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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] [MESH Headings] [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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Palmberg L, Löppönen A, Hyvärinen M, Portegijs E, Rantanen T, Rantalainen T, Karavirta L. Physical Behavior Profiles Among Older Adults and Their Associations With Physical Capacity and Life-Space Mobility. J Aging Phys Act 2024; 32:472-479. [PMID: 38364819 DOI: 10.1123/japa.2023-0225] [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: 06/30/2023] [Revised: 11/21/2023] [Accepted: 01/02/2024] [Indexed: 02/18/2024]
Abstract
We identified data-driven multidimensional physical activity (PA) profiles using several novel accelerometer-derived metrics. Participants aged 75, 80, and 85 (n = 441) wore triaxial accelerometers for 3-7 days. PA profiles were formed with k-means cluster analysis based on PA minutes, intensity, fragmentation, sit-to-stand transitions, and gait bouts for men and women. Associations with physical capacity and life-space mobility were examined using age-adjusted general linear models. Three profiles emerged: "Exercisers" and "actives" accumulated relatively high PA minutes, with actives engaging in lighter intensity PA. "Inactives" had the highest activity fragmentation and lowest PA volume, intensity, and gait bouts. Inactives showed lower scores in physical capacity and life-space mobility compared with exercisers and actives. Exercisers and actives had similar physical capacity and life-space mobility, except female exercisers had higher walking speed in the 6-min walk test. Our findings demonstrate the importance of assessing PA as multidimensional behavior rather than focusing on a single metric.
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Affiliation(s)
- Lotta Palmberg
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyvaskyla, Jyvaskyla, Finland
| | - Antti Löppönen
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyvaskyla, Jyvaskyla, Finland
- Physical Activity, Sports and Health Research Group, Department of Movement Sciences, KU Leuven, Leuven, Belgium
| | - Matti Hyvärinen
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyvaskyla, Jyvaskyla, Finland
| | - Erja Portegijs
- Center for Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Taina Rantanen
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyvaskyla, Jyvaskyla, Finland
| | - Timo Rantalainen
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyvaskyla, Jyvaskyla, Finland
| | - Laura Karavirta
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyvaskyla, Jyvaskyla, Finland
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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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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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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 PMCID: PMC11348893 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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Mantoani LC, Furlanetto KC, Camillo CA, de Oliveira JM, Polastri C, Schneider LP, Zamboti CL, Hernandes NA, Pitta F. Comparison of Physical Activity Patterns among Three Major Chronic Respiratory Diseases. J Clin Med 2023; 12:6832. [PMID: 37959297 PMCID: PMC10650693 DOI: 10.3390/jcm12216832] [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: 09/19/2023] [Revised: 10/18/2023] [Accepted: 10/24/2023] [Indexed: 11/15/2023] Open
Abstract
Although the level of physical activity in daily life (PADL) plays a vital role concerning the health of subjects with chronic lung diseases, it remains uncertain how PADL patterns compare among different conditions. This study's objective was to compare the PADL levels of subjects with COPD, asthma and idiopathic pulmonary fibrosis (IPF); and to investigate PADL behaviour in different diseases' severity. Stable subjects who had not undergone pulmonary rehabilitation in the previous year were included. Subjects were divided into two subgroups according to disease severity: mild/moderate and severe/very severe. The primary outcome was time spent in moderate-to-vigorous physical activities (MVPA) (Actigraph GT3x) measured during one week over 12 h/day; other assessments included pulmonary function, peripheral muscle strength and exercise capacity. Comparisons among subgroups were corrected for age, BMI and sex. The analysis involved 119 subjects (47 asthma, 48 COPD and 24 IPF). Subjects with asthma had higher PADL levels than those with COPD and IPF (MVPA 18(14-22) vs. 8(4-12) vs. 7(1-12) min/day, respectively; p ancova = 0.002). Subjects with severe/very severe IPF had the lowest PADL level among all subgroups. Adult subjects with asthma have higher PADL levels than those with COPD and IPF, whereas patients with severe and very severe IPF are the most physically inactive subjects.
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Affiliation(s)
- Leandro Cruz Mantoani
- Laboratory of Research in Respiratory Physiotherapy (LFIP), Department of Physiotherapy, Londrina State University (UEL), Londrina 86047-970, Brazil; (K.C.F.); (C.A.C.); (J.M.d.O.); (C.P.); (L.P.S.); (C.L.Z.); (N.A.H.)
- Department of Physiotherapy, Faculty of Science and Technology, São Paulo State University (UNESP), Presidente Prudente 19060-080, Brazil
- Graduate Associated Program in Rehabilitation Sciences, University Pitagoras UNOPAR / UEL, Londrina 86041-140, Brazil
| | - Karina Couto Furlanetto
- Laboratory of Research in Respiratory Physiotherapy (LFIP), Department of Physiotherapy, Londrina State University (UEL), Londrina 86047-970, Brazil; (K.C.F.); (C.A.C.); (J.M.d.O.); (C.P.); (L.P.S.); (C.L.Z.); (N.A.H.)
- Graduate Associated Program in Rehabilitation Sciences, University Pitagoras UNOPAR / UEL, Londrina 86041-140, Brazil
| | - Carlos Augusto Camillo
- Laboratory of Research in Respiratory Physiotherapy (LFIP), Department of Physiotherapy, Londrina State University (UEL), Londrina 86047-970, Brazil; (K.C.F.); (C.A.C.); (J.M.d.O.); (C.P.); (L.P.S.); (C.L.Z.); (N.A.H.)
- Department of Physiotherapy, Faculty of Science and Technology, São Paulo State University (UNESP), Presidente Prudente 19060-080, Brazil
- Graduate Associated Program in Rehabilitation Sciences, University Pitagoras UNOPAR / UEL, Londrina 86041-140, Brazil
| | - Joice Mara de Oliveira
- Laboratory of Research in Respiratory Physiotherapy (LFIP), Department of Physiotherapy, Londrina State University (UEL), Londrina 86047-970, Brazil; (K.C.F.); (C.A.C.); (J.M.d.O.); (C.P.); (L.P.S.); (C.L.Z.); (N.A.H.)
| | - Cláudia Polastri
- Laboratory of Research in Respiratory Physiotherapy (LFIP), Department of Physiotherapy, Londrina State University (UEL), Londrina 86047-970, Brazil; (K.C.F.); (C.A.C.); (J.M.d.O.); (C.P.); (L.P.S.); (C.L.Z.); (N.A.H.)
| | - Lorena Paltanin Schneider
- Laboratory of Research in Respiratory Physiotherapy (LFIP), Department of Physiotherapy, Londrina State University (UEL), Londrina 86047-970, Brazil; (K.C.F.); (C.A.C.); (J.M.d.O.); (C.P.); (L.P.S.); (C.L.Z.); (N.A.H.)
| | - Camile Ludovico Zamboti
- Laboratory of Research in Respiratory Physiotherapy (LFIP), Department of Physiotherapy, Londrina State University (UEL), Londrina 86047-970, Brazil; (K.C.F.); (C.A.C.); (J.M.d.O.); (C.P.); (L.P.S.); (C.L.Z.); (N.A.H.)
- Department of Physiotherapy, Faculty of Science and Technology, São Paulo State University (UNESP), Presidente Prudente 19060-080, Brazil
| | - Nidia Aparecida Hernandes
- Laboratory of Research in Respiratory Physiotherapy (LFIP), Department of Physiotherapy, Londrina State University (UEL), Londrina 86047-970, Brazil; (K.C.F.); (C.A.C.); (J.M.d.O.); (C.P.); (L.P.S.); (C.L.Z.); (N.A.H.)
| | - Fabio Pitta
- Laboratory of Research in Respiratory Physiotherapy (LFIP), Department of Physiotherapy, Londrina State University (UEL), Londrina 86047-970, Brazil; (K.C.F.); (C.A.C.); (J.M.d.O.); (C.P.); (L.P.S.); (C.L.Z.); (N.A.H.)
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Murakami Y, Minakata Y, Kato M, Sasaki S, Azuma Y, Kawabe K, Ono H. Determinants of Activity Phenotype in Patients with Chronic Obstructive Pulmonary Disease. Int J Chron Obstruct Pulmon Dis 2023; 18:1919-1929. [PMID: 37671143 PMCID: PMC10476663 DOI: 10.2147/copd.s421755] [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: 05/19/2023] [Accepted: 08/15/2023] [Indexed: 09/07/2023] Open
Abstract
Introduction Physical activity (PA) and sedentary behavior (SB) have attracted attention in chronic obstructive pulmonary disease (COPD), and there have been efforts to evaluate PA and SB separately. The factors associated with the characteristics of the four activity phenotypes defined by the durations of PA and SB are largely unknown. The aim of this study was to clarify the factors that could differentiate each activity phenotype. Materials and Methods Study subjects were outpatients with stable COPD who were ≥40 years of age. We investigated the influence of 26 different factors on the activity phenotypes of COPD and extracted the factors that showed significant differences among the four activity phenotypes. Results Two hundred sixteen patients were included in the analysis. Exercise capacity and dyspnea were determinants that distinguished the low PA groups from the high PA groups. The pulmonary function and desaturation during exercise were factors that distinguished the high PA with low SB group from the low PA with high SB group. BMI, grip strength, upper arm circumference and HbA1c were higher in the low PA and low SB group than in the low PA and high SB group. Conclusion These factors could be the determinants discriminating activity phenotypes of patients with COPD.
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Affiliation(s)
- Yusuke Murakami
- Department of Respiratory Medicine, National Hospital Organization Wakayama Hospital, Wakayama, 644-0044, Japan
| | - Yoshiaki Minakata
- Department of Respiratory Medicine, National Hospital Organization Wakayama Hospital, Wakayama, 644-0044, Japan
| | - Mai Kato
- Department of Respiratory Medicine, National Hospital Organization Wakayama Hospital, Wakayama, 644-0044, Japan
| | - Seigo Sasaki
- Department of Respiratory Medicine, National Hospital Organization Wakayama Hospital, Wakayama, 644-0044, Japan
| | - Yuichiro Azuma
- Department of Respiratory Medicine, National Hospital Organization Wakayama Hospital, Wakayama, 644-0044, Japan
| | - Kazumi Kawabe
- Department of Respiratory Medicine, National Hospital Organization Wakayama Hospital, Wakayama, 644-0044, Japan
| | - Hideya Ono
- Department of Respiratory Medicine, National Hospital Organization Wakayama Hospital, Wakayama, 644-0044, Japan
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Minakata Y, Azuma Y, Sasaki S, Murakami Y. Objective Measurement of Physical Activity and Sedentary Behavior in Patients with Chronic Obstructive Pulmonary Disease: Points to Keep in Mind during Evaluations. J Clin Med 2023; 12:jcm12093254. [PMID: 37176694 PMCID: PMC10179547 DOI: 10.3390/jcm12093254] [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: 03/31/2023] [Revised: 04/24/2023] [Accepted: 04/26/2023] [Indexed: 05/15/2023] Open
Abstract
Objective measurement methods using accelerometers have become the mainstream approach for evaluating physical activity (PA) and sedentary behavior (SB). However, several problems face the objective evaluation of PA and SB in patients with chronic obstructive pulmonary disease (COPD). For example, indicators of PA differ depending on whether the accelerometer detects the kind of activity on the one hand, or its intensity on the other. Measured data are also strongly influenced by environmental factors (weather, season, employment status, etc.) and methodological factors (days with uncommon activities, non-wearing time, minimum required wearing time per day, minimum number of valid days required, etc.). Therefore, adjusting for these factors is required when evaluating PA or SB, especially when evaluating the effects of intervention. The exclusion of sleeping time, unification of total measurement time, and minimization of the required wearing time per day might be more important for the evaluation of ST than for evaluating PA. The lying-down-time-to-sitting-time ratio was shown to be larger in COPD patients than in healthy subjects. In this review, we clarified the problems encountered during objective evaluations of PA and SB in patients with COPD and encouraged investigators to recognize the presence of these problems and the importance of adjusting for them.
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Affiliation(s)
- Yoshiaki Minakata
- National Hospital Organization Wakayama Hospital, 1138 Wada, Mihama-Cho, Hidaka-gun, Wakayama 644-0044, Japan
| | - Yuichiro Azuma
- National Hospital Organization Wakayama Hospital, 1138 Wada, Mihama-Cho, Hidaka-gun, Wakayama 644-0044, Japan
| | - Seigo Sasaki
- National Hospital Organization Wakayama Hospital, 1138 Wada, Mihama-Cho, Hidaka-gun, Wakayama 644-0044, Japan
| | - Yusuke Murakami
- National Hospital Organization Wakayama Hospital, 1138 Wada, Mihama-Cho, Hidaka-gun, Wakayama 644-0044, Japan
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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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Oostrik L, Bourbeau J, Doiron D, Ross B, Zhi-Li P, Aaron SD, Chapman KR, Hernandez P, Maltais F, Marciniuk DD, O'Donnell D, Tan WC, Sin DD, Walker B, Janaudis-Ferreira T. Physical Activity and Symptom Burden in COPD: The Canadian Obstructive Lung Disease Study. CHRONIC OBSTRUCTIVE PULMONARY DISEASES (MIAMI, FLA.) 2023; 10:89-101. [PMID: 36563057 PMCID: PMC9995232 DOI: 10.15326/jcopdf.2022.0349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Background The relationship between symptom burden and physical activity (PA) in chronic obstructive pulmonary disease (COPD) remains poorly understood with limited data on undiagnosed individuals and those with mild to moderate disease. Objective The primary objective was to evaluate the relationship between symptom burden and moderate-to-vigorous intensity PA (MVPA) in individuals from a random population-based sampling mirroring the population at large. Methods Baseline participants of the Canadian Cohort Obstructive Lung Disease (n=1558) were selected for this cross-sectional sub-study. Participants with mild COPD (n=406) and moderate COPD (n=331), healthy individuals (n=347), and those at risk of developing COPD (n=474) were included. The Community Healthy Activities Model Program for Seniors (CHAMPS) questionnaire was used to estimate MVPA in terms of energy expenditure. High symptom burden was classified using the COPD Assessment Test ([CAT] ≥10). Results Significant associations were demonstrated between high symptom burden and lower MVPA levels in the overall COPD sample (β=-717.09; 95% confidence interval [CI]=-1079.78, -354.40; p<0.001) and in the moderate COPD subgroup (β=-694.1; 95% CI=-1206.54, -181.66; p=0.006). A total of 72% of the participants with COPD were previously undiagnosed. The undiagnosed participants had significantly higher MVPA than those with physician diagnosed COPD (β=-592.41 95% CI=-953.11, -231.71; p=0.001). Conclusion MVPA was found to be inversely related to symptom burden in a large general population sample that included newly diagnosed individuals, most with mild to moderate COPD. Assessment of symptom burden may help identify patients with lower MVPA, especially for moderate COPD and for relatively inactive individuals with mild COPD.
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Affiliation(s)
- Loes Oostrik
- Physical Therapy Sciences, Program in Clinical Health Sciences, University Medical Center Utrecht, Utrecht University, Netherlands
| | - Jean Bourbeau
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada.,Respiratory Epidemiology and Clinical Research Unit, Research Institute, McGill University Health Center, Montreal, Quebec, Canada.,Montreal Chest Institute, McGill University Health Centre, Montreal, Quebec, Canada
| | - Dany Doiron
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada.,Respiratory Epidemiology and Clinical Research Unit, Research Institute, McGill University Health Center, Montreal, Quebec, Canada
| | - Bryan Ross
- Montreal Chest Institute, McGill University Health Centre, Montreal, Quebec, Canada
| | - Pei Zhi-Li
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada.,Respiratory Epidemiology and Clinical Research Unit, Research Institute, McGill University Health Center, Montreal, Quebec, Canada
| | - Shawn D Aaron
- Ottawa Hospital Research Institute, Ottawa University, Ottawa, Canada
| | - Kenneth R Chapman
- Toronto General Hospital Research Institute, University of Toronto, Toronto, Canada
| | - Paul Hernandez
- Division of Respirology, Faculty of Medicine, Dalhousie University, Halifax, Canada
| | - Francois Maltais
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Quebec, Canada
| | - Darcy D Marciniuk
- Respiratory Research Centre, University of Saskatchewan, Saskatoon, Canada
| | - Denis O'Donnell
- Division of Respiratory and Critical Care Medicine, Queen's University, Kingston, Canada
| | - Wan C Tan
- Centre for Heart Lung Innovation, University of British Columbia, St Paul's Hospital, Vancouver, Canada
| | - Don D Sin
- Centre for Heart Lung Innovation, University of British Columbia, St Paul's Hospital, Vancouver, Canada
| | - Brandie Walker
- Department of Medicine, University of Calgary, Alberta, Canada
| | - Tania Janaudis-Ferreira
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada.,Respiratory Epidemiology and Clinical Research Unit, Research Institute, McGill University Health Center, Montreal, Quebec, Canada.,School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada
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11
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Kingsnorth AP, Rowlands AV, Maylor BD, Sherar LB, Steiner MC, Morgan MD, Singh SJ, Esliger DW, Orme MW. A More Intense Examination of the Intensity of Physical Activity in People Living with Chronic Obstructive Pulmonary Disease: Insights from Threshold-Free Markers of Activity Intensity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12355. [PMID: 36231652 PMCID: PMC9564743 DOI: 10.3390/ijerph191912355] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 09/26/2022] [Accepted: 09/27/2022] [Indexed: 06/16/2023]
Abstract
Physical activity (PA) intensity of people living with chronic obstructive pulmonary disease (COPD) is typically evaluated using intensity thresholds developed in younger, healthier populations with greater exercise capacity and free from respiratory symptoms. This study therefore compared (i) PA differences between COPD and non-COPD controls using both traditional intensity thresholds and threshold-free metrics that represent the volume and intensity of the whole PA profile, and (ii) explored the influence of exercise capacity on observed differences. Moderate-to-vigorous physical activity (MVPA), average acceleration (proxy for volume, mg) and intensity distribution of activity were calculated for 76 individuals with COPD and 154 non-COPD controls from wrist-worn ActiGraph accelerometry. PA profiles representing the minimum intensity (acceleration, mg) during the most active accumulated 5-960 min were plotted. Estimated VO2peak and relative intensity were derived from the incremental shuttle walk test distance. Compared to the non-COPD control group, individuals with COPD recorded fewer MVPA minutes (59 vs. 83 min/day), lower overall waking activity (29.1 vs. 36.4 mg) and a poorer waking intensity distribution (-2.73 vs. -2.57). Individuals with COPD also recorded a lower absolute intensity (acceleration, mg) for their most active 5-960 min, but higher intensity relative to their estimated exercise capacity derived from the ISWT. People with COPD have a lower volume and absolute intensity of PA than controls but perform PA at a higher relative intensity. There is a need to move away from absolute intensity thresholds, and towards personalised or relative-intensity thresholds, to reflect reduced exercise capacity in COPD populations.
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Affiliation(s)
- Andrew P. Kingsnorth
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester LE5 4PW, UK
- NIHR Leicester Biomedical Research Centre, Leicester LE5 4PW, UK
| | - Alex V. Rowlands
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester LE5 4PW, UK
- NIHR Leicester Biomedical Research Centre, Leicester LE5 4PW, UK
| | - Benjamin D. Maylor
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester LE5 4PW, UK
- NIHR Leicester Biomedical Research Centre, Leicester LE5 4PW, UK
| | - Lauren B. Sherar
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK
| | - Michael C. Steiner
- Department of Respiratory Sciences, University of Leicester, Leicester LE1 9HN, UK
- Centre for Exercise and Rehabilitation Science, NIHR Leicester Biomedical Research Centre-Respiratory, Leicester LE3 9QP, UK
| | - Mike D. Morgan
- Department of Respiratory Sciences, University of Leicester, Leicester LE1 9HN, UK
- Centre for Exercise and Rehabilitation Science, NIHR Leicester Biomedical Research Centre-Respiratory, Leicester LE3 9QP, UK
| | - Sally J. Singh
- Department of Respiratory Sciences, University of Leicester, Leicester LE1 9HN, UK
- Centre for Exercise and Rehabilitation Science, NIHR Leicester Biomedical Research Centre-Respiratory, Leicester LE3 9QP, UK
| | - Dale W. Esliger
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK
| | - Mark W. Orme
- Department of Respiratory Sciences, University of Leicester, Leicester LE1 9HN, UK
- Centre for Exercise and Rehabilitation Science, NIHR Leicester Biomedical Research Centre-Respiratory, Leicester LE3 9QP, UK
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12
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Validation of Simple Prediction Equations for Step Count in Japanese Patients with Chronic Obstructive Pulmonary Disease. J Clin Med 2022; 11:jcm11195535. [PMID: 36233400 PMCID: PMC9571043 DOI: 10.3390/jcm11195535] [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: 08/09/2022] [Revised: 09/02/2022] [Accepted: 09/19/2022] [Indexed: 11/17/2022] Open
Abstract
Physical activity is decreased in patients with chronic obstructive pulmonary disease, and decreased physical activity leads to a poor prognosis. To determine an individual’s target step count from the measured step counts and predicted step counts, simple and detailed prediction equations for step count were developed. To verify the validity of the simple prediction equation, the validity of the simple equation was evaluated in a different cohort and the correlation between the step counts calculated by the simple equation and those by the detailed prediction equation were evaluated. When the step counts calculated by the simple prediction equation for all participants were compared with the measured step counts, a significant correlation was obtained among them, and the calculated values were found to be reproducible with the measured values in patients with a measured step count of <6500 by Bland−Altman plots. Furthermore, the values calculated by the simple prediction equation and those calculated by the detailed prediction equation showed a significant correlation. In conclusion, the simple prediction equation was considered reasonable.
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13
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Al Chikhanie Y, Bailly S, Amroussa I, Veale D, Hérengt F, Verges S. Clustering of COPD patients and their response to pulmonary rehabilitation. Respir Med 2022; 198:106861. [DOI: 10.1016/j.rmed.2022.106861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 04/09/2022] [Accepted: 04/23/2022] [Indexed: 11/26/2022]
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14
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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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15
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COPD profiles and treatable traits using minimal resources: identification, decision tree and stability over time. Respir Res 2022; 23:30. [PMID: 35164762 PMCID: PMC8842856 DOI: 10.1186/s12931-022-01954-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 02/08/2022] [Indexed: 12/11/2022] Open
Abstract
Abstract
Background and objective
Profiles of people with chronic obstructive pulmonary disease (COPD) often do not describe treatable traits, lack validation and/or their stability over time is unknown. We aimed to identify COPD profiles and their treatable traits based on simple and meaningful measures; to develop and validate a decision tree and to explore profile stability over time.
Methods
An observational, prospective study was conducted. Clinical characteristics, lung function, symptoms, impact of the disease (COPD Assessment Test—CAT), health-related quality of life, physical activity, lower-limb muscle strength and functional status were collected cross-sectionally and a subsample was followed-up monthly over six months. A principal component analysis and a clustering procedure with k-medoids were applied to identify profiles. A decision tree was developed and validated cross-sectionally. Stability was explored over time with the ratio between the number of timepoints that a participant was classified in the same profile and the total number of timepoints (i.e., 6).
Results
352 people with COPD (67.4 ± 9.9 years; 78.1% male; FEV1 = 56.2 ± 20.6% predicted) participated and 90 (67.6 ± 8.9 years; 85.6% male; FEV1 = 52.1 ± 19.9% predicted) were followed-up. Four profiles were identified with distinct treatable traits. The decision tree included CAT (< 18 or ≥ 18 points); age (< 65 or ≥ 65 years) and FEV1 (< 48 or ≥ 48% predicted) and had an agreement of 71.7% (Cohen’s Kappa = 0.62, p < 0.001) with the actual profiles. 48.9% of participants remained in the same profile whilst 51.1% moved between two (47.8%) or three (3.3%) profiles over time. Overall stability was 86.8 ± 15%.
Conclusion
Four profiles and treatable traits were identified with simple and meaningful measures possibly available in low-resource settings. A decision tree with three commonly used variables in the routine assessment of people with COPD is now available for quick allocation to the identified profiles in clinical practice. Profiles and treatable traits may change over time in people with COPD hence, regular assessments to deliver goal-targeted personalised treatments are needed.
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16
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A cluster analysis of device-measured physical activity behaviours and the association with chronic conditions, multi-morbidity and healthcare utilisation in adults aged 45 years and older. Prev Med Rep 2022; 24:101641. [PMID: 34976692 PMCID: PMC8684033 DOI: 10.1016/j.pmedr.2021.101641] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 10/06/2021] [Accepted: 11/13/2021] [Indexed: 02/06/2023] Open
Abstract
Most adults do not meet physical activity guidelines with negative implications for health. The aim of this study was to profile adults using multiple physical activity behaviours and to investigate associations with chronic conditions, multi-morbidity and healthcare utilisation. The study used data generated from a sample of adults aged 45 years and older (N = 485), recruited to the Move for Life randomised control trial. Participants wore an accelerometer for eight consecutive days. Hierarchical cluster analysis was conducted using the variables: moderate to vigorous intensity physical activity, light intensity physical activity, step count, waking sedentary time, standing time and bed hours. Descriptive statistics were used to investigate associations with self-reported number of chronic illnesses, multi-morbidity and healthcare utilisation. Four distinct physical activity behaviour profiles were identified: inactive-sedentary (n = 50, 10.3%), low activity (n = 295, 60.8%), active (n = 111, 22.9%) and very active (n = 29, 6%). The inactive-sedentary cluster had the highest prevalence of chronic illnesses, in particular, mental illness (p = 0.006) and chronic lung disease (p = 0.032), as well as multi-morbidity, complex multi-morbidity and healthcare utilisation. The prevalence of any practice nurse visit (p = 0.033), outpatient attendances (p = 0.04) and hospital admission (p = 0.034) were higher in less active clusters. The results have provided an insight into how physical activity behaviour is associated with chronic illness and healthcare utilisation. A group within the group has been identified that is more likely to be unwell. Provisions need to be made to reduce barriers for participation in physical activity for adults with complex multi-morbidity and very low physical activity.
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17
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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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18
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Effects of eccentric vs concentric cycling training on patients with moderate COPD. Eur J Appl Physiol 2021; 122:489-502. [PMID: 34799753 DOI: 10.1007/s00421-021-04850-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 11/12/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE The present study compared the effects of eccentric cycling (ECC) and conventional concentric cycling (CONC) training on muscle function, body composition, functional performance, and quality of life (QOL) of patients with moderate chronic obstructive pulmonary disease (COPD). METHODS Twenty patients (age: 69.6 ± 10.1 years, forced expiratory volume in 1-s: 73.2 ± 11.4% of predicted) were randomly allocated to ECC (n = 10) or CONC (n = 10) group. They performed 12 weeks of ECC or CONC training at similar perceived exertion. The workload, heart rate (HR), blood oxygen saturation (SpO2), and dyspnea were monitored during cycling. Outcomes measures included maximal voluntary isometric contraction (MVC) strength of the knee extensors, rate of force development (RFD), lower limb fat-free (LLFFM) and fat (LLFM) mass, 6-min walking test (6MWT), timed up-and-go test (TUG), stairs ascending (SAWT) and descending walking time (SDWT), and QOL assessed by the Saint George's respiratory questionnaire. RESULTS ECC produced on average threefold greater (P < 0.001) workload (211.8 ± 106.0 kJ) than CONC (78.1 ± 62.6 kJ) over 34 training sessions. ECC showed 1.5 ± 2.1% greater SpO2, 24.7 ± 4.1% lower HR, and 64.4 ± 29.6% lower dyspnea in average than CONC (P < 0.001). ECC increased LLFFM (4.5 ± 6.2%; P = 0.03), while CONC decreased LLFM (3.3 ± 6.4%; P = 0.04) after training. Both ECC and CONC reduced (P < 0.05) SAWT (- 16.1 ± 9.3% vs - 10.1 ± 14.4%) and SDWT (- 12.2 ± 12.6% vs - 14.4 ± 14.7%), and improved (P < 0.05) QOL (33.4 ± 38.8 vs 26.1 ± 36.6%) similarly, but only ECC improved (P < 0.05) RFD (69-199%), TUG (13.6 ± 13.6%), and 6MWT (25.3 ± 27.7%). CONCLUSION These results suggest that ECC training with less cardio-pulmonary demands was more effective in increasing functional performance and muscle mass for COPD patients than CONC training.
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19
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Carl J, Schultz K, Janssens T, von Leupoldt A, Pfeifer K, Geidl W. The "can do, do do" concept in individuals with chronic obstructive pulmonary disease: an exploration of psychological mechanisms. Respir Res 2021; 22:260. [PMID: 34615520 PMCID: PMC8493747 DOI: 10.1186/s12931-021-01854-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 09/27/2021] [Indexed: 12/18/2022] Open
Abstract
Background The “can do, do do” concept aims at identifying subgroups among persons with chronic obstructive pulmonary disease (COPD). Following a two-dimensional categorization, individuals are binarily classified with respect to their levels of physical capacity (“can’t do” or “can do”) and physical activity (“don’t do” or “do do”), resulting in four disjunct quadrants. The approach has been debated recently and the latest articles have concluded that the quadrants should be specifically examined in terms of psychological aspects of physical activity. Therefore, the goal of the present study was to explore the role of psychological variables in physical activity in the context of the “can do, do do” quadrant concept. Methods Within the scope of secondary data analyses of the “Stay Active After Rehabilitation” (STAR) randomized controlled trial, a total of 298 COPD rehabilitants of an inpatient pulmonary rehabilitation program were grouped into the suggested quadrants. We set fixed cut-offs at 70% of relative 6-min walking test performances for healthy individuals (physical capacity dimension) and 5.000 steps per day (physical activity dimension). Univariate and multivariate logistic regression analyses served to analyze whether depression scores, fear avoidance behaviors, disease-specific anxiety, self-concordance for physical activity, and five indicators of physical activity-related health competence (PAHCO) effectively discriminated between the “don’t do” and “do do” groups. Results Among persons with lower relative physical capacity, depression scores, fear avoidance behaviors, and disease-specific anxiety (univariate case) significantly differentiated between the more and the less active. Among persons with higher relative physical capacity, fear avoidance behaviors, disease-specific anxiety, as well as three PAHCO indicators (physical activity-specific self-efficacy, self-control, and affect regulation) significantly separated the more and the less active. In multivariate analyses, only fear avoidance behaviors and affect regulation discriminated among individuals with better relative physical capacity. Conclusion The findings identified important psychological and competence-oriented variables that explain discrepancies in the quadrant concept. Based on this, we discuss implications for physical activity promotion in individuals with COPD. Respiratory research can benefit from future studies complementing the quadrant concept through further behavioral analyses. Trial registration Clinicaltrials.gov, ID: NCT02966561. Registered 17 November, 2016, https://clinicaltrials.gov/ct2/show/NCT02966561.
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Affiliation(s)
- J Carl
- Department of Sport Science and Sport, Friedrich-Alexander University Erlangen-Nürnberg, Gebbertstraße 123b, 91058, Erlangen, Germany.
| | - K Schultz
- Klinik Bad Reichenhall, Centre for Rehabilitation, Pneumology, Orthopaedics, Salzburger Str. 8 - 11, 83435, Bad Reichenhall, Germany
| | - T Janssens
- Research Group on Health Psychology, Katholieke Universiteit Leuven, Tiensestraat 102, Box 3726, 3000, Leuven, Belgium
| | - A von Leupoldt
- Research Group on Health Psychology, Katholieke Universiteit Leuven, Tiensestraat 102, Box 3726, 3000, Leuven, Belgium
| | - K Pfeifer
- Department of Sport Science and Sport, Friedrich-Alexander University Erlangen-Nürnberg, Gebbertstraße 123b, 91058, Erlangen, Germany
| | - W Geidl
- Department of Sport Science and Sport, Friedrich-Alexander University Erlangen-Nürnberg, Gebbertstraße 123b, 91058, Erlangen, Germany
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20
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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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21
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Monitoring Physical Activity with a Wearable Sensor in Patients with COPD during In-Hospital Pulmonary Rehabilitation Program: A Pilot Study. SENSORS 2021; 21:s21082742. [PMID: 33924536 PMCID: PMC8068926 DOI: 10.3390/s21082742] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 04/08/2021] [Accepted: 04/11/2021] [Indexed: 01/10/2023]
Abstract
Accelerometers have become a standard method of monitoring physical activity in everyday life by measuring acceleration in one, two, or three axes. These devices provide reliable and objective measurements of the duration and intensity of physical activity. We aimed to investigate whether patients undertake physical activity during non-supervised days during stationary rehabilitation and whether patients adhere to the rigor of 24 h monitoring. The second objective was to analyze the strengths and weaknesses of such kinds of sensors. The research enrolled 13 randomly selected patients, qualified for in-patient, 3 week, high-intensity, 5 times a week pulmonary rehabilitation. The SenseWear armband was used for the assessment of physical activity. Participants wore the device 24 h a day for the next 4 days (Friday-Monday). The analysis of the number of steps per day, the time spent lying as well as undertaking moderate or vigorous physical activity (>3 metabolic equivalents of task (METs)), and the energy expenditure expressed in kcal showed no statistically significant difference between the training days and the days off. It seems beneficial to use available physical activity sensors in patients with chronic obstructive pulmonary disease (COPD); measurable parameters provide feedback that may increase the patient's motivation to be active to achieve health benefits.
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Cruz J, Jácome C, Oliveira A, Paixão C, Rebelo P, Flora S, Januário F, Valente C, Andrade L, Marques A. Construct validity of the brief physical activity assessment tool for clinical use in COPD. CLINICAL RESPIRATORY JOURNAL 2021; 15:530-539. [PMID: 33484059 DOI: 10.1111/crj.13333] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 01/19/2021] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Low physical activity (PA) levels are associated with poor health-related outcomes in Chronic Obstructive Pulmonary Disease (COPD). Thus, PA should be routinely assessed in clinical practice. OBJECTIVES This study assessed the construct validity of the Brief Physical Activity Assessment Tool (BPAAT) for clinical use in COPD and explored differences in age, sex and COPD grades. METHODS After linguistic adaptation of the tool to Portuguese, 110 patients (66.4 ± 9.6yrs, 72.7% male, FEV1 = 59.3 ± 25.5%predicted) completed the BPAAT and received an accelerometer. The BPAAT includes two questions assessing the weekly frequency and duration of vigorous- and moderate-intensity PA/walking, classifying individuals as insufficiently or sufficiently active. The BPAAT was correlated with accelerometry (moderate PA, MPA = 1952-5724 counts-per-min [CPM]); vigorous PA, VPA = 5725-∞CPM; moderate-to-vigorous PA, MVPA = 1952-∞CPM; daily steps), through: Spearman's correlations (ρ) for continuous data; %agreement, Kappa, sensitivity and specificity, positive and negative predictive values (PPV, NPV) for categorical data. RESULTS The BPAAT identified 73.6% patients as "insufficiently active" and 26.4% as "sufficiently active". The BPAAT was weakly to moderately correlated with accelerometry (0.394 ≤ ρ ≤ 0.435, P < 0.05), except for VPA (P = 0.440). This was also observed in age (<65/≥65yrs), COPD grades (GOLD 1-2/3-4) and in male patients (0.363 ≤ ρ ≤ 0.518, P < 0.05 except for VPA). No significant correlations were found in female patients (P > 0.05). Agreement was fair to moderate (0.36 ≤ κ ≤ 0.43; 73.6% ≤ %agreement ≤ 74.5%; 0.50 ≤ sensitivity ≤ 0.52; 0.84 ≤ specificity ≤ 0.91, 0.55 ≤ PPV ≤ 0.79, 0.72 ≤ NPV ≤ 0.82). CONCLUSION The BPAAT may be useful to screen patients' PA, independently of age and COPD grade, and identify male patients who are insufficiently active. Care should be taken when using this tool to assess vigorous PA or female patients.
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Affiliation(s)
- Joana Cruz
- Centre for Innovative Care and Health Technology (ciTechCare), School of Health Sciences (ESSLei), Polytechnic of Leiria, Leiria, Portugal.,Lab 3R - Respiratory Research and Rehabilitation Laboratory, School of Health Sciences, University of Aveiro (ESSUA), Aveiro, Portugal
| | - Cristina Jácome
- Lab 3R - Respiratory Research and Rehabilitation Laboratory, School of Health Sciences, University of Aveiro (ESSUA), Aveiro, Portugal.,CINTESIS -Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Ana Oliveira
- Lab 3R - Respiratory Research and Rehabilitation Laboratory, School of Health Sciences, University of Aveiro (ESSUA), Aveiro, Portugal.,Respiratory Medicine, West Park Healthcare Centre, Toronto, ON, Canada.,School of Rehabilitation Sciences, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Cátia Paixão
- Lab 3R - Respiratory Research and Rehabilitation Laboratory, School of Health Sciences, University of Aveiro (ESSUA), Aveiro, Portugal.,iBiMED - Institute of Biomedicine, University of Aveiro, Aveiro, Portugal
| | - Patrícia Rebelo
- Lab 3R - Respiratory Research and Rehabilitation Laboratory, School of Health Sciences, University of Aveiro (ESSUA), Aveiro, Portugal.,iBiMED - Institute of Biomedicine, University of Aveiro, Aveiro, Portugal
| | - Sofia Flora
- Centre for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, Leiria, Portugal
| | - Filipa Januário
- Serviço de Medicina Física e de Reabilitação - Centro Hospitalar de Leiria, Leiria, Portugal
| | - Carla Valente
- Pulmonology Department, Centro Hospitalar do Baixo Vouga, Aveiro, Portugal
| | - Lília Andrade
- Pulmonology Department, Centro Hospitalar do Baixo Vouga, Aveiro, Portugal
| | - Alda Marques
- Lab 3R - 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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Rutkowski S, Szczegielniak J, Szczepańska-Gieracha J. Evaluation of the Efficacy of Immersive Virtual Reality Therapy as a Method Supporting Pulmonary Rehabilitation: A Randomized Controlled Trial. J Clin Med 2021; 10:jcm10020352. [PMID: 33477733 PMCID: PMC7832322 DOI: 10.3390/jcm10020352] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 01/11/2021] [Accepted: 01/13/2021] [Indexed: 12/24/2022] Open
Abstract
Anxiety has been estimated to occur in 21–96% and depression in 27–79% of patients with chronic obstructive pulmonary disorder (COPD). We found a scarcity of literature providing evidence on how virtual reality (VR) therapy affects the intensity of depressive and anxiety symptoms and stress levels in COPD patients undergoing in-hospital pulmonary rehabilitation (PR). This study enrolled 50 COPD patients with symptoms of stress, depression, and anxiety, randomly assigned to one of two groups. The two groups participated in the traditional PR programme additionally: the VR-group performed 10 sessions of immersive VR-therapy and the control group performed 10 sessions of Schultz autogenic training. Comparison of the changes in stress levels and depressive and anxiety symptoms was the primary outcome. Analysis of the results showed a reduction in stress levels only in the VR-group (p < 0.0069), with a medium effect size (d = 0.353). The symptoms of depression (p < 0.001, d = 0.836) and anxiety (p < 0.0009, d = 0.631) were statistically significantly reduced only in the VR-group, with a strong effect size. The enrichment of pulmonary rehabilitation with immersive VR therapy brings benefits in terms of mood improvement and reduction in anxiety and stress in patients with COPD.
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Affiliation(s)
- Sebastian Rutkowski
- Department of Physical Education and Physiotherapy, Opole University of Technology, 45-758 Opole, Poland;
- Correspondence: ; Tel.: +48-507-027-792
| | - Jan Szczegielniak
- Department of Physical Education and Physiotherapy, Opole University of Technology, 45-758 Opole, Poland;
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24
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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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25
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Minakata Y, Sasaki S. Data Reproducibility and Effectiveness of Bronchodilators for Improving Physical Activity in COPD Patients. J Clin Med 2020; 9:jcm9113497. [PMID: 33138116 PMCID: PMC7692282 DOI: 10.3390/jcm9113497] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 10/24/2020] [Accepted: 10/27/2020] [Indexed: 11/16/2022] Open
Abstract
Increasing physical activity (PA) in patients with chronic obstructive pulmonary disease (COPD) is an important issue, however, the effect of bronchodilators on PA is still controversial. The indicators of PA, as measured by an accelerometer, can easily fluctuate based on several factors, which might cause inconsistent results. In this review, we listed the indicators of PA and the factors influencing the reproducibility of indicators of PA, and reviewed reports in which the effects of bronchodilators on PA were evaluated by an accelerometer. Then, we investigated the association between the processing of influencing factors and the effectiveness of bronchodilators for improving the PA of COPD patients. Fifteen reports were extracted using the PubMed database. In all seven reports in which adjustment was performed for at least two of four influencing factors (non-wear time, data from days with special behavior, environmental factors, and number of valid days required to obtain reproducible data), bronchodilators showed beneficial effects on PA. No adjustment was made for any of these factors in any of the four bronchodilator-ineffective reports. This suggests that the processing of influencing factors to secure reproducibility might affect the results regarding the effectiveness of bronchodilators for improving PA in COPD patients.
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26
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Leis R, Jurado-Castro JM, Llorente-Cantarero FJ, Anguita-Ruiz A, Iris Rupérez A, Bedoya-Carpente JJ, Vázquez-Cobela R, Aguilera CM, Bueno G, Gil-Campos M. Cluster Analysis of Physical Activity Patterns, and Relationship with Sedentary Behavior and Healthy Lifestyles in Prepubertal Children: Genobox Cohort. Nutrients 2020; 12:E1288. [PMID: 32370020 PMCID: PMC7282254 DOI: 10.3390/nu12051288] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Revised: 04/23/2020] [Accepted: 04/26/2020] [Indexed: 12/31/2022] Open
Abstract
Sedentary habits during childhood are associated with adverse health outcomes. The aim of this work was to cluster lifestyle behaviors and metabolic biomarkers to establish different patterns in children. Their physical and sedentary activities were evaluated by accelerometry, and questionnaires that included lifestyle behaviors, such as adherence to a Mediterranean diet, anthropometry and blood biochemical markers. Cluster analysis was performed to establish different groups based on physical activity levels. A total of 489 children were finally selected. Cluster 1 included children with a mostly sedentary state, whereas Cluster 3 included the most active children and Cluster 2 included children that did not fit into either the sedentary or the highly active groups. In Cluster 3, 56% of children were in a sports club, and a lower percentage used electronic devices in their rooms compared to the other groups. Cluster 1 children exhibited higher insulin, HOMA-IR and triacylglycerides with respect to the other groups. No differences were found regarding adherence to a Mediterranean diet. The choice to practice an extracurricular sport could be an influencing factor to increase exercise and ensure an active lifestyle in children. Reducing or limiting screen time mainly in children's rooms could contribute to an active lifestyle.
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Affiliation(s)
- Rosaura Leis
- Unidad de Investigación en Nutrición, Crecimiento y Desarrollo Humano de Galicia, Departamento de Pediatría, Hospital Clínico Universitario de Santiago, Universidad de Santiago de Compostela, IDIS, 15706 Santiago de Compostela, Spain; (R.L.); (J.J.B.-C.); (R.V.-C.)
- CIBEROBN, (Physiopathology of Obesity and Nutrition) Institute of Health Carlos III (ISCIII), 28029 Madrid, Spain; (F.J.L.-C.); (A.A.-R.); (C.M.A.); (M.G.-C.)
| | - Jose Manuel Jurado-Castro
- Metabolism and Investigation Unit, Reina Sofia University Hospital, Maimónides Institute of Biomedicine Research of Córdoba (IMIBIC), University of Córdoba, 14071 Córdoba, Spain;
| | - Francisco Jesus Llorente-Cantarero
- CIBEROBN, (Physiopathology of Obesity and Nutrition) Institute of Health Carlos III (ISCIII), 28029 Madrid, Spain; (F.J.L.-C.); (A.A.-R.); (C.M.A.); (M.G.-C.)
- Department of Artistic and Corporal Education, Faculty of Education, University of Córdoba, 14004 Córdoba, Spain
| | - Augusto Anguita-Ruiz
- CIBEROBN, (Physiopathology of Obesity and Nutrition) Institute of Health Carlos III (ISCIII), 28029 Madrid, Spain; (F.J.L.-C.); (A.A.-R.); (C.M.A.); (M.G.-C.)
- Department of Biochemistry and Molecular Biology II, Institute of Nutrition and Food Technology “José Mataix”, Center of Biomedical Research, University of Granada, Armilla, 18016 Granada, Spain
- Instituto de Investigación Biosanitaria ibs, 18014 Granada, Spain
| | - Azahara Iris Rupérez
- GENUD Research Group, University of Zaragoza, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria (IIS) Aragón, 50013 Zaragoza; Spain;
| | - Juan Jose Bedoya-Carpente
- Unidad de Investigación en Nutrición, Crecimiento y Desarrollo Humano de Galicia, Departamento de Pediatría, Hospital Clínico Universitario de Santiago, Universidad de Santiago de Compostela, IDIS, 15706 Santiago de Compostela, Spain; (R.L.); (J.J.B.-C.); (R.V.-C.)
| | - Rocío Vázquez-Cobela
- Unidad de Investigación en Nutrición, Crecimiento y Desarrollo Humano de Galicia, Departamento de Pediatría, Hospital Clínico Universitario de Santiago, Universidad de Santiago de Compostela, IDIS, 15706 Santiago de Compostela, Spain; (R.L.); (J.J.B.-C.); (R.V.-C.)
- CIBEROBN, (Physiopathology of Obesity and Nutrition) Institute of Health Carlos III (ISCIII), 28029 Madrid, Spain; (F.J.L.-C.); (A.A.-R.); (C.M.A.); (M.G.-C.)
| | - Concepción María Aguilera
- CIBEROBN, (Physiopathology of Obesity and Nutrition) Institute of Health Carlos III (ISCIII), 28029 Madrid, Spain; (F.J.L.-C.); (A.A.-R.); (C.M.A.); (M.G.-C.)
- Department of Biochemistry and Molecular Biology II, Institute of Nutrition and Food Technology “José Mataix”, Center of Biomedical Research, University of Granada, Armilla, 18016 Granada, Spain
- Instituto de Investigación Biosanitaria ibs, 18014 Granada, Spain
| | - Gloria Bueno
- CIBEROBN, (Physiopathology of Obesity and Nutrition) Institute of Health Carlos III (ISCIII), 28029 Madrid, Spain; (F.J.L.-C.); (A.A.-R.); (C.M.A.); (M.G.-C.)
- GENUD Research Group, University of Zaragoza, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria (IIS) Aragón, 50013 Zaragoza; Spain;
- Unidad de Endocrinología Pediátrica, Hospital Clínico Lozano Blesa, Facultad de Medicina, Universidad de Zaragoza, 50009 Zaragoza, Spain
| | - Mercedes Gil-Campos
- CIBEROBN, (Physiopathology of Obesity and Nutrition) Institute of Health Carlos III (ISCIII), 28029 Madrid, Spain; (F.J.L.-C.); (A.A.-R.); (C.M.A.); (M.G.-C.)
- Metabolism and Investigation Unit, Reina Sofia University Hospital, Maimónides Institute of Biomedicine Research of Córdoba (IMIBIC), University of Córdoba, 14071 Córdoba, Spain;
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Wang Z, Hu X, Dai Q. Is it possible to reverse frailty in patients with chronic obstructive pulmonary disease? Clinics (Sao Paulo) 2020; 75:e1778. [PMID: 33146351 PMCID: PMC7561069 DOI: 10.6061/clinics/2020/e1778] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 06/25/2020] [Indexed: 12/20/2022] Open
Abstract
In recent years, frailty has attracted increasing attention from clinicians and health care workers. The influence of frailty on the elderly, especially those with chronic diseases of the respiratory system, is highly significant. Frailty is particularly more common in patients with chronic obstructive pulmonary disease (COPD). Frailty and COPD share many risk factors and pathophysiological mechanisms. As a comprehensive interventional method for chronic respiratory diseases, pulmonary rehabilitation is an important basic measure for the management of patients with COPD. Frailty in these patients can be reversed using pulmonary rehabilitation by targeting five components of the frailty phenotype at the entry point. The present review discusses the benefits of pulmonary rehabilitation in patients with COPD complicated by frailty and provides a theoretical basis for pulmonary rehabilitation treatment in this population. In addition, the timing of pulmonary rehabilitation is also addressed, with the prefrail stage being the "golden" period. The implementation of pulmonary rehabilitation must vary among individuals, and individualized treatment strategies will help maximize benefits.
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Affiliation(s)
- Zhe Wang
- Department of Geriatrics Medicine I, Qinghai University Affiliated Hospital, Xining, People’s Republic of China
- *Corresponding author. E-mail:
| | - Xiaojing Hu
- Department of Geriatrics Medicine I, Qinghai University Affiliated Hospital, Xining, People’s Republic of China
| | - Qingxiang Dai
- Department of Geriatrics Medicine I, Qinghai University Affiliated Hospital, Xining, People’s Republic of China
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