Objectively Measured Physical Activity in Patients with COPD: Recommendations from an International Task Force on Physical Activity

Demeyer, Heleen; Mohan, Divya; Burtin, Chris; Vaes, Anouk W.; Heasley, Matthew G.; Bowler, Russell P.; Casaburi, Richard; Cooper, Christopher B.; Corriol‐Rohou, Solange; Frei, Anja; Hamilton, Alan; Hopkinson, Nicholas S; Karlsson, Niklas; Man, William D.-C.; Moy, Marilyn L.; Pitta, Fábio; Polkey, Michael I.; Puhan, Milo A.; Rennard, Stephen I.; Rochester, Carolyn L.; Rossiter, Harry B.; Sciurba, Frank C.; Singh, Sally; Tal‐Singer, Ruth; Vogiatzis, Ioannis; Watz, Henrik; Lummel, Rob van; Wyatt, Jeremy; Merrill, Debora; Spruit, Martijn A.; Garcia‐Aymerich, Judith; Troosters, Thierry; Biomarker, Chronic Lung Disease

doi:10.15326/jcopdf.2021.0213

Cited by 54 publications

(78 citation statements)

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“…Additionally, the activPAL calculates body posture as sitting, lying, standing and stepping in hours per day, and energy expenditure in metabolic equivalent of tasks (value) using static and dynamic acceleration information,42 which will be analysed as secondary outcomes. Following the recommendation by Demeyer et al , only measurements including a minimum of three completely measured days will be considered valid to be included in the analysis 43…”

Section: Methods and Analysismentioning

confidence: 99%

Effect of targeted nutrient supplementation on physical activity and health-related quality of life in COPD: study protocol for the randomised controlled NUTRECOVER trial

et al. 2022

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IntroductionPhysical and mental health are often affected in chronic obstructive pulmonary disease (COPD) adversely affecting disease course and quality of life. Abnormalities in whole body and cellular energy metabolism, dietary and plasma nutrient status and intestinal permeability have been well established in these patients as systemic determinants of functional decline and underexplored treatable traits. The aim of this study is to investigate the efficacy of 1 year targeted nutrient supplementation on physical activity level and health-related quality of life in patients with COPD.Methods and analysisThis study is a single-centre randomised, placebo-controlled, double-blind trial in 166 patients with COPD recruited from multiple hospitals in the Netherlands. The intervention group will receive a multinutrient supplement, including vitamin D, tryptophan, long-chain polyunsaturated fatty acids and prebiotic dietary fibres as main components (94 kCal per daily dose). The control group will receive an isocaloric isonitrogenous placebo. Both groups will ingest one portion per day for at least 12 months and will additionally receive counselling on healthy lifestyle and medical adherence over the course of the study. Coprimary outcomes are physical activity assessed by triaxial accelerometry and health-related quality of life measured by the EuroQol-5 dimensions questionnaire. Secondary outcomes are cognitive function, psychological well-being, physical performance, patient-reported outcomes and the metabolic profile assessed by body composition, systemic inflammation, plasma nutrient levels, intestinal integrity and microbiome composition. Outcomes will be measured at baseline and after 12 months of supplementation. In case patients are hospitalised for a COPD exacerbation, a subset outcome panel will be measured during a 4-week recovery period after hospitalisation.Ethics and disseminationThis study was approved by the local Ethics Committee of Maastricht University. Subjects will be included after written informed consent is provided. Study outcomes will be disseminated through presentations at (inter)national conferences and through peer-reviewed journals.Trial registrationNCT03807310.

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Section: Methods and Analysismentioning

confidence: 99%

Effect of targeted nutrient supplementation on physical activity and health-related quality of life in COPD: study protocol for the randomised controlled NUTRECOVER trial

et al. 2022

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“…Data were extracted from the accelerometer using Actilife software v6.10.4 (Actigraph Pensacola, Pensacola, FL, USA). The PA assessment was judged adequate and representative if it included at least 4 valid days (i.e., days with at least 8 hours of wear time) [ 29 ]. All valid days were included in the analyses.…”

Section: Methodsmentioning

confidence: 99%

What Motivates Patients with COPD to Be Physically Active? A Cross-Sectional Study

Pimenta

Silva

Flora

et al. 2021

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Motivation can be broadly defined as what moves people to act. Low motivation is a frequently reported factor for the reduced physical activity (PA) levels observed in patients with chronic obstructive pulmonary disease (COPD). This study assessed patients’ motives to be physically active, according to three pulmonary rehabilitation (PR) participation groups (Never PR, Previous PR and Current PR) and explored whether these motives were related to the PA levels and clinical characteristics. The motives to be physically active were assessed with the Exercise Motivation Inventory-2 (EMI-2, 14 motivational factors, five dimensions) and PA with accelerometry (PA groups: <5000 steps/day vs. ≥5000 steps/day). The clinical variables included symptoms, impact of the disease, exercise capacity and comorbidities. Ninety-two patients (67.4 ± 8.1 years, 82.6% male, forced expiratory volume in 1s (FEV1) 48.3 ± 18.9% predicted; 30.4% Never PR, 51% Previous PR and 18.5% Current PR) participated. The motivational dimensions related to health/fitness presented the highest scores (3.8 ± 1.1; 3.4 ± 1.3). The motives to be active were not significantly different between PA groups (p > 0.05) but having less symptoms and ≥two comorbidities were associated with higher scores in psychological/health and body-related motives, respectively (p < 0.05). The findings may encourage health professionals to actively explore with patients their motives to be physically active to individualise PA promotion.

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“…Additional contributory factors affecting PA levels include comorbidities [ 23 ] (especially diastolic cardiac dysfunction) [ 24 ], depression [ 25 ], systemic inflammation [ 21 ], older age [ 13 ], having a physically active loved one [ 26 ], social support [ 27 ], time of year [ 28 ], living environment, motivation, self-efficacy and cultural influences [ 14 ]. As for healthy persons, low PA levels among those with COPD are associated with poor health outcomes [ 7 ], including worse symptoms [ 29 ], possible faster decline in lung function [ 7 , 30 , 31 , 32 ], increased hospitalization risk [ 33 , 34 , 35 ] and increased mortality [ 36 ]. As such, treatment interventions targeted to improving PA levels are desirable as a means to improve health outcomes for people with COPD.…”

Section: The Rationale For Physical Activity Promotion For Individual...mentioning

confidence: 99%

“…Although in several of the trials discussed above, the gain in step count following tele-PR (where reported) was greater than the proposed MID of 600 steps/day [ 57 ], one key limitation of the existing literature regarding the impact of tele-PR on PA levels among individuals with COPD is that the number of steps per day documents only one of several dimensions of PA [ 7 , 98 ]. Other aspects of PA not captured by steps per day include activity type, total amount, intensity, time of day or sedentary behavior.…”

Section: Limitations Of Evidence Regarding Telehealth Interventions T...mentioning

confidence: 99%

“…Physical activity levels are impacted by genetic, physical, cultural, environmental, financial and motivational factors [ 3 ]. Low PA levels are associated with many adverse health outcomes, including obesity, cardiovascular disease, deconditioning, physical disability, type II diabetes, cancer, depression, cognitive impairment, osteoporosis, systemic inflammation, reduced quality of life (QOL), increased healthcare utilization and increased mortality [ 4 , 5 , 6 , 7 , 8 , 9 ]. Of note, sedentary behavior has been defined as waking behavior with energy expenditure < 1.5 metabolic equivalent task (METs) in sitting or reclining posture [ 7 ], and it specifically (distinct from PA per se) is an important determinant of health outcomes including mortality [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

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Does Telemedicine Promote Physical Activity?

Rochester

2022

Life

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Exercise capacity and physical activity are different concepts: the former refers to what an individual is capable of performing, while the latter refers to what the individual does in daily life. Low levels of physical activity (PA), which are very common in individuals with COPD, are associated with poor health outcomes, including increased symptoms, a more rapid decline in lung function, increased health care utilization and increased mortality risk. Because of these pervasive negative outcomes, attempts have been made to increase physical activity in individuals with COPD, hoping that success in this area will mitigate the negative effects of inactivity. Based on its ability to increase exercise capacity and reduce dyspnea in COPD and other chronic respiratory diseases, pulmonary rehabilitation (PR) would be expected also increase physical activity in these patients. However, accessibility to pulmonary rehabilitation programs is problematic in some areas, and studies testing its effectiveness in this outcome area have had inconsistent results. Using telehealth interventions using technology to provide medical care conveniently over a distance would have the benefit of reaching a larger proportion of individuals with COPD. A systematic review of clinical trials testing telehealth to promote physical activity had mixed results and low-certainty evidence, resulting in the inability to recommend any single type of intervention. Thus, using telehealth interventions to promote physical activity for individuals with chronic respiratory diseases, while promising, remains an area where future investigations are needed to identify its optimal modalities and clarify its benefits.

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Objectively Measured Physical Activity in Patients with COPD: Recommendations from an International Task Force on Physical Activity

Cited by 54 publications

References 6 publications

Effect of targeted nutrient supplementation on physical activity and health-related quality of life in COPD: study protocol for the randomised controlled NUTRECOVER trial

Effect of targeted nutrient supplementation on physical activity and health-related quality of life in COPD: study protocol for the randomised controlled NUTRECOVER trial

What Motivates Patients with COPD to Be Physically Active? A Cross-Sectional Study

Does Telemedicine Promote Physical Activity?

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