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Liu L, Wen W, Andersen SW, Shrubsole MJ, Steinwandel MD, Lipworth LE, Sudenga SL, Zheng W. Sitting Time, Physical Activity and Mortality: A Cohort Study In Low-Income Older Americans. Am J Prev Med 2024:S0749-3797(24)00260-5. [PMID: 39089431 DOI: 10.1016/j.amepre.2024.07.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Revised: 07/24/2024] [Accepted: 07/24/2024] [Indexed: 08/04/2024]
Abstract
INTRODUCTION Physical inactivity and sedentary behavior are recognized as independent risk factors for many diseases. However, studies investigating their associations with total and cause-specific mortality in low-income and Black populations are limited, particularly among older adults. METHODS A prospective cohort study was conducted among 8,337 predominantly low-income and Black Americans aged ≥65 years residing in the southern United States. Participants reported their daily sitting time and leisure-time physical activity (LTPA) at baseline (2002-2009), and mortality data were collected through 2019. Analysis was conducted from September 2022 to October 2023. RESULTS During a median follow-up of 12.25 years, nearly 50% (n=4,111) were deceased. A prolonged sitting time (>10 hours/day versus <4 hours/day) was associated with elevated all-cause mortality (hazard ratios [HR], 1.15; 95% confidence intervals [CI], 1.04-1.27) after adjusting for LTPA and other potential confounders. LTPA was associated with a reduced risk of all-cause mortality, with an adjusted HR of 0.75 (95% CI 0.64, 0.88) associated with 150-300 minutes per week of moderate-intensity physical activity. Individuals who were physically inactive and had a sitting time of >10 hours/day had the highest mortality risk (HR, 1.48; 95% CI, 1.23-1.78), compared with those who were physically active and had low sitting time. These associations were more pronounced for mortality due to cardiovascular diseases. CONCLUSIONS High sitting time is an independent risk factor for all-cause and cardiovascular disease mortality, and LTPA could partially attenuate the adverse association of prolonged sitting time with mortality.
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Affiliation(s)
- Lili Liu
- Department of Medicine, Division of Epidemiology, Vanderbilt Epidemiology Center, School of Medicine, Vanderbilt University, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Wanqing Wen
- Department of Medicine, Division of Epidemiology, Vanderbilt Epidemiology Center, School of Medicine, Vanderbilt University, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Shaneda W Andersen
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
| | - Martha J Shrubsole
- Department of Medicine, Division of Epidemiology, Vanderbilt Epidemiology Center, School of Medicine, Vanderbilt University, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Mark D Steinwandel
- Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Loren E Lipworth
- Department of Medicine, Division of Epidemiology, Vanderbilt Epidemiology Center, School of Medicine, Vanderbilt University, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Staci L Sudenga
- Department of Medicine, Division of Epidemiology, Vanderbilt Epidemiology Center, School of Medicine, Vanderbilt University, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Wei Zheng
- Department of Medicine, Division of Epidemiology, Vanderbilt Epidemiology Center, School of Medicine, Vanderbilt University, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee.
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Watson KE, Lee AL, Dwyer TJ, McKeough ZJ. Applying the treatable traits approach in bronchiectasis-A scoping review of traits, measurements and treatments implemented by allied health professionals and nurses. Respir Med 2024; 222:107503. [PMID: 38141863 DOI: 10.1016/j.rmed.2023.107503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 12/14/2023] [Accepted: 12/16/2023] [Indexed: 12/25/2023]
Abstract
BACKGROUND Using treatable traits as a management approach in bronchiectasis involves determining identifiable, clinically relevant, measurable and treatable problems to develop a management strategy in collaboration with the patient. OBJECTIVE To identify new treatable traits not previously reported in the literature and treatment strategies for new and existing traits that could be implemented in an outpatient clinic or community setting by an allied health professional or nurse in adults with bronchiectasis. METHODS A scoping review was conducted with searches of MEDLINE, CINAHL, AMED, Embase, Cochrane Central Register of Controlled Trials and PsycInfo. The search yielded 9963 articles with 255 articles proceeding to full text review and 114 articles included for data extraction. RESULTS Sixteen new traits were identified, including fatigue (number of studies with new trait (n) = 13), physical inactivity (n = 13), reduced peripheral muscle power and/or strength (n = 12), respiratory muscle weakness (n = 9) and sedentarism (n = 6). The main treatment strategies for new and existing traits were airway clearance therapy (number of citations (n) = 86), pulmonary rehabilitation (n = 58), inspiratory muscle training (n = 20) and nebulised saline (n = 12). CONCLUSION This review identifies several new traits in bronchiectasis and highlights the common treatments for new and existing traits that can be implemented in a treatable traits approach in an outpatient clinic or community setting by an allied health professional or nurse.
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Affiliation(s)
- Kirsty E Watson
- Sydney School of Health Sciences, The University of Sydney, Sydney, Australia; Department of Allied Health, Central Queensland Hospital and Health Service, Rockhampton, Australia.
| | - Annemarie L Lee
- Department of Physiotherapy, School of Primary and Allied Health Care, Monash University, Melbourne, Australia; Institute for Breathing and Sleep, 145 Studley Road, Heidelberg, Australia
| | - Tiffany J Dwyer
- Sydney School of Health Sciences, The University of Sydney, Sydney, Australia; Department of Respiratory Medicine, Royal Prince Alfred Hospital, Sydney, Australia
| | - Zoe J McKeough
- Sydney School of Health Sciences, The University of Sydney, Sydney, Australia
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Murakami Y, Minakata Y, Kato M, Sasaki S, Azuma Y, Kawabe K, Ono H. Determinants of Activity Phenotype in Patients with Chronic Obstructive Pulmonary Disease. Int J Chron Obstruct Pulmon Dis 2023; 18:1919-1929. [PMID: 37671143 PMCID: PMC10476663 DOI: 10.2147/copd.s421755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 08/15/2023] [Indexed: 09/07/2023] Open
Abstract
Introduction Physical activity (PA) and sedentary behavior (SB) have attracted attention in chronic obstructive pulmonary disease (COPD), and there have been efforts to evaluate PA and SB separately. The factors associated with the characteristics of the four activity phenotypes defined by the durations of PA and SB are largely unknown. The aim of this study was to clarify the factors that could differentiate each activity phenotype. Materials and Methods Study subjects were outpatients with stable COPD who were ≥40 years of age. We investigated the influence of 26 different factors on the activity phenotypes of COPD and extracted the factors that showed significant differences among the four activity phenotypes. Results Two hundred sixteen patients were included in the analysis. Exercise capacity and dyspnea were determinants that distinguished the low PA groups from the high PA groups. The pulmonary function and desaturation during exercise were factors that distinguished the high PA with low SB group from the low PA with high SB group. BMI, grip strength, upper arm circumference and HbA1c were higher in the low PA and low SB group than in the low PA and high SB group. Conclusion These factors could be the determinants discriminating activity phenotypes of patients with COPD.
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Affiliation(s)
- Yusuke Murakami
- Department of Respiratory Medicine, National Hospital Organization Wakayama Hospital, Wakayama, 644-0044, Japan
| | - Yoshiaki Minakata
- Department of Respiratory Medicine, National Hospital Organization Wakayama Hospital, Wakayama, 644-0044, Japan
| | - Mai Kato
- Department of Respiratory Medicine, National Hospital Organization Wakayama Hospital, Wakayama, 644-0044, Japan
| | - Seigo Sasaki
- Department of Respiratory Medicine, National Hospital Organization Wakayama Hospital, Wakayama, 644-0044, Japan
| | - Yuichiro Azuma
- Department of Respiratory Medicine, National Hospital Organization Wakayama Hospital, Wakayama, 644-0044, Japan
| | - Kazumi Kawabe
- Department of Respiratory Medicine, National Hospital Organization Wakayama Hospital, Wakayama, 644-0044, Japan
| | - Hideya Ono
- Department of Respiratory Medicine, National Hospital Organization Wakayama Hospital, Wakayama, 644-0044, Japan
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Bertuol C, da Silveira MHC, Krug RDR, Kupske JW, Mielke GI, Del Duca GF. Use of electronic devices in leisure time modifies the prevalence and factors associated with sedentary behavior derived exclusively from excessive television viewing among Brazilian adults. BMC Public Health 2023; 23:1602. [PMID: 37608246 PMCID: PMC10463304 DOI: 10.1186/s12889-023-16517-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 08/12/2023] [Indexed: 08/24/2023] Open
Abstract
The growing interest in the study of sedentary behavior is justified by its increasing presence in people's daily lives, particularly in leisure time. The aim of this study was to compare the prevalence and factors associated with sedentary behavior derived exclusively from TV time and from its combination with the time spent using other electronic devices among Brazilian adults (n = 52,443). This cross-sectional study used data from the Vigitel survey (2019), which included subjects ≥ 18 years old who resided in the capitals of the 26 Brazilian states and Federal District. High TV time (≥ 4 h/day), and its combination with computer, tablet, or cell phone use (≥ 4 h/day), as well as sociodemographic, behavioral, and health characteristics were self-reported. Adjusted logistic regression was used to estimate odds ratios and 95% confidence intervals (95%CI). The prevalence of high sedentary behavior almost tripled when TV viewing was added to the time spent using other electronic devices (from 12.2%; 95%CI: 11.6; 12.8, to 34.7%; 95%CI: 33.8; 35.6), notably among the youngest (32.0 percentage points). Individuals living without a partner, who smoked, consumed alcohol and processed foods excessively, were physically inactive, and had hypertension were more likely to have both outcomes than their counterparts. Older and less educated individuals were more likely to spend excessive time watching TV and less likely to have high use of other electronic devices in addition to TV viewing than their peers. Including computer, tablet, or cell phone led to an increase in the prevalence of high sedentary behavior. The magnitude and direction of the associations of age and education with high sedentary behavior varied according to the method how high sedentary behavior was defined. Projects, programs, and policies must consider the different indicators of sedentary behavior in monitoring and promoting a healthier lifestyle.
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Affiliation(s)
- Cecília Bertuol
- Graduate Program in Physical Education, Federal University of Santa Catarina, Campus Universitário Reitor João David Ferreira Lima, Florianópolis, SC, 88040-900, Brazil.
| | - Murilo Henrique Corrêa da Silveira
- Graduate Program in Physical Education, Federal University of Santa Catarina, Campus Universitário Reitor João David Ferreira Lima, Florianópolis, SC, 88040-900, Brazil
| | - Rodrigo de Rosso Krug
- Graduate Program in Integrative Health Care, University of Cruz Alta, Cruz Alta, RS, 98020-290, Brazil
| | - Juliedy Waldow Kupske
- Graduate Program in Human Movement Science, Federal University of Rio Grande do Sul, Rua Felizardo 750, Porto Alegre, RS, 90690-200, Brazil
| | - Grégore Iven Mielke
- School of Public Health, The University of Queensland, Brisbane, QLD, 4006, Australia
| | - Giovani Firpo Del Duca
- Graduate Program in Physical Education, Federal University of Santa Catarina, Campus Universitário Reitor João David Ferreira Lima, Florianópolis, SC, 88040-900, Brazil
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O’Shea O, Casey S, Giblin C, Stephenson A, Carroll TP, McElvaney NG, McDonough SM. Physical Activity, Exercise Capacity and Sedentary Behavior in People with Alpha-1 Antitrypsin Deficiency: A Scoping Review. Int J Chron Obstruct Pulmon Dis 2023; 18:1231-1250. [PMID: 37346078 PMCID: PMC10281283 DOI: 10.2147/copd.s389001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 03/07/2023] [Indexed: 06/23/2023] Open
Abstract
Alpha-1 antitrypsin deficiency (AATD) is a hereditary disorder and a genetic risk factor for chronic obstructive pulmonary disease (COPD). Physical activity (PA) is important for the prevention and treatment of chronic disease. Little is known about PA in people with AATD. Therefore, we aimed to map the research undertaken to improve and/or measure PA, sedentary behaviour (SB) or exercise in people with AATD. Searches were conducted in CINAHL, Medline, EMBASE and clinical trial databases for studies published in 2021. Databases were searched for keywords (physical activity, AATD, exercise, sedentary behavior) as well as synonyms of these terms, which were connected using Boolean operators. The search yielded 360 records; 37 records were included for review. All included studies (n = 37) assessed exercise capacity; 22 studies reported the use of the six-minute walk test, the incremental shuttle walk test and cardiopulmonary exercise testing were reported in three studies each. Other objective measures of exercise capacity included a submaximal treadmill test, the Naughton protocol treadmill test, cycle ergometer maximal test, endurance shuttle walk test, constant cycle work rate test, a peak work rate test and the number of flights of stairs a participant was able to walk without stopping. A number of participant self-reported measures of exercise capacity were noted. Only one study aimed to analyze the effects of an intensive fitness intervention on daily PA. One further study reported on an exercise intervention and objectively measured PA at baseline. No studies measured SB. The assessment of PA and use of PA as an intervention in AATD is limited, and research into SB absent. Future research should measure PA and SB levels in people with AATD and explore interventions to enhance PA in this susceptible population.
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Affiliation(s)
- Orlagh O’Shea
- School of Physiotherapy, Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin 2, Ireland
| | - Saidhbhe Casey
- School of Physiotherapy, Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin 2, Ireland
| | - Ciaran Giblin
- School of Physiotherapy, Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin 2, Ireland
| | - Aoife Stephenson
- School of Physiotherapy, Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin 2, Ireland
- School of Health Sciences, University of Southampton, Southampton, UK
| | - Tomás P Carroll
- Irish Centre for Genetic Lung Disease, Department of Medicine, Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Beaumont Hospital, Dublin 9, Ireland
| | - Noel G McElvaney
- Irish Centre for Genetic Lung Disease, Department of Medicine, Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Beaumont Hospital, Dublin 9, Ireland
| | - Suzanne M McDonough
- School of Physiotherapy, Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin 2, Ireland
- School of Health Sciences, University of Southampton, Southampton, UK
- Centre for Health and Rehabilitation Technologies, School of Health Sciences, Ulster University, Newtownabbey, BT37 0QB, UK
- School of Physiotherapy, University of Otago, Dunedin, New Zealand
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Minakata Y, Azuma Y, Sasaki S, Murakami Y. Objective Measurement of Physical Activity and Sedentary Behavior in Patients with Chronic Obstructive Pulmonary Disease: Points to Keep in Mind during Evaluations. J Clin Med 2023; 12:jcm12093254. [PMID: 37176694 PMCID: PMC10179547 DOI: 10.3390/jcm12093254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 04/24/2023] [Accepted: 04/26/2023] [Indexed: 05/15/2023] Open
Abstract
Objective measurement methods using accelerometers have become the mainstream approach for evaluating physical activity (PA) and sedentary behavior (SB). However, several problems face the objective evaluation of PA and SB in patients with chronic obstructive pulmonary disease (COPD). For example, indicators of PA differ depending on whether the accelerometer detects the kind of activity on the one hand, or its intensity on the other. Measured data are also strongly influenced by environmental factors (weather, season, employment status, etc.) and methodological factors (days with uncommon activities, non-wearing time, minimum required wearing time per day, minimum number of valid days required, etc.). Therefore, adjusting for these factors is required when evaluating PA or SB, especially when evaluating the effects of intervention. The exclusion of sleeping time, unification of total measurement time, and minimization of the required wearing time per day might be more important for the evaluation of ST than for evaluating PA. The lying-down-time-to-sitting-time ratio was shown to be larger in COPD patients than in healthy subjects. In this review, we clarified the problems encountered during objective evaluations of PA and SB in patients with COPD and encouraged investigators to recognize the presence of these problems and the importance of adjusting for them.
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Affiliation(s)
- Yoshiaki Minakata
- National Hospital Organization Wakayama Hospital, 1138 Wada, Mihama-Cho, Hidaka-gun, Wakayama 644-0044, Japan
| | - Yuichiro Azuma
- National Hospital Organization Wakayama Hospital, 1138 Wada, Mihama-Cho, Hidaka-gun, Wakayama 644-0044, Japan
| | - Seigo Sasaki
- National Hospital Organization Wakayama Hospital, 1138 Wada, Mihama-Cho, Hidaka-gun, Wakayama 644-0044, Japan
| | - Yusuke Murakami
- National Hospital Organization Wakayama Hospital, 1138 Wada, Mihama-Cho, Hidaka-gun, Wakayama 644-0044, Japan
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Xiang X, Huang L, Fang Y, Cai S, Zhang M. Physical activity and chronic obstructive pulmonary disease: a scoping review. BMC Pulm Med 2022; 22:301. [PMID: 35932050 PMCID: PMC9354440 DOI: 10.1186/s12890-022-02099-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 07/31/2022] [Indexed: 11/25/2022] Open
Abstract
Background Reduced physical activity (PA) was the strongest predictor of all-cause mortality in patients with chronic obstructive pulmonary disease (COPD). This scoping review aimed to map the evidence on the current landscape of physical activity, barriers and facilitators, and assessment tools across COPD patients. Methods Arksey and O’Malley’s scoping review methodology framework guided the conduct of this review. An electronic search was conducted on five English databases (PubMed, Cochrane Library, PsycINFO, CINAHL and Web of Science) and three Chinese databases (CNKI, CQVIP and WAN-FANG) in January 2022. Two authors independently screened the literature, extracted the studies characteristics. Results The initial search yielded 4389 results, of which 1954 were duplicates. Of the remaining 135 articles, 42 studies met the inclusion criteria. Among the reviewed articles, there were 14 (33.3%) cross-sectional study, 9 (21.4%) cohort study, 4 (9.5%) longitudinal study, 3 qualitative study, 12 (28.7%) randomized control trials. The main barriers identified were older age, women, lung function, comorbidities, COPD symptoms (fear of breathlessness and injury, severe fatigue, anxiety and depression), GOLD stage, frequency of exacerbation, oxygen use, lack of motivation and environment-related (e.g., season and weather). Twelve studies have evaluated the effects of physical exercise (e.g., walking training, pulmonary rehabilitation (PR), pedometer, self-efficacy enhancing intervention and behavioral modification intervention) on PA and showed significant positive effects on the prognosis of patients. However, in real life it is difficult to maintain PA in people with COPD. Conclusions Changing PA behavior in patients with COPD requires multidisciplinary collaboration. Future studies need to identify the best instruments to measure physical activity in clinical practice. Future studies should focus on the effects of different types, time and intensity of PA in people with COPD and conduct randomized, adequately-powered, controlled trials to evaluate the long-term effectiveness of behavioral change interventions in PA. Supplementary Information The online version contains supplementary material available at 10.1186/s12890-022-02099-4.
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Affiliation(s)
- Xinyue Xiang
- Department of Nursing, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Lihua Huang
- Department of Nursing, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China.
| | - Yong Fang
- Department of Nursing, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Shasha Cai
- Department of Nursing, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Mingyue Zhang
- Department of Nursing, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
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Coll F, Cavalheri V, Gucciardi DF, Wulff S, Hill K. Quantifying the Effect of Monitor Wear Time and Monitor Type on the Estimate of Sedentary Time in People with COPD: Systematic Review and Meta-Analysis. J Clin Med 2022; 11:jcm11071980. [PMID: 35407588 PMCID: PMC8999633 DOI: 10.3390/jcm11071980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 03/24/2022] [Accepted: 03/30/2022] [Indexed: 01/25/2023] Open
Abstract
In studies that have reported device-based measures of sedentary time (ST) in people with chronic obstructive pulmonary disease (COPD), we explored if the monitor type and monitor wear time moderated the estimate of this measure. Five electronic databases were searched in January 2021. Studies were included if >70% of participants had stable COPD, and measures of ST (min/day) were collected using wearable technology. Meta-regression was used to examine the influence of moderators on ST, monitor type, and wear time. The studies identified were a total of 1153, and 36 had usable data for meta-analyses. The overall pooled estimate of ST (mean [95% CI]) was 524 min/day [482 to 566] with moderate heterogeneity among effect sizes (I2 = 42%). Monitor wear time, as well as the interaction of monitor wear time and monitor type, were moderators of ST (p < 0.001). The largest difference (−318 min; 95% CI [−212 to −424]) was seen between studies where participants wore a device without a thigh inclinometer for 24 h (and removed sleep during analysis) (675 min, 95% CI [589 to 752]) and studies where participants wore a device with a thigh inclinometer for 12 h only (356 min; 95% CI [284 to 430]). In people with COPD, the monitor wear time and the interaction of the monitor wear time and the monitor type moderated the estimate of ST.
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Affiliation(s)
- Fiona Coll
- Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, WA 6102, Australia; (F.C.); (V.C.); (D.F.G.)
- Physiotherapy Department, Royal Perth Hospital, Perth, WA 6000, Australia;
| | - Vinicius Cavalheri
- Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, WA 6102, Australia; (F.C.); (V.C.); (D.F.G.)
- Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, WA 6102, Australia
- Allied Health, South Metropolitan Health Service, Perth, WA 6150, Australia
- Exercise Medicine Research Institute, Edith Cowan University, Perth, WA 6027, Australia
| | - Daniel F. Gucciardi
- Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, WA 6102, Australia; (F.C.); (V.C.); (D.F.G.)
- Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, WA 6102, Australia
| | - Sheldon Wulff
- Physiotherapy Department, Royal Perth Hospital, Perth, WA 6000, Australia;
| | - Kylie Hill
- Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, WA 6102, Australia; (F.C.); (V.C.); (D.F.G.)
- Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, WA 6102, Australia
- Institute for Respiratory Health, Sir Charles Gairdner Hospital, Nedlands, WA 6009, Australia
- Correspondence: ; Tel.: +61-8-9226-2774
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Cosío BG, Hernández C, Chiner E, Gimeno-Santos E, Pleguezuelos E, Seijas N, Rigau D, López-Campos JL, Soler-Cataluña JJ, Calle M, Miravitlles M, Casanova C. Spanish COPD Guidelines (GesEPOC 2021): Non-pharmacological Treatment Update. Arch Bronconeumol 2022; 58:345-351. [PMID: 35312554 DOI: 10.1016/j.arbres.2021.08.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 08/19/2021] [Indexed: 11/02/2022]
Abstract
In addition to recommendations for pharmacological treatment stratified for risk and phenotype, the new 2021 edition of the Spanish COPD Guidelines (GesEPOC 2021) proposes a personalized approach to treatable traits, defined as a characteristic (clinical, physiological, or biological) that can be identified by diagnostic tests or biomarkers, for which a specific treatment is available. Some treatable traits, such as malnutrition, sedentarism, emphysema or respiratory failure, can be treated with non-pharmacological therapies, and this was not covered in detail in the guidelines. This section of GesEPOC 2021 includes a narrative update with recommendations on dietary treatment, physical activity, respiratory rehabilitation, oxygen therapy, non-invasive ventilation, volume reduction, and lung transplantation. A PICO question with recommendations on the use of supplemental oxygen during exercise in COPD patients without severe hypoxemia is also included.
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Affiliation(s)
- Borja G Cosío
- Servicio de Neumología, Hospital Universitario Son Espases-IdISBa, Palma de Mallorca, España; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, España.
| | - Carme Hernández
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, España; Dispositivo Transversal de Hospitalización a Domicilio, Hospital Clinic de Barcelona, Barcelona, España
| | - Eusebi Chiner
- Servicio de Neumología, Hospital Universitario San Juan de Alicante, Alicante, España
| | - Elena Gimeno-Santos
- Servicio de Neumología, Hospital Clínico de Barcelona; Programa de enfermedades no transmisibles y medio ambiente, Instituto de Salud Global (ISGlobal) de Barcelona, Barcelona, España
| | - Eulogio Pleguezuelos
- Servicio de Medicina Física y Rehabilitación, Hospital de Mataró, Mataró (Barcelona), España
| | - Nuria Seijas
- Dispositivo Transversal de Hospitalización a Domicilio, Hospital Clinic de Barcelona, Barcelona, España
| | - David Rigau
- Centro Cochrane Iberoamericano, Barcelona, España
| | - José Luis López-Campos
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, España; Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío, Universidad de Sevilla, España
| | - Juan José Soler-Cataluña
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, España; Servicio de Neumología, Hospital Arnau de Vilanova, Valencia, España
| | - Myriam Calle
- Servicio de Neumología, Hospital Clínico San Carlos; Departamento de Medicina, Facultad de Medicina, Universidad Complutense de Madrid; Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, España
| | - Marc Miravitlles
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, España; Servicio de Neumología, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, España
| | - Ciro Casanova
- Servicio de Neumología-Unidad de Investigación, Hospital Universitario de La Candelaria, Universidad de La Laguna, Tenerife, España
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Cosío BG, Hernández C, Chiner E, Gimeno-Santos E, Pleguezuelos E, Seijas N, Rigau D, López-Campos JL, Soler-Cataluña JJ, Calle M, Miravitlles M, Casanova C. [Translated article] Spanish COPD Guidelines (GesEPOC 2021): Non-pharmacological Treatment Update. ARCHIVOS DE BRONCONEUMOLOGÍA 2022. [DOI: 10.1016/j.arbres.2021.08.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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Wshah A, Selzler AM, Hill K, Brooks D, Goldstein R. Embedding a Behavior Change Program Designed to Reduce Sedentary Time Within a Pulmonary Rehabilitation Program Is Feasible in People With COPD. J Cardiopulm Rehabil Prev 2021; 42:45-51. [PMID: 34520411 DOI: 10.1097/hcr.0000000000000624] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE This study examined the feasibility of embedding a 4-wk intervention, which sought to reduce sedentary time (SED), into a pulmonary rehabilitation program (PRP) in people with chronic obstructive pulmonary disease. METHODS This was an intervention study that comprised one face-to-face session and three follow-up visits. Primary outcomes related to feasibility and included adherence to data completion undertaken before and during the intervention period, participant satisfaction with the intervention (out of 100%), and participant achievement of intervention goals. Secondary outcomes, collected before and after the intervention period, included SED and daily step count. RESULTS Of 28 eligible individuals approached to participate, 21 (75%) were enrolled and 19 (90%) completed the program (13 females; age 69.1 ± 8.7 yr). Sixteen participants (84%) were adherent to wearing a physical activity monitor before and during the intervention period. The satisfaction score was 90 ± 12%. Over the intervention period, a total of 73 intervention goals were set, of which 41 (56%) were achieved. The effect of the intervention on SED was unclear. CONCLUSIONS Embedding this intervention in a PRP appears to be feasible; however, its impact on SED should be further evaluated.
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Affiliation(s)
- Adnan Wshah
- Respiratory Medicine, West Park Healthcare Centre, Toronto, Ontario, Canada (Drs Wshah, Selzler, Brooks, and Goldstein); Rehabilitation Sciences Institute (Drs Wshah, Brooks, and Goldstein) and Department of Medicine (Drs Brooks and Goldstein), University of Toronto, Toronto, Ontario, Canada; Department of Physical and Occupational Therapy, Hashemite University, Zarqa, Jordan (Dr Wshah); School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia (Dr Hill); and School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada (Dr Brooks)
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12
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Cheng SWM, Alison J, Stamatakis E, Dennis S, McNamara R, Spencer L, McKeough Z. Six-week behaviour change intervention to reduce sedentary behaviour in people with chronic obstructive pulmonary disease: a randomised controlled trial. Thorax 2021; 77:231-238. [PMID: 34226203 DOI: 10.1136/thoraxjnl-2020-214885] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 06/02/2021] [Indexed: 11/03/2022]
Abstract
INTRODUCTION This study aimed to determine whether a 6-week behaviour change intervention was more effective than a sham intervention for reducing sedentary behaviour (SB) in people with chronic obstructive pulmonary disease (COPD). METHODS People with stable COPD on the waitlist for entry into pulmonary rehabilitation were recruited to this multicentre trial with randomisation (independent, concealed allocation) to either an intervention group or sham group, assessor blinding and intention-to-treat (ITT) analysis. The behaviour change intervention consisted of once weekly sessions for 6 weeks with a physiotherapist to reduce SB through education, guided goals setting and real-time feedback on SB. The sham intervention consisted of once weekly phone calls for 6 weeks to monitor health status. SB was measured continuously over 7 days using thigh-worn accelerometry (activPAL3 micro). The primary outcome was time spent in SB. Participants with at least 4 days of ≥10 hours waking wear time were included in the ITT analysis and those who reported achieving ≥70% of goals to reduce SB or who completed all sham calls were included in a per-protocol analysis. RESULTS 70 participants were recruited and 65 completed the study (mean±SD age 74±9 years, mean FEV1 55%±19% predicted, 49% male). At 6 weeks, no between-group differences in time spent in SB were observed in the ITT analysis (mean difference 5 min/day, 95% CI -38 to 48) or per-protocol analysis (-16 min/day, 95% CI -80 to 48). DISCUSSION A 6-week behaviour change intervention did not reduce time in SB compared with a sham intervention in people with stable moderate-to-severe COPD prior to pulmonary rehabilitation.
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Affiliation(s)
- Sonia Wing Mei Cheng
- Discipline of Physiotherapy, The University of Sydney, Sydney, New South Wales, Australia .,Department of Physiotherapy, Macquarie University Hospital, Sydney, New South Wales, Australia
| | - Jennifer Alison
- Discipline of Physiotherapy, The University of Sydney, Sydney, New South Wales, Australia.,Allied Health Professorial Unit, Sydney Local Health District, Sydney, New South Wales, Australia
| | - Emmanuel Stamatakis
- Charles Perkins Centre, School of Public Health, Prevention Research Collaboration, The University of Sydney, Sydney, New South Wales, Australia
| | - Sarah Dennis
- Discipline of Physiotherapy, The University of Sydney, Sydney, New South Wales, Australia.,Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia
| | - Renae McNamara
- Department of Physiotherapy, Prince of Wales Hospital and Community Health Services, Randwick, New South Wales, Australia.,Woolcock Emphysema Centre, Woolcock Institute of Medical Research, Sydney, New South Wales, Australia
| | - Lissa Spencer
- Department of Physiotherapy, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - Zoe McKeough
- Discipline of Physiotherapy, The University of Sydney, Sydney, New South Wales, Australia
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13
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Coll F, Cavalheri V, Gucciardi DF, Wulff S, Hill K. In People With COPD, There Is Limited Evidence That Exercise Training Reduces Sedentary Time, and Behavior Change Techniques Are Poorly Reported: Systematic Review and Meta-Analysis. Phys Ther 2021; 101:6178888. [PMID: 33742675 DOI: 10.1093/ptj/pzab097] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 01/07/2021] [Accepted: 02/24/2021] [Indexed: 12/17/2022]
Abstract
OBJECTIVE In people with chronic obstructive pulmonary disease (COPD), the authors sought to explore (1) the effect of any intervention on the time spent in sedentary behavior and, (2) which behavior change techniques (BCTs) have shown promise in achieving this lifestyle target. METHODS Five electronic databases were searched on January 7, 2021. Studies were included if they (1) recruited people with stable COPD, (2) applied an intervention ≥4 weeks, and (3) measure sedentary time (ST) before and after the intervention period using wearable technology or via self-reports of television viewing. The primary analyses were restricted to data reported in randomized controlled trials (RCTs). All BCTs described during the intervention periods were mapped using an established taxonomy. RESULTS Of the 1142 records identified, 8 were RCTs, of which 6 had exercise training as the intervention. Random effects meta-analysis of data from 4 of these 6 trials that implemented exercise training showed no clear effect on ST (mean difference, -3.4 minutes; 95% CI, -27.9-21.0 minutes). Commonly mapped BCTs in the majority of studies included action planning and instruction on how to perform the behavior. Of all the BCTs mapped, 25% were reported with sufficient information to be graded "beyond reasonable doubt." CONCLUSION Despite robust evidence that exercise training improves functional outcomes and reduces dyspnea, this intervention does not seem to translate into behavior change. The primary analysis demonstrated that, in adults with COPD, the effect of exercise training on ST was, at best, uncertain. The BCTs embedded within the interventions were often poorly reported. Future RCTs are required that appropriately report BCT and ST to improve the precision of our estimate of the effect exercise training may have on ST, and BCTs used during intervention periods need to be reported with greater specificity. IMPACT In people with COPD, there is currently limited evidence to suggest that exercise training will reduce sedentary behavior. To move this area of research forward, BCTs embedded within these interventions need to be described with greater precision. LAY SUMMARY In people with COPD, interventions such as exercise training do not seem to produce a reduction in sedentary behavior (ie, time spent sitting or lying down) during daily life. The techniques used to help people change their sedentary behavior were poorly reported, so we do not know what exactly was done and therefore cannot know what may have worked well.
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Affiliation(s)
- Fiona Coll
- Curtin School of Allied Health, Faculty of Health Science, Curtin University, Perth, Western Australia, Australia.,Physiotherapy Department, Royal Perth Hospital, Perth, Western Australia, Australia
| | - Vinicius Cavalheri
- Curtin School of Allied Health, Faculty of Health Science, Curtin University, Perth, Western Australia, Australia.,Allied Health, South Metropolitan Health Service, Perth, Western Australia, Australia.,Institute for Respiratory Health, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | - Daniel F Gucciardi
- Curtin School of Allied Health, Faculty of Health Science, Curtin University, Perth, Western Australia, Australia
| | - Sheldon Wulff
- Physiotherapy Department, Royal Perth Hospital, Perth, Western Australia, Australia
| | - Kylie Hill
- Curtin School of Allied Health, Faculty of Health Science, Curtin University, Perth, Western Australia, Australia.,Institute for Respiratory Health, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
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14
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Lei Y, Zou K, Xin J, Wang Z, Liang K, Zhao L, Ma X. Sedentary behavior is associated with chronic obstructive pulmonary disease: A generalized propensity score-weighted analysis. Medicine (Baltimore) 2021; 100:e25336. [PMID: 33950922 PMCID: PMC8104186 DOI: 10.1097/md.0000000000025336] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Accepted: 02/26/2021] [Indexed: 02/05/2023] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is the fourth and third leading cause of death worldwide and in China, respectively. Sedentary behavior has been shown to increase the risk of respiratory disease, such as asthma. However, the relationship between sedentary behavior and COPD is unclear. This study aimed to investigate the association between sedentary behavior and COPD.Data was extracted from the 2018 a large-scale cross-sectional study of Chronic Disease and Lifestyle Population Survey in Sichuan Province of China, in which sedentary behavior and chronic diseases were self-reported according to medical records. The association between sedentary behavior on risk of COPD was estimated using multivariable regression model in non-matching cohorts and generalized propensity score-weighted (GPSW)cohorts, respectively, controlling for potential confounders.Individuals who remained sedentary for more than 7 hours per day were more likely to have COPD than the control group (<3 hours) both in conventional multivariate logistic regression analysis (OR = 2.020, 95%CI: 1.575-2.585, P < .001) and GPSW analysis (OR = 2.381, 95%CI: 1.778-3.188, P < .001). After GPSW and the sensitivity analysis using refined smoking variable further found a dose-effect between sedentary behavior and COPD, with 1.242 (95%CI: 1.006-1.532, P < .05) times risk of COPD in those sedentary behavior of more than 5 hours per day (GPSW) and 1.377 (95%CI: 1.092-1.736, P < .05) times risk in those sedentary behavior above 5 hours per day (sensitivity analysis), comparing with the control group.Sedentary behavior is independently associated with increased risk of COPD, adjusting for other confounders. The findings of this study have important implications for future research and public health guidance. Reducing sedentary time may have a significant role in COPD prevention.
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Affiliation(s)
- Yalin Lei
- Department of Health-Related Social and Behavioral Sciences
| | - Kun Zou
- Department of Health Policy and Management, West China School of Public Health and West China Fourth Hospital, Sichuan University
- Research Center for Rural Health Development
- Institute for Healthy Cities, Sichuan
| | - Junguo Xin
- School of Public Health, Chengdu Medical College, Sichuan
- International Initiative on Spatial Lifecourse Epidemiology (ISLE)
| | - Zhuo Wang
- Department of Chronic and Non-communicable Disease Control and Prevention, Sichuan Center of Disease Control and Prevention
- International Initiative on Spatial Lifecourse Epidemiology (ISLE)
| | - Kaili Liang
- Department of Radiology, Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China
| | - Li Zhao
- Department of Health Policy and Management, West China School of Public Health and West China Fourth Hospital, Sichuan University
- International Initiative on Spatial Lifecourse Epidemiology (ISLE)
- Research Center for Rural Health Development
- Institute for Healthy Cities, Sichuan
| | - Xiao Ma
- Department of Health-Related Social and Behavioral Sciences
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15
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Bertuol C, Tozetto WR, Streb AR, Del Duca GF. Combined relationship of physical inactivity and sedentary behaviour with the prevalence of noncommunicable chronic diseases: data from 52,675 Brazilian adults and elderly. Eur J Sport Sci 2021; 22:617-626. [PMID: 33476222 DOI: 10.1080/17461391.2021.1880646] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
This paper aims to verify the association between the combined relationship of physical inactivity and sedentary behaviour (SB) at leisure-time and the prevalence of noncommunicable chronic diseases (NCDs) in Brazilian adults and elderly. This is a cross-sectional study, derived from the VIGITEL system, with individuals ≥18 years old (n = 52,675). The presence of NCDs (diabetes, hypertension, and obesity) and the independent variables were defined by self-report. Binary logistic regression was used. While adults with the presence of, at least, one risky behaviour had a higher odds to have obesity (OR active + high SB: 1.25; 95%CI: 1.01;1.54; OR inactive + low SB: 1.47; 95%CI: 1.25;1.73; OR inactive + high SB: 1.77; 95%CI: 1.47;2.12), the elderly had an increased risk for this outcome only when classified as inactive (OR inactive + low SB: 1.43; 95%CI: 1.17;1.75; OR inactive + high SB: 1.87; 95%CI: 1.47;2.38). Inactive adults with low SB were more likely to have diabetes (OR inactive + low SB: 1.31; 95%CI: 1.00;1.71) and hypertension (OR inactive + low SB: 1.26; 95%CI: 1.08;1.46), while physical inactivity was again more strongly associated with these outcomes in the elderly, for diabetes (OR inactive + low SB: 1.23; 95%CI: 1.02;1.48; OR inactive + high SB: 1.75; 95%CI: 1.39;2.19), and hypertension (OR inactive + low SB: 1.22; 95%CI: 1.05;1.41; OR inactive + high SB: 1.60; 95%CI: 1.33;1.94) Both leisure-time behaviours carry a high risk of the prevalence of different NCDs, however, physical inactivity, isolated or combined, showed a greater association with the evaluated outcomes.Highlights This cross-national survey included representative sample of people ≥18 years old.Adults with at least one evident risky behavior had a higher chance of obesity.Inactive adults with low sedentary behavior had higher chances for diabetes and hypertension.Physical inactivity was more strongly associated with all diseases in the elderly.
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Affiliation(s)
- Cecília Bertuol
- Sports Center, Federal University of Santa Catarina, Florianopolis, Brazil
| | | | - Anne Ribeiro Streb
- Sports Center, Federal University of Santa Catarina, Florianopolis, Brazil
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16
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Minakata Y, Sasaki S. Data Reproducibility and Effectiveness of Bronchodilators for Improving Physical Activity in COPD Patients. J Clin Med 2020; 9:jcm9113497. [PMID: 33138116 PMCID: PMC7692282 DOI: 10.3390/jcm9113497] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 10/24/2020] [Accepted: 10/27/2020] [Indexed: 11/16/2022] Open
Abstract
Increasing physical activity (PA) in patients with chronic obstructive pulmonary disease (COPD) is an important issue, however, the effect of bronchodilators on PA is still controversial. The indicators of PA, as measured by an accelerometer, can easily fluctuate based on several factors, which might cause inconsistent results. In this review, we listed the indicators of PA and the factors influencing the reproducibility of indicators of PA, and reviewed reports in which the effects of bronchodilators on PA were evaluated by an accelerometer. Then, we investigated the association between the processing of influencing factors and the effectiveness of bronchodilators for improving the PA of COPD patients. Fifteen reports were extracted using the PubMed database. In all seven reports in which adjustment was performed for at least two of four influencing factors (non-wear time, data from days with special behavior, environmental factors, and number of valid days required to obtain reproducible data), bronchodilators showed beneficial effects on PA. No adjustment was made for any of these factors in any of the four bronchodilator-ineffective reports. This suggests that the processing of influencing factors to secure reproducibility might affect the results regarding the effectiveness of bronchodilators for improving PA in COPD patients.
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17
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Cheng SWM, Alison JA, Stamatakis E, Dennis SM, McKeough ZJ. Patterns and Correlates of Sedentary Behaviour Accumulation and Physical Activity in People with Chronic Obstructive Pulmonary Disease: A Cross-Sectional Study. COPD 2020; 17:156-164. [DOI: 10.1080/15412555.2020.1740189] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Sonia W. M. Cheng
- Discipline of Physiotherapy, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Jennifer A. Alison
- Discipline of Physiotherapy, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- Allied Health Professorial Unit, Sydney Local Health District, Sydney, Australia
| | - Emmanuel Stamatakis
- Charles Perkins Centre, School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Sarah M. Dennis
- Discipline of Physiotherapy, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- Ingham Institute for Applied Medical Research, Sydney, Australia
| | - Zoe J. McKeough
- Discipline of Physiotherapy, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
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18
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Minakata Y, Motegi T, Ueki J, Gon Y, Nakamura S, Anzai T, Hirata K, Ichinose M. Effect of tiotropium/olodaterol on sedentary and active time in patients with COPD: post hoc analysis of the VESUTO ® study. Int J Chron Obstruct Pulmon Dis 2019; 14:1789-1801. [PMID: 31496678 PMCID: PMC6689763 DOI: 10.2147/copd.s208081] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 07/10/2019] [Indexed: 12/31/2022] Open
Abstract
Background Patients with COPD are less physically active. This post hoc analysis of a randomized, double-blind, active-controlled, crossover trial assessed the efficacy of once-daily tiotropium/olodaterol combination therapy versus tiotropium monotherapy in Japanese patients with COPD. Patients and methods Patients were provided with a three-axis accelerometer to measure sedentary and active behavior defined as 1.0-1.5 metabolic equivalents (METs), ≥2.0 METs, and ≥3.0 METs, respectively. Of the 182 patients enrolled, 131 satisfied the conditions for the present analysis and were randomized to tiotropium monotherapy (n=62) or tiotropium/olodaterol combination therapy (n=69). Results Tiotropium/olodaterol combination therapy significantly reduced the duration of 1.0-1.5 MET activity by 8.64 mins (p=0.040) and significantly increased the duration of ≥2.0 MET and ≥3.0 MET activity by 6.51 mins (p=0.017) and 2.60 mins (p=0.008), respectively, compared with tiotropium alone. Subgroup analyses showed that better lung function, milder dyspnea, and higher levels of physical activity at baseline were associated with reduced sedentary time and increased duration of physical activity. Conclusion Tiotropium/olodaterol combination therapy significantly reduced sedentary time and improved physical activity compared with tiotropium monotherapy. This trial was registered in ClinicalTrials.gov (NCT02629965).
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Affiliation(s)
- Yoshiaki Minakata
- Department of Respiratory Medicine, National Hospital Organization Wakayama Hospital, Wakayama, Japan
| | - Takashi Motegi
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Jun Ueki
- Clinical Research Unit of Respiratory Pathophysiology, Juntendo University Graduate School of Health Care and Nursing, Chiba, Japan
| | - Yasuhiro Gon
- Division of Respiratory Medicine, Department of Internal Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Shuhei Nakamura
- Medical Division, Nippon Boehringer Ingelheim Co. Ltd., Tokyo, Japan
| | - Tatsuhiko Anzai
- Clinical Information Division Data Science Center, Statistics Analysis Department 1, EPS Corporation, Tokyo, Japan
| | - Kazuto Hirata
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Masakazu Ichinose
- Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
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19
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McKeough ZJ, Large SL, Spencer LM, Cheng SWM, McNamara RJ. An observational study of self-reported sedentary behaviour in people with chronic obstructive pulmonary disease and bronchiectasis. Braz J Phys Ther 2019; 24:399-406. [PMID: 31182285 DOI: 10.1016/j.bjpt.2019.05.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 05/22/2019] [Accepted: 05/28/2019] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Few studies have examined sedentary behaviour in chronic respiratory disease. The limited evidence suggests that increased levels of sedentary behaviour are associated with increased mortality. OBJECTIVES This study aimed to compare the level of self-reported sedentary behaviour in people with chronic obstructive pulmonary disease (COPD) and bronchiectasis as well as to identify associations between sedentary time with functional performance measures and health-related quality of life in the chronic respiratory disease group. METHODS An observational study design was used. Participants completed the Sedentary Behaviour Questionnaire from which average sedentary time (hours/day) was determined. Functional performance was measured using the six-minute walk test, the four-metre gait speed test and the five sit-to-stand test. Health-related quality of life was measured using the St George's Respiratory Questionnaire. Sedentary time was compared between groups using an unpaired t-test. Univariate analysis explored relationships amongst variables. RESULTS The convenience sample consisted of 103 people with COPD [52% male; mean±SD age: 73±9 years, FEV1% predicted: 56±23] and 33 people with bronchiectasis [52% male; 74±8 years, FEV1% predicted: 69±25]. Average self-reported sedentary time in COPD was 7.6±2.7 hours/day and in bronchiectasis was 8.0±4.1 hours/day, with no between-group difference (-0.4, 95% CI -1.7, 0.8). No associations were found between sedentary time and any functional performance outcome or with health-related quality of life. CONCLUSION There was no difference in the high sedentary time between people with COPD and bronchiectasis. Sedentary behaviour was not associated with functional performance or disease-related health-related quality of life in people with chronic respiratory disease.
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Affiliation(s)
- Zoe J McKeough
- Discipline of Physiotherapy, Faculty of Health Sciences, University of Sydney, Sydney, NSW, Australia.
| | - Sarah L Large
- Discipline of Physiotherapy, Faculty of Health Sciences, University of Sydney, Sydney, NSW, Australia
| | - Lissa M Spencer
- Pulmonary Rehabilitation Clinic, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - Sonia W M Cheng
- Discipline of Physiotherapy, Faculty of Health Sciences, University of Sydney, Sydney, NSW, Australia
| | - Renae J McNamara
- Pulmonary Rehabilitation Clinic, Prince of Wales Hospital, Randwick, NSW, Australia; Woolcock Emphysema Centre, Woolcock Institute of Medical Research, The University of Sydney, Sydney, NSW, Australia
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20
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McDonald VM, Osadnik CR, Gibson PG. Treatable traits in acute exacerbations of chronic airway diseases. Chron Respir Dis 2019; 16:1479973119867954. [PMID: 31409129 PMCID: PMC6696844 DOI: 10.1177/1479973119867954] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 07/09/2019] [Indexed: 01/06/2023] Open
Abstract
Acute exacerbations of chronic airway disease are common occurrences that cause a major burden of illness. Acute exacerbations are associated with impaired health status, increased lung function decline, hospitalization and increased risk of death. Exacerbation avoidance is a major priority. Despite this goal, exacerbations continue to occur and the need for effective models of care that optimize patient outcomes are urgently needed. 'Treatable Traits' is an approach to personalized medicine that has been proposed for the management of airway diseases. The treatable traits approach allows for the recognition of clinically important, identifiable and treatable disease characteristics, followed by targeted and individualized treatment interventions to address each trait. We review the literature relating to treatable traits in airway diseases; in particular, those traits that can predict exacerbations and approaches to management that aim to prevent exacerbations by using a treatable traits model of care. We propose this approach as a potentially useful model of care to both prevent and manage acute exacerbations.
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Affiliation(s)
- Vanessa M McDonald
- Priority Research Centre for Healthy Lungs and Centre of Excellence
in Severe Asthma, Faculty of Health and Medicine, University of Newcastle, New South
Wales, Australia
- Department of Respiratory and Sleep Medicine, John Hunter Hospital,
Newcastle, Australia
| | - Christian R Osadnik
- Department of Physiotherapy, Monash University, Melbourne,
Australia
- Monash Lung and Sleep, Monash Health, Melbourne, Australia
| | - Peter G Gibson
- Priority Research Centre for Healthy Lungs and Centre of Excellence
in Severe Asthma, Faculty of Health and Medicine, University of Newcastle, New South
Wales, Australia
- Department of Respiratory and Sleep Medicine, John Hunter Hospital,
Newcastle, Australia
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