Activity Questionnaire (IPAQ) and the association between PA and other variables was investigated. Complete information of PA level was obtained in 734 COPD patients consecutively recruited from specialized outpatient clinics; 448 (61%) were men, with a mean age of 69.6 years (standard deviation [SD] = 8.7) and a mean FEV1 (% predicted) = 49.1% (17.5%). In 37.9% the level of PA was low, and the average sitting time was 36.1 h per week. Patients with low levels of PA were older, with higher levels of dyspnea and higher CAT scores. Additionally, we found that patients with low level of PA presented more symptoms during the day. Low levels of PA have been observed in a large proportion of COPD patients of Latin America, which is higher in women and older patients and it is related with worse functional and clinical characteristics.
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Affiliation(s)
- Laura Mendoza
- Neumology Unit, Hospital Clínico Universidad de Chile, Santiago de Chile, Chile
| | - María Montes de Oca
- Hospital Universitario de Caracas, Universidad Central de Venezuela, Caracas, Venezuela
| | | | - Alejandro Casas
- Pneumology Department, Fundación Neumológica Colombiana, Universidad del Rosario, Bogotá, Colombia
| | | | - Ana López
- Hospital Privado Universitario de Córdoba, Córdoba, Argentina
| | | | | | | | - Ana M B Menezes
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Marc Miravitlles
- Department of Pneumology. Hospital Universitari Vall d´Hebron, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus; CIBER de Enfermedades Respiratorias (CIBERES), Barcelona, Spain
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