Impact of Home Oxygen Therapy on the Level of Physical Activities in Daily Life in Subjects With COPD

Abstract

BACKGROUND: Chronic hypoxemia in patients with COPD is a limiting factor that is associated with disease progression and significantly contributes to decreased physical activity. Although correction of hypoxemia results in physiological improvements, oxygen therapy may be related to social isolation and inactivity. However, few studies have objectively investigated the level of physical activity in daily life (PADL) in these patients. The objective of this study was to compare the level of PADL in subjects with COPD on home oxygen therapy and in subjects with no oxygen therapy, and to investigate whether home oxygen therapy is associated with the level of PADL. METHODS: In this study, 29 subjects with COPD composed the home oxygen therapy group, and 30 subjects with COPD composed the control group. All of them underwent assessment of anthropometric measurements, spirometry, peripheral muscle strength, limitations in activities of dalily living, perception of dyspnea, health status, as well as PADL monitoring. RESULTS: Home oxygen therapy subjects showed less time walking (P ‫؍‬ .001), in active physical activities (P ‫؍‬ .003), in physical activities > 3 METs (P ‫؍‬ .001), and in physical activities < 1.5 METs (P ‫؍‬ .042), as well as fewer steps (P ‫؍‬ .001). Physical inactivity was present in 24 home oxygen subjects (82.8%) and 18 control subjects (60%). Oxygen therapy was associated with severe physical inactivity (Cramer's V ‫؍‬ 0.29, P ‫؍‬ .040). The time using oxygen therapy (h/d) was the strongest predictor of the level of PADL (r 2 ‫؍‬ 0.38-0.43, P < .001). CONCLUSION: Subjects with COPD using oxygen at home showed reduced level of PADL. The results indicate that oxygen therapy is associated with severe physical inactivity and may be a predictor of the level of PADL.

<p>Physical Activity in Patients with Chronic Obstructive Pulmonary Disease on Long-Term Oxygen Therapy: A Cross-Sectional Study</p>

“…Using the same device, a multi-center study conducted on more than 1000 COPD patients33 reported that age, BMI, dyspnea severity and airflow obstruction were associated with PA measures and hourly patterns. In a recent smaller study,20 patients on LTOT showed less time walking, as well as in physical activities, in physical activities ≥ 3 METs, and in physical activities < 1.5 METs, and took fewer steps compared to control patients not needing LTOT. Physical inactivity was present in 83% of LTOT subjects and 60% of control subjects.…”

“…Although correction of hypoxemia results in physiological improvements, LTOT may be related to social isolation and inactivity due to clinical, physiological and organizational problems. Despite reports that pulmonary rehabilitation can improve exercise capacity also in these patients,16 there are few studies evaluating PA in COPD patients on LTOT 17–20. Furthermore, to the best of our knowledge, there is no information on the influence of exercise-induced desaturation on PA or on the burden of oxygen-delivery devices.…”

Sedentary Time and Cognitive Impairment in Patients Using Long-Term Oxygen Therapy: A Cross-Sectional Study

“…Few studies have evaluated the sedentary time of patients on LTOT [9,43], and the sedentary time of Japanese patients on LTOT has not been clarified. The sedentary time of patients on LTOT has been reported to be 623 min [9]. This finding is consistent with the sedentary time of the patients enrolled in this study at 600 min.…”

“…In a meta-synthesis of qualitative research studies, Cullen et al [46] noted that LTOT equipment usage leads to incapacity because of psychological factors such as stigma and prejudice. Furthermore, Cani et al [9] showed that the length of the cannula from the concentrator decreased mobility in patients on LTOT. Based on the findings of previous studies, the activity of patients on LTOT may be hindered by LTOT equipment.…”

“…LTOT improves survival outcomes and increases physical activity in CRD patients [8]. In contrast, a few previous studies have indicated that patients on LTOT have increased sedentary time, which represents inactivity, compared to non-LTOT patients with comparable respiratory dysfunction [9]. To determine the optimal treatment strategies for CRD patients with severe respiratory dysfunction on LTOT, it is essential to understand the cause of increased sedentary time in this group.…”