No impact of exacerbation frequency and severity on the physical activity decline in COPD: a long-term observation.
- Sievi NA Pulmonary Division, University Hospital of Zurich, Zurich, Switzerland, christian.clarenbach@usz.ch.
- Kohler M Pulmonary Division, University Hospital of Zurich, Zurich, Switzerland, christian.clarenbach@usz.ch.
- Thurnheer R Pulmonary Division, Cantonal Hospital of Münsterlingen, Münsterlingen, Switzerland.
- Leuppi JD University Clinic of Medicine, Cantonal Hospital Baselland and University of Basel, Basel, Switzerland.
- Irani S Pulmonary Division, Cantonal Hospital of Aarau, Aarau, Switzerland.
- Frey M Pulmonary Division, Clinic Barmelweid, Barmelweid, Switzerland.
- Brutsche M Pulmonary Division, Cantonal Hospital of St Gallen, St Gallen, Switzerland.
- Brack T Pulmonary Division, Cantonal Hospital of Glarus, Glarus, Switzerland.
- Clarenbach CF Pulmonary Division, University Hospital of Zurich, Zurich, Switzerland, christian.clarenbach@usz.ch.
- 2019-03-14
Published in:
- International journal of chronic obstructive pulmonary disease. - 2019
COPD
daily physical activity
exacerbation
Actigraphy
Adult
Aged
Disease Progression
Exercise
Exercise Tolerance
Female
Fitness Trackers
Health Status
Humans
Longitudinal Studies
Lung
Male
Middle Aged
Prospective Studies
Pulmonary Disease, Chronic Obstructive
Risk Factors
Severity of Illness Index
Spirometry
Time Factors
Walking
English
Introduction
COPD exacerbations are associated with a concomitant profound reduction in daily physical activity (PA). Thereby, exacerbation frequency and severity may have an amplifying effect. Whether the reduced level of PA returns to the level prior to exacerbation or has a sustained negative impact on activity behavior over time is unclear.
Methods
The number of steps per day over 1 week, as a measure of daily PA, was assessed annually in a cohort of patients with COPD. Exacerbation frequency and severity were documented. Uni- and multivariate mixed effect models were used to investigate associations between change in number of steps per day (dependent variable) and exacerbations. Stratification by possible confounders was performed.
Results
One hundred and eighty one COPD patients (median [quartile] age 64 [59/69] years, 65% male, median [quartiles] FEV1 % pred. 46 [33/65]) suffered a total of 273 exacerbations during the observation period (median [quartiles] follow-up time of 2.1 [1.6/3.1] years). Neither the frequency nor the severity of exacerbations was significantly related to the overall decline in PA over time. Stratification by different possible confounders such as age, sex and disease severity did not yield a subgroup in which exacerbations enhance the decrease in PA over time.
Conclusion
The drop in PA during the phase of an acute exacerbation seems not to be a lasting phenomenon leading to a fundamental change in activity behavior.
Trial registration
www.ClinicalTrials.gov, NCT01527773.
COPD exacerbations are associated with a concomitant profound reduction in daily physical activity (PA). Thereby, exacerbation frequency and severity may have an amplifying effect. Whether the reduced level of PA returns to the level prior to exacerbation or has a sustained negative impact on activity behavior over time is unclear.
Methods
The number of steps per day over 1 week, as a measure of daily PA, was assessed annually in a cohort of patients with COPD. Exacerbation frequency and severity were documented. Uni- and multivariate mixed effect models were used to investigate associations between change in number of steps per day (dependent variable) and exacerbations. Stratification by possible confounders was performed.
Results
One hundred and eighty one COPD patients (median [quartile] age 64 [59/69] years, 65% male, median [quartiles] FEV1 % pred. 46 [33/65]) suffered a total of 273 exacerbations during the observation period (median [quartiles] follow-up time of 2.1 [1.6/3.1] years). Neither the frequency nor the severity of exacerbations was significantly related to the overall decline in PA over time. Stratification by different possible confounders such as age, sex and disease severity did not yield a subgroup in which exacerbations enhance the decrease in PA over time.
Conclusion
The drop in PA during the phase of an acute exacerbation seems not to be a lasting phenomenon leading to a fundamental change in activity behavior.
Trial registration
www.ClinicalTrials.gov, NCT01527773.
- Language
-
- English
- Open access status
- gold
- Identifiers
-
- DOI 10.2147/COPD.S188710
- PMID 30863043
- Persistent URL
- https://folia.unifr.ch/global/documents/266726
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