Physical Activity Patterns in Patients in Different Stages of Chronic Obstructive Pulmonary Disease

Abstract

It has previously been suggested that exercise capacity is decreased in COPD and that it is associated with degree of disease. The reduced exercise capacity may plausibly be due to low levels of physical activity in this patient group. The aim of the present study was to assess exercise capacity and physical activity in different stages of COPD and to examine the associations between exercise capacity, pulmonary function and degree of physical activity. A total of 44 COPD patients and 17 healthy subjects participated in the study. Exercise capacity was assessed using the 6-minute walking test and physical activity was assessed using an accelerometer worn all waking hours during 7 days. Mean exercise capacity was significantly lower in COPD patients compared with healthy subjects. Mean physical activity level and time spent at least moderately active were significantly lower in patients with moderate and severe COPD compared with healthy subjects while no differences in time spent sedentary were observed between the study groups. Pulmonary function, mean physical activity level and time spent at least moderately physically active were significantly associated with exercise capacity in the patients. We conclude that patients with moderate and severe COPD are less physically active compared with healthy subjects. Furthermore, mean physical activity level and physical activity of at least moderate intensity are positively associated with exercise capacity in COPD, while time spent sedentary is not, which stresses an important role of physical activity on exercise capacity in these patients.

Physical activity and fatigue in chronic obstructive pulmonary disease – A population based study

“…In a German cohort of COPD subjects [38] recruited from a registry of patients used for clinical trials, Watz et al showed that the number of steps per day was significantly decreased for GOLD 2 subjects and that there was a shift in subjects being classified as active to sedentary at GOLD 1 compared to controls. In a previous Swedish study including data from 44 patients with mild-to severe COPD recruited from primary care, those with moderate-to severe disease were less physical active than healthy controls [39]. Our study showed that physical activity is reduced among COPDsubjects with GOLD 2 and higher not only in selected populations, but also in a large population based cohort, when compared to subjects without COPD.…”

An official European Respiratory Society statement on physical activity in COPD

“…Accordingly, most studies in COPD have found moderately positive associations between either 6-min walking distance or peak work rate in an incremental exercise test and objectively measured physical activity (table 3) [40,65,74,79,96].…”

The importance of physical activity

“…Reduced physical activity is associated with greater disease severity (worse lung function) [65,66], higher levels of dyspnoea [65,66], lower exercise capacity [67][68][69][70] and lower health-related quality of life [66,[71][72][73], but these conclusions are based on low-to very low-quality research from mostly cross-sectional studies [56]. How being physically active affects balance and bone mineral density is inconsistent in the literature [56].…”