Physical activity and exercise capacity in patients with moderate COPD exacerbations

Alahmari, AD; Kowlessar, Beverly; Patel, Anant; Mackay, Alexander; Allinson, James P.; Wedzicha, Jadwiga A.; Donaldson, Gavin C.

doi:10.1183/13993003.01105-2015

Cited by 65 publications

(45 citation statements)

References 40 publications

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“…Combining accelerometers with e-diaries is theoretically advantageous for researchers interested in measuring intentional and incidental PA using diary methods (e.g., Alahmari et al, 2016; Forrest, Smith, Fussner, Dodd, & Clerkin, 2016). It is promising to see that the use of the diary mitigated the effects of the accelerometer on participants’ self-reported activity at follow-up.…”

Section: Discussionmentioning

confidence: 99%

The impact of E-diaries and accelerometers on young adults' perceived and objectively assessed physical activity

Eisenberg

Phillips

Fowler

et al. 2017

Psychology of Sport and Exercise

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Objective E-diaries and accelerometers promise more objective, real-time measurements of health behavior. However, social-psychological theory suggests that using electronic behavioral monitoring may influence rather than just record physical activity (PA), especially when a device is novel. Design Participants (n=146) were randomly assigned to either an accelerometer-only, e-diary-only, accelerometer+e-diary, or a no-technology control group for one week to assess how these technologies influenced PA, both perceived and actual, in young adults. Method Participants reported their PA, overall and number of discrete exercise sessions (DES) at baseline and follow-up; accelerometers provided daily step counts and e-diaries captured daily reports of PA for the active week of the study. Results Average daily steps in the accelerometer-only and accelerometer+e-diary groups did not differ nor did daily reports of PA via e-diary compared to accelerometer+e-diary group, showing that neither technology affected actual PA. ANCOVAS tested group differences in perceived PA; The accelerometer-only group had increased perceived overall PA but not DES compared to no-technology control. Conclusions Accelerometers may increase perceived overall PA, but the tested technologies did not increase DES or actual PA, suggesting that they may be viable unbiased measures of PA.

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Section: Discussionmentioning

confidence: 99%

The impact of E-diaries and accelerometers on young adults' perceived and objectively assessed physical activity

Eisenberg

Phillips

Fowler

et al. 2017

Psychology of Sport and Exercise

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“…COPD patients that suffer from frequent exacerbations are more prone to weight loss and muscle wasting [7, 8]. Furthermore, Alahmari et al showed that frequent exacerbations are associated with increased muscle weakness and a decline in exercise capacity [9]. …”

Section: Introductionmentioning

confidence: 99%

Differential regulation of muscle protein turnover in response to emphysema and acute pulmonary inflammation

Ceelen¹,

Schols²,

Hoof³

et al. 2017

Respir Res

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BackgroundExacerbations in COPD are often accompanied by pulmonary and systemic inflammation, and associated with increased susceptibility to and prevalence of weight loss and muscle wasting. Muscle mass loss during disease exacerbations may contribute to emphysema-associated muscle atrophy. However, whether pulmonary inflammation in presence of emphysema differentially affects skeletal muscle, including protein synthesis and degradation signaling pathways has not previously been addressed. The aims of this study were to 1) develop a mouse model of disease exacerbation-associated muscle wasting, 2) evaluate whether emphysema and muscle wasting can be monitored non-invasively and 3) assess alterations in muscle protein turnover regulation.MethodsEmphysema was induced by three, weekly intra-tracheal (IT) elastase (E) or vehicle control (vc) instillations, followed by one single IT-LPS bolus (L) or vc instillation to mimic pulmonary inflammation-driven disease exacerbation. Consequently, four experimental groups were defined: vc/vc (‘C’), E/vc (‘E’), vc/LPS (‘L’), E/LPS (‘E + L’). Using micro cone-beam CT-scans, emphysema development and muscle mass changes were monitored, and correlated to muscle weight 48 h after LPS instillation. Protein turnover signaling was assessed in muscle tissue collected 24 h post LPS instillation.ResultsMicro-CT imaging correlated strongly with established invasive measurements of emphysema and muscle atrophy. Pulmonary inflammation following LPS instillation developed irrespective of emphysema and body and muscle weight were similarly reduced in the ‘L’ and ‘E + L’ groups. Accordingly, mRNA and protein expression levels of genes of the ubiquitin-proteasome pathway (UPS) and the autophagy-lysosomal pathway (ALP) were upregulated in skeletal muscle following IT-LPS (‘L’ and ‘E + L’). In contrast, mTOR signaling, which controls ALP and protein synthesis, was reduced by pulmonary inflammation (‘L’ and ‘E + L’) as well as emphysema as a single insult (‘E’) compared to control.ConclusionChanges in lung tissue density and muscle mass can be monitored non-invasively to evaluate emphysema and muscle atrophy longitudinally. Acute loss of muscle mass evoked by pulmonary inflammation is similar in control and emphysematous mice. Although muscle atrophy cues in response to pulmonary inflammation are not altered by emphysema, emphysema itself affects protein synthesis and ALP signaling, which may interfere with muscle mass recovery and impair maintenance of muscle mass in emphysema.Electronic supplementary materialThe online version of this article (doi:10.1186/s12931-017-0531-z) contains supplementary material, which is available to authorized users.

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“…This is important as GP managed exacerbations have been associated with declines in exercise capacity and muscle strength, and reduced physical activity can impact on quality of life. 13 This study aimed to compare the rates of hospitalized and general practice (GP) treated AECOPD before and after PR, using primary care data from the UK Clinical Practice Research Datalink (CPRD), linked with Hospital Episode Statistics (HES). Firstly, exacerbation rates were compared in those who were eligible and referred for PR versus those who were eligible and were not referred during all time observed (Observation 1: Figure 1).…”

Section: Introductionmentioning

confidence: 99%

Effects of Pulmonary Rehabilitation on Exacerbation Number and Severity in People With COPD

Moore

Newson

Joshi

et al. 2017

Chest

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Conflict of Interest DisclosuresJKQ reports grants from the Medical Research Council (MRC), GlaxoSmithKline (GSK), British Lung Foundation (BLF), Wellcome Trust, during the conduct of the study, and personal fees from AstraZeneca and Boehringer Ingelheim, outside of the submitted work. MS reports other current research grants from Arthritis Research UK, Public Health England and the EU EITHealth Programme, with no conflicts of interest. SS reports grants from the National Institute for Health Research (NIHR), GlaxoSmithKline (GSK), Boehringer Ingelheim and Novartis and personal fees from Novartis and AstraZeneca. All other authors report no other conflicts of interest. 2 AbstractBackground: In previous systematic reviews, predominantly of randomised controlled trials,

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Physical activity and exercise capacity in patients with moderate COPD exacerbations

Cited by 65 publications

References 40 publications

The impact of E-diaries and accelerometers on young adults' perceived and objectively assessed physical activity

The impact of E-diaries and accelerometers on young adults' perceived and objectively assessed physical activity

Differential regulation of muscle protein turnover in response to emphysema and acute pulmonary inflammation

Effects of Pulmonary Rehabilitation on Exacerbation Number and Severity in People With COPD

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