Benefits of physical activity on COPD hospitalisation depend on intensity

Abstract

The present study aims to disentangle the independent effects of the quantity and the intensity of physical activity on the risk reduction of chronic obstructive pulmonary disease (COPD) hospitalisations.177 patients from the Phenotype Characterization and Course of COPD (PAC-COPD) cohort (mean±SD age 71±8 years, forced expiratory volume in 1 s 52±16% predicted) wore the SenseWear Pro 2 Armband accelerometer (BodyMedia, Pittsburgh, PA, USA) for eight consecutive days, providing data on quantity (steps per day, physically active days and daily active time) and intensity (average metabolic equivalent tasks) of physical activity. Information on COPD hospitalisations during follow-up (2.5±0.8 years) was obtained from validated centralised datasets.During follow-up 67 (38%) patients were hospitalised. There was an interaction between quantity and intensity of physical activity in their effects on COPD hospitalisation risk. After adjusting for potential confounders in the Cox regression model, the risk of COPD hospitalisation was reduced by 20% (hazard ratio (HR) 0.79, 95% CI 0.67-0.93; p=0.005) for every additional 1000 daily steps at low average intensity. A greater quantity of daily steps at high average intensity did not influence the risk of COPD hospitalisations (HR 1.01, p=0.919). Similar results were found for the other measures of quantity of physical activity.Greater quantity of low-intensity physical activity reduces the risk of COPD hospitalisation, but highintensity physical activity does not produce any risk reduction. @ERSpublications Greater quantity of low-intensity physical activity reduces the risk of COPD hospitalisation

Long-Term Effects of an Internet-Mediated Pedometer-Based Walking Program for Chronic Obstructive Pulmonary Disease: Randomized Controlled Trial

“…Our Internet-mediated, pedometer-based intervention focuses specifically on walking, a low-intensity PA that most patients can do. It has already been shown that a greater quantity of low-intensity PA reduces risk of COPD hospitalizations, whereas high-intensity PA does not result in risk reduction [15]. …”

“…It has been shown that a greater quantity of low-intensity PA reduces risk of COPD hospitalizations, whereas high-intensity PA does not result in risk reduction [15]. In a cohort of persons with COPD, those who walk the least have risks that are 2 and 6 times higher for acute exacerbations and COPD-related hospitalizations, respectively, compared to those who walk the most [12].…”

Promoting physical activity in COPD: Insights from a randomized trial of a web-based intervention and pedometer use

“…Data support that a range of types and intensities of PA beyond aerobic exercise, which is emphasized in pulmonary rehabilitation, may be beneficial in COPD [16]. Increased low-intensity PA was significantly associated with a decreased risk of COPD-related hospitalizations, whereas increased high-intensity PA demonstrated no benefit [17]. …”

The effect of a regular walking program on dyspnoea severity and quality of life in normal weight, overweight, and obese patients with chronic obstructive pulmonary disease

“…International guidelines suggest that patients with COPD should walk at least 20 to 30 minutes every day (GOLD, 2016; The Australian Lung Foundation, 2012). Physical activity and exercise not only help patients with COPD to maintain their fitness levels but also decrease dyspnoea and fatigue developing during activity, increase walking distance and muscle strength and endurance, improve the quality of life, and decrease the frequency of exacerbations, length of hospital stay, use of health care services, and mortality rates (Breyer et al, 2010;de Blok et al, 2006;Donaire-Gonzalez et al, 2015;Garcia-Aymerich, Lange, Benet, Schnohr, & Anto, 2006;Kawagoshi et al, 2015;Martinez et al, 2014;Mendoza et al, 2015;Moy et al, 2015;Spruit et al, 2004;Vorrink, Kort, Troosters, & Lammers, 2011;Watz et al, 2014).…”