Physical Activity Is Associated with Attenuated Disease Progression in Chronic Obstructive Pulmonary Disease

Abstract

Introduction Chronic obstructive pulmonary disease (COPD) progression is variable and affects several disease domains, including decline in lung function, exercise capacity, muscle strength, and health status as well as changes in body composition. We aimed to assess the longitudinal association of physical activity (PA) with these a priori selected components of disease progression. Methods We studied 114 COPD patients from the PAC-COPD cohort (94% male, mean [SD], 70 yr [8 yr] of age, 54 [16] forced expiratory volume in 1 s % predicted) at baseline and 2.6 yr (0.6 yr) later. Baseline PA was assessed by accelerometry. Multivariable general linear models were built to assess the association between PA and changes in lung function, functional exercise capacity, muscle strength, health status, and body composition. All models were adjusted for confounders and the respective baseline value of each measure. Results Per each 1000 steps higher baseline PA, forced expiratory volume in 1 s declined 7 mL less (P < 0.01), forced vital capacity 9 mL less (P = 0.03) and carbon monoxide diffusing capacity 0.10 mL·min−1·mm Hg−1 less (P = 0.04), while the St George’s Respiratory Questionnaire symptom domain deteriorated 0.4 points less (P = 0.03), per year follow-up. Physical activity was not associated with changes in functional exercise capacity, muscle strength, other domains of health status or body composition. Conclusions Higher PA is associated with attenuated decline in lung function and reduced health status (symptoms domain) deterioration in moderate-to-very severe COPD patients.

Use of pedometers as a tool to promote daily physical activity levels in patients with COPD: a systematic review and meta-analysis

“…Furthermore, future studies should investigate the combined benefits of pulmonary rehabilitation, physical activity promotion and cognitive behavioural therapy for those patients with severe COPD who are anxious and depressed and therefore exhibit limitations in improving daily physical activity. Moreover, future studies could incorporate the addition of semi-automated tele-coaching as delivered by DEMEYER et al [7], as a low maintenance approach to providing continued support towards daily physical activity feedback [38].…”

“…The higher the given score, the better the quality. Cut-off points of the scale were excellent (9-10), good (6)(7)(8), fair (4-5) and poor (<3) [18].…”

“…Studies comparing the levels of physical activity in patients with COPD with healthy age-matched controls have reported significantly lower levels in those with COPD [3][4][5]. In addition, low levels of physical activity in patients with COPD are associated with an increased risk of hospitalisation and mortality [3,6,7]. Therefore, effective approaches to improve daily physical activity are needed in patients with COPD.…”

Progression of physical inactivity in COPD patients: the effect of time and climate conditions – a multicentre prospective cohort study

“…2 Reduced daily PA is observed early in the course of the disease, 3,4 has a range of causes and consequences, including an association with several systemic components of COPD 5,6 and is a strong predictor of exacerbation rate, hospital admission and mortality. 7 However, published data on longitudinal studies which evaluated changes in PA with time relative to other features of the disease are currently limited [8][9][10][11] and are not without limitations. In a single-center study Waschki et al established that PA declines with time, 9 evaluating a mixed population of COPD and chronic bronchitis patients, while in another longitudinal study with similar results, more than 90% of participants were male.…”

“…In a single-center study Waschki et al established that PA declines with time, 9 evaluating a mixed population of COPD and chronic bronchitis patients, while in another longitudinal study with similar results, more than 90% of participants were male. 11 Moreover, most published studies assessed changes in PA after a relatively long followup period of more than 2 years, [9][10][11] during which several other disease features had also worsened.…”