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Man W, Chaplin E, Daynes E, Drummond A, Evans RA, Greening NJ, Nolan C, Pavitt MJ, Roberts NJ, Vogiatzis I, Singh SJ. British Thoracic Society Clinical Statement on pulmonary rehabilitation. Thorax 2023; 78:s2-s15. [PMID: 37770084 DOI: 10.1136/thorax-2023-220439] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/03/2023]
Affiliation(s)
- William Man
- Royal Brompton & Harefield Hospitals, Guy's and St.Thomas' NHS Foundation Trust, London, UK
| | - Emma Chaplin
- Centre for Exercise and Rehabilitation Science, NIHR Biomedical Research Centre - Respiratory, Glenfield Hospital, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Enya Daynes
- Centre for Exercise and Rehabilitation Science, NIHR Biomedical Research Centre - Respiratory, Glenfield Hospital, University Hospitals of Leicester NHS Trust, Leicester, UK
- Department of Respiratory Sciences, Institute for Lung Health, University of Leicester, Leicester, UK
| | - Alistair Drummond
- Royal Brompton & Harefield Hospitals, Guy's and St.Thomas' NHS Foundation Trust, London, UK
| | - Rachael A Evans
- Centre for Exercise and Rehabilitation Science, NIHR Biomedical Research Centre - Respiratory, Glenfield Hospital, University Hospitals of Leicester NHS Trust, Leicester, UK
- Department of Respiratory Sciences, Institute for Lung Health, University of Leicester, Leicester, UK
| | - Neil J Greening
- Centre for Exercise and Rehabilitation Science, NIHR Biomedical Research Centre - Respiratory, Glenfield Hospital, University Hospitals of Leicester NHS Trust, Leicester, UK
- Department of Respiratory Sciences, Institute for Lung Health, University of Leicester, Leicester, UK
| | - Claire Nolan
- Royal Brompton & Harefield Hospitals, Guy's and St.Thomas' NHS Foundation Trust, London, UK
- Department of Health Sciences, College of Health Medicine and Life Sciences, Brunel University London, London, UK
| | - Matthew J Pavitt
- University Hospitals Sussex NHS Foundation Trust, Brighton, UK
- Brighton and Sussex Medical School, Brighton, UK
| | - Nicola J Roberts
- School of Health and Social Care, Edinburgh Napier University, Edinburgh, UK
| | - Ioannis Vogiatzis
- Department of Sport, Exercise and Rehabilitation, School of Health and Life Sciences, Northumberland University Newcastle, Newcastle Upon Tyne, UK
| | - Sally J Singh
- Centre for Exercise and Rehabilitation Science, NIHR Biomedical Research Centre - Respiratory, Glenfield Hospital, University Hospitals of Leicester NHS Trust, Leicester, UK
- Department of Respiratory Sciences, Institute for Lung Health, University of Leicester, Leicester, UK
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Grabara M. The association between physical activity and musculoskeletal disorders-a cross-sectional study of teachers. PeerJ 2023; 11:e14872. [PMID: 36852223 PMCID: PMC9961098 DOI: 10.7717/peerj.14872] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 01/19/2023] [Indexed: 02/24/2023] Open
Abstract
Purpose Combined with insufficient physical activity (PA) prolonged and improperly performed sedentary work can lead to musculoskeletal disorders (MSDs). The aim of this study was (I) to evaluate the self-reported level of PA and the prevalence of MSDs in male and female teachers, and (II) to investigate the association between PA and MSDs in teachers in Polish primary and secondary schools. Methods The study included 254 teachers from primary and secondary schools from Upper Silesia, Poland, excluding physical education teachers. The level of PA was assessed using the Seven-Day Physical Activity Recall (SDPAR). A standardized Nordic Musculoskeletal Questionnaire (NMQ) was used to assess the prevalence of MSDs. Results A similar percentage of female (80%) and male (90%) teachers met the WHO recommendations on moderate-intensity PA. The recommendations on performing vigorous-intensity PA were met by significantly (p = 0.002) less female than male teachers (50% and 75% respectively). Lower back disorders during the last 12 months and the last 7 days (57% and 45%, respectively) were the most commonly reported MSDs by teachers, followed by neck (53%, 40%), upper back (39%, 28%), and knee disorders (37%, 26%). The highest pain intensity was experienced by the teachers in the lower back and neck. Teachers with a greater number of MSDs were less likely to engage in vigorous-intensity PA and total PA than those with fewer painful areas of the body. Pain intensity in the neck, knees, upper- and lower back, and wrists/hands was negatively related to moderate and total PA. BMI negatively correlated with total PA, moderate-intensity PA vigorous-intensity PA, and high vigorous-intensity PA. Conclusions The study revealed the association between PA and MSDs in studied teachers. The most of the studied teachers met the WHO recommendation, and women were less likely to perform vigorous and high-vigorous PA than men. The lower back and neck disorders were the most common among the teachers.
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Flora S, Marques A, Hipólito N, Morais N, Silva CG, Januário F, Rodrigues F, Carreira BP, Cruz J. Test-retest reliability, agreement and construct validity of the International Physical Activity Questionnaire short-form (IPAQ-sf) in people with COPD. Respir Med 2023; 206:107087. [PMID: 36525854 DOI: 10.1016/j.rmed.2022.107087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 11/07/2022] [Accepted: 12/05/2022] [Indexed: 12/12/2022]
Abstract
INTRODUCTION This study assessed the test-retest reliability/agreement and construct validity of the International Physical Activity Questionnaire short-form (IPAQ-sf) in patients with chronic obstructive pulmonary disease (COPD). It also explored differences in its validity according to age, sex and GOLD airflow obstruction levels. METHODS 62 participants (68 ± 8 years, 53 males, FEV1 51 ± 23%pred) completed the Portuguese IPAQ-sf, wore an accelerometer for 7 days and completed a second IPAQ-sf. Test-retest reliability/agreement was assessed with Intraclass Correlation Coefficient (ICC2,1), 95% Limits of Agreement (LoA), standard error of measurement (SEM) and minimal detectable change (MDC95) for continuous variables, and percentage of agreement (%agreement) for categories ("active"/"inactive"). Validity was assessed with 95% LoA and Spearman's correlations (ρ) between IPAQ-sf 2 (METs-min/week, time in vigorous [VPA], moderate PA [MPA] and walking) and accelerometry (time in MVPA, VPA, MPA and step counts) for continuous variables; %agreement, Cohen's kappa, and sensitivity specificity and±predictive values for categories. Correlations were also performed for age, sex and GOLD airflow obstruction grades. RESULTS Reliability was good (ICC2,1 = 0.707) with wide LoA (-6446-6409 METs-min/week). SEM and MDC95 were 1840 and 4971 METs-min/week, respectively. %agreement between the two IPAQ-sf was 84% (kappa = 0.660). Positive, moderate and significant correlations were found between IPAQ-sf and accelerometry (0.396 ≤ ρ ≤ 0.527, p < 0.001), except for VPA (p > 0.05). The strongest correlations were found in age (<65 years) and male (0.466 ≤ ρ ≤ 0.653, p < 0.05). %agreement between tools was 65% (kappa = 0.313), with high sensitivity (0.830) but low specificity (0.500). CONCLUSIONS The IPAQ-sf seems valid to be used in COPD but caution on its widespread use is recommended as its accuracy may be limited.
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Affiliation(s)
- Sofia Flora
- Center for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, Leiria, Portugal
| | - Alda Marques
- Lab 3R - Respiratory Research and Rehabilitation Laboratory, School of Health Sciences (ESSUA) and Institute of Biomedicine (iBiMED), University of Aveiro, Aveiro, Portugal
| | - Nádia Hipólito
- Center for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, Leiria, Portugal
| | - Nuno Morais
- Center for Innovative Care and Health Technology (ciTechCare), Polytechnic Institute of Leiria; School of Health Sciences, Polytechnic Institute of Leiria, Centre for Rapid and Sustainable Product Development (CDRSP), Polytechnic Institute of Leiria, Leiria, Portugal
| | - Cândida G Silva
- Center for Innovative Care and Health Technology (ciTechCare), Polytechnic Institute of Leiria, School of Health Sciences, Polytechnic Institute of Leiria, Coimbra Chemistry Centre, Department of Chemistry, University of Coimbra, Coimbra, Portugal
| | - Filipa Januário
- Physical Medicine and Rehabilitation Department, Leiria Hospital Center, Leiria, Portugal
| | - Fátima Rodrigues
- Institute of Health Environmental, Faculty of Medicine, University of Lisbon, Pulmonary Rehabilitation Unit, Hospital Pulido Valente, University Hospital Center North Lisbon, Lisboa, Portugal
| | - Bruno P Carreira
- Center for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, School of Health Sciences, Polytechnic of Leiria - Leiria; Unidade de Saúde Familiar Pedro e Inês, ACES Oeste Norte, Alcobaça, Portugal
| | - J Cruz
- Center for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria; School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal.
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Neale CD, Christensen PE, Dall C, Ulrik CS, Godtfredsen N, Hansen H. Sleep Quality and Self-Reported Symptoms of Anxiety and Depression Are Associated with Physical Activity in Patients with Severe COPD. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16804. [PMID: 36554684 PMCID: PMC9778999 DOI: 10.3390/ijerph192416804] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 11/25/2022] [Accepted: 12/07/2022] [Indexed: 06/17/2023]
Abstract
Sleep quantity, quality and symptoms of depression or anxiety potentially affect the level of daily physical activity (PAL) and plausibly counteracts benefits from pulmonary rehabilitation programs. Their collective impact on PAL is sparsely investigated, particularly in patients with severely progressed chronic obstructive pulmonary disease (COPD). Aim: To investigate if sleep quantity, quality and symptoms from self-reported hospital anxiety and depression scores (HADS) are associated with PAL. Methods: In this exploratory cross-sectional study data were analysed from 148 participants with COPD; GOLD grade II-IV; GOLD group B to D (52% female, mean 69.7 ± SD of 8.4 years, FEV1% predicted 33.6 ± 10.9, 6MWD 327 ± 122 m, CAT 20 ± 7 points), eligible for conventional outpatient hospital-based pulmonary rehabilitation. Participants had sleep and PAL measured 24 h per day for five consecutive days with an activPAL monitor. Adjusted negative binomial regression was applied to investigate the associations with PAL. Results: Participants walked median (25th, 75th percentile) of 2358 (1325.75; 3822.25) steps per day and 14% walked >5000 steps per day on average. Time in bed (TIB) were a median (25th, 75th percentile) of 8.3 (7.1; 9.7) hours and numbers of nocturnal sleeping bouts (NSB) were 1.5 (0.8; 3), Anxiety (HADS-A) and depression (HADS-D) scores were median (25th, 75th percentile) of 5 (3; 8) points and 3 (2; 6) points, respectively, whereof 29% (HADS-A) and 15% (HADS-D) reported scores ≥8 points indicating significant symptoms. The fully adjusted rate ratio (RR) for steps per day for TIB (hours) [RR 0.97 (95% CI: 0.92; 1.02)], NSB (numbers) [RR 1.02 (95% CI: 0.97; 1.07)] were not significantly associated with number of steps per day, while there was a significantly association with number of steps per day for HADS-A [RR 1.04 (95% CI: 1.01; 1.07)] and HADS-D [RR 0.95 (95% CI: 0.91; 0.99)]. Conclusion: This exploratory cross-sectional study found a statistically significant association between HADS-A and HADS-D with numbers of steps per day in patients with severe COPD.
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Affiliation(s)
- Christopher D. Neale
- Department of Physical and Occupational Therapy, Copenhagen University Hospital, 2400 Copenhagen, Denmark
| | | | - Christian Dall
- Department of Physical and Occupational Therapy, Copenhagen University Hospital, 2400 Copenhagen, Denmark
- Institute for Clinical Medicine, University of Copenhagen, 2200 Copenhagen, Denmark
| | - Charlotte Suppli Ulrik
- Institute for Clinical Medicine, University of Copenhagen, 2200 Copenhagen, Denmark
- Respiratory Research Unit and Department of Respiratory Medicine, Copenhagen University Hospital, 2650 Hvidovre, Denmark
| | - Nina Godtfredsen
- Institute for Clinical Medicine, University of Copenhagen, 2200 Copenhagen, Denmark
- Respiratory Research Unit and Department of Respiratory Medicine, Copenhagen University Hospital, 2650 Hvidovre, Denmark
| | - Henrik Hansen
- Respiratory Research Unit and Department of Respiratory Medicine, Copenhagen University Hospital, 2650 Hvidovre, Denmark
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Ramon MA, Esteban C, Ortega F, Cebollero P, Carrascosa I, Martinez-González C, Sobradillo P, Soler-Cataluña JJ, Miravitlles M, García-Río F. Discriminant Validity of a Single Clinical Question for the Screening of Inactivity in Individuals Living with COPD. Int J Chron Obstruct Pulmon Dis 2022; 17:3033-3044. [PMID: 36483675 PMCID: PMC9725925 DOI: 10.2147/copd.s378758] [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: 06/16/2022] [Accepted: 11/24/2022] [Indexed: 12/05/2022] Open
Abstract
Introduction Quantifying physical activity in chronic obstructive pulmonary disease (COPD) with questionnaires and activity monitors in clinical practice is challenging. The aim of the present study was to analyse the discriminant validity of a single clinical question for the screening of inactive individuals living with COPD. Methods A multicentre study was carried out in stable COPD individuals both in primary and tertiary care. Patients wore the Dynaport accelerometer for 8 days and then answered 5 physical activity questions developed for the study, referring to the week in which their physical activity was monitored. Receiver operating characteristic (ROC) curve analysis with physical activity level (PAL) as the gold standard reference was used to determine the best cut-off point for each of the 5 clinical physical activity questions tested. Results A total of 86 COPD participants were analysed (males 68.6%; mean (SD) age 66.6 (8.5) years; FEV1 50.9 (17.3)% predicted; mean of 7305 (3906) steps/day). Forty-two (48.8%) participants were considered physically inactive (PAL ≤1.69). Answers to 4 out of 5 questions significantly differed in active vs inactive patients. The Kappa index and ROC curves showed that the answer to the question "On average, how many minutes per day do you walk briskly?" had the best discriminative capacity for inactivity, with an area under the curve (AUC) (95% Confidence interval (CI)) of 0.73 (0.63-0.84) and 30 min/day was identified as the best cut-off value (sensitivity (95% CI): 0.75 (0.60-0.87); specificity: 0.76 (0.61-0.88)). Conclusion The present results indicate that self-reported brisk walk time lower than 30 min/day may be a valid tool for the screening of inactivity in individuals living with COPD in routine care, if more detailed physical activity measures are not feasible.
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Affiliation(s)
- Maria Antonia Ramon
- Pneumology Department, Hospital Universitari Vall d´Hebron/Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Barcelona Hospital Campus; Physical Therapy Department, Universitat Internacional de Catalunya and CIBER de Enfermedades Respiratorias (CIBERES), Barcelona, Spain
| | - Cristóbal Esteban
- Respiratory Department, Hospital Galdakao; Health Services Research on Chronic Patients Network (REDISSEC) and BioCrues-Bizkaia Health Research Institute, Baracaldo, Spain
| | - Francisco Ortega
- Pneumology Department, Hospital Universitario Virgen del Rocío; Instituto de Biomedicina de Sevilla (IBiS), and CIBER de Enfermedades Respiratorias (CIBERES), Sevilla, Spain
| | - Pilar Cebollero
- Pneumology Department, Hospital CH de Navarra, Pamplona, Spain
| | - Inés Carrascosa
- Pneumology Department, Hospital Urduliz, Urduliz, Bizkaia, Spain
| | | | | | | | - Marc Miravitlles
- Pneumology Department, Hospital Universitari Vall d´Hebron/Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Barcelona Hospital Campus and CIBER de Enfermedades Respiratorias (CIBERES), Barcelona, Spain,Correspondence: Marc Miravitlles, Pneumology Department, Hospital Universitari Vall d´Hebron/Vall d’Hebron Institut de Recerca (VHIR), Vall d´Hebron Barcelona Hospital Campus, P. Vall d’Hebron 119-129, Barcelona, 08035, Spain, Tel +34 934893000, Fax +34 93 274 82 08, Email
| | - Francisco García-Río
- Pneumology Department, Hospital Universitario La Paz-IdiPAZ, and CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
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Shirahata T, Nishida Y, Sato H, Yogi S, Akagami T, Nagata M, Tanaka S, Nakamura H, Katsukawa F. Impact of non-exercise activity thermogenesis on physical activity in patients with COPD. Sci Prog 2022; 105:368504221117064. [PMID: 36082951 PMCID: PMC10450459 DOI: 10.1177/00368504221117064] [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] [Indexed: 11/16/2022]
Abstract
Physical inactivity is associated with comorbidities and mortality in chronic obstructive pulmonary disease (COPD) patients. Although non-exercise activity thermogenesis (NEAT) is important for evaluating the physical activity level (PAL) of patients with chronic diseases, it has not yet been assessed in COPD patients. This study included male patients with COPD (n = 28) and high risk for COPD (n = 8). Total energy expenditure (TEE) and basal metabolic rate (BMR) were measured using the doubly labeled water (DLW) method and indirect calorimetry, respectively. PAL was calculated as TEE/BMR, while the NEAT was obtained from a questionnaire. Physical activity was also assessed using an accelerometer. The total NEAT score was correlated with PAL (r = 0.534, P < 0.001), while PAL was correlated more strongly with the non-locomotive NEAT score (r = 0.548, P < 0.001) than the locomotive NEAT score (r = 0.278, P = 0.10). Regarding accelerometer-obtained data, this questionnaire mainly reflected steps/day and the duration of light locomotive and non-locomotive daily activities. The NEAT score is a possible option for evaluating PAL in daily clinical practice. The present results indicated that non-locomotive activity may have a greater impact on PAL than locomotive activity in COPD patients.
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Affiliation(s)
- Toru Shirahata
- Department of Respiratory Medicine, Saitama Medical University, Saitama, Japan
| | - Yuki Nishida
- Department of Nutrition and Metabolism, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
- Sports Medicine Research Center, Keio University, Yokohama, Japan
| | - Hideaki Sato
- Department of Respiratory Medicine, Saitama Medical University, Saitama, Japan
| | - Sanehiro Yogi
- Department of Respiratory Medicine, Saitama Medical University, Saitama, Japan
| | - Tomoe Akagami
- Department of Respiratory Medicine, Saitama Medical University, Saitama, Japan
| | - Makoto Nagata
- Department of Respiratory Medicine, Saitama Medical University, Saitama, Japan
| | - Shigeho Tanaka
- Department of Nutrition and Metabolism, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
- Faculty of Nutrition, Kagawa Nutrition University, Saitama, Japan
| | - Hidetoshi Nakamura
- Department of Respiratory Medicine, Saitama Medical University, Saitama, Japan
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Thyregod M, Løkke A, Skou ST, Larsen J, Bodtger U. Changes in systemic inflammation after pulmonary rehabilitation in patients with COPD and severe physical inactivity - an exploratory study. Chron Respir Dis 2022; 19:14799731221112439. [PMID: 36113167 PMCID: PMC9483968 DOI: 10.1177/14799731221112439] [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] [Indexed: 11/16/2022] Open
Abstract
Background: Severe physical inactivity (SPI) in patients with COPD is associated
with a poor prognosis. It is unknown whether there is a link between SPI and
systemic inflammation, and if systemic inflammation in SPI changes following
pulmonary rehabilitation (PR). Methods: A prospective, observational study of patients referred for at least
7 weeks of PR comprising 2 h of exercise therapy and education twice weekly. At
baseline and after PR, daily physical activity level (PAL) was measured with a
validated activity monitor, SenseWear® as well as systemic
inflammation: b-eosinophils, p-fibrinogen, p-CRP, s-IL-6 and s-CD 163. SPI was
defined as PAL <1.4. Results: At baseline, SPI was present in 31 of the 57 patients included, and 23%
(7/31) improved to non-SPI after PR. We observed no differences between patients
with SPI and non-SPI, except baseline plasma fibrinogen level was slightly yet
significantly higher in patients with SPI (median 13.3 [6.2–23.6] vs 11.2
[6.5–16.7] µmol/l) but change in fibrinogen levels differed insignificantly
between patients who improved to non-SPI at follow-up compared to patients with
persistent SPI (−0.6 [−16.9–9.9] vs −0.4 [−11.2–1.2] µmol/l). Conclusion: SPI in COPD appears not to be associated with a distinct inflammatory
profile compared to less sedentary COPD patients attending pulmonary
rehabilitation. Currently biomarkers have no role in the detection of SPI in
COPD.
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Affiliation(s)
- Mimi Thyregod
- Department of Respiratory Medicine, 91907Naestved Hospital, Nastved, Denmark.,Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Anders Løkke
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.,Department of Medicine, 4321Little Belt Hospital University, Vejle, Denmark
| | - Søren T Skou
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, 573169University of Southern Denmark, Odense, Denmark.,The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Region Zealand, Denmark
| | - Jacob Larsen
- Department of Pathology, 53140Zealand University Hospital, Roskilde, Denmark
| | - Uffe Bodtger
- Department of Respiratory Medicine, 91907Naestved Hospital, Nastved, Denmark.,Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.,Department of Respiratory Medicine, Zealand University Hospital, Roskilde, Denmark
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Román-Rodríguez M, Kocks JWH. Targeting exertional breathlessness to improve physical activity: the role of primary care. NPJ Prim Care Respir Med 2021; 31:41. [PMID: 34504091 PMCID: PMC8429707 DOI: 10.1038/s41533-021-00254-8] [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: 12/22/2020] [Accepted: 08/19/2021] [Indexed: 02/08/2023] Open
Abstract
Primary care physicians (PCPs) play a crucial role in the diagnosis and management of chronic obstructive pulmonary disease (COPD). By working together with patients to target exertional breathlessness and increase physical activity, PCPs have an important role to play, early in the disease course, in improving patient outcomes in both the short and long term. In this article, we consider how physical activity affects disease progression from the PCP perspective. We discuss the role of pharmacological therapy, the importance of an holistic approach and the role of PCPs in assessing and promoting physical activity. The complexity and heterogeneity of COPD make it a challenging disease to treat. Patients' avoidance of activity, and subsequent decline in capacity to perform it, further impacts the management of the disease. Improving patient tolerance of physical activity, increasing participation in daily activities and helping patients to remain active are clear goals of COPD management. These may require an holistic approach to management, including pulmonary rehabilitation and psychological programmes in parallel with bronchodilation therapy, in order to address both physiological and behavioural factors. PCPs have an important role to optimise therapy, set goals and communicate the importance of maintaining physical activity to their patients. In addition, optimal treatment that addresses activity-related breathlessness can help prevent the downward spiral of inactivity and get patients moving again, to improve their overall health and long-term prognosis.
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Affiliation(s)
- Miguel Román-Rodríguez
- Son Pisà Primary Health Care Centre, Balearic Health System, Mallorca, Spain.
- Primary Care Chronic Respiratory Research Unit, Instituto de Investigación Sanitaria de las Islas Baleares (IdISBa), Mallorca, Spain.
| | - Janwillem W H Kocks
- General Practitioners Research Institute, Groningen, The Netherlands
- Groningen Research Institute for Asthma and COPD (GRIAC), University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Observational and Pragmatic Research Institute, Singapore, Singapore
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Zampogna E, Bertolotti G, Ambrosino N, Lo Bello G, Cherubino F, Ianni A, Paneroni M, Pignatti P, Visca D, Zanini A, Giordano A. The Maugeri daily activity profile: a tool to assess physical activity in patients with chronic obstructive pulmonary disease. Monaldi Arch Chest Dis 2021; 91. [PMID: 33840180 DOI: 10.4081/monaldi.2021.1680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 03/22/2021] [Indexed: 11/23/2022] Open
Abstract
Patients with chronic obstructive pulmonary disease (COPD) report reduced physical activity (PA). There are only few tools available to assess PA and sedentary behavior in these patients, and none of them aims to differentiate between sedentary and active patterns. The aim of the study was to evaluate an easy tool to profile daily activity time in a cohort of patients with COPD, compared to healthy subjects; the study was set at the Istituti Clinici Scientifici Maugeri (ICS), IRCCS of Tradate and Lumezzane, Italy, and at the Ente Ospedaliero Cantonale Novaggio, Switzerland (Italian Speaking). The populations were inpatients with COPD, healthy subjects. The items of the Maugeri Daily Activity (MaDA) profile were chosen based on literature, interviews with patients and health professionals. Time spent during sleep (ST), when awake (AT), active (ACT) or in sedentary behavior (SET) were recorded. Lung function tests, arterial blood gases, the modified Medical Research Council (mMRC), the six-minute walking distance test (6MWD), the COPD Assessment Test (CAT), and the body-mass index, airflow obstruction, dyspnea, and exercise capacity (BODE) index were also assessed in patients. Sixty patients with COPD and 60 healthy controls filled in the questionnaire. As compared to controls, patients showed longer AT and SET. Active time of patients was significantly correlated with mMRC, CAT, Bode Index and 6MWD, but not with demographics, anthropometrics or stages of disease. Using this tool, we found that patients with COPD spent longer time awake and in sedentary behavior. The MaDA may be useful to evaluate PA in patients with COPD.
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Affiliation(s)
| | | | | | | | | | - Alessandra Ianni
- Respiratory Rehabilitation, ICS Maugeri IRCCS Institute of Tradate.
| | - Mara Paneroni
- Respiratory Rehabilitation, ICS Maugeri IRCCS Institute of Lumezzane.
| | | | - Dina Visca
- Respiratory Rehabilitation, ICS Maugeri IRCCS Institute of Tradate.
| | | | - Andrea Giordano
- Respiratory Rehabilitation, ICS Maugeri IRCCS Institute of Veruno.
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Cruz J, Jácome C, Oliveira A, Paixão C, Rebelo P, Flora S, Januário F, Valente C, Andrade L, Marques A. Construct validity of the brief physical activity assessment tool for clinical use in COPD. CLINICAL RESPIRATORY JOURNAL 2021; 15:530-539. [PMID: 33484059 DOI: 10.1111/crj.13333] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 01/19/2021] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Low physical activity (PA) levels are associated with poor health-related outcomes in Chronic Obstructive Pulmonary Disease (COPD). Thus, PA should be routinely assessed in clinical practice. OBJECTIVES This study assessed the construct validity of the Brief Physical Activity Assessment Tool (BPAAT) for clinical use in COPD and explored differences in age, sex and COPD grades. METHODS After linguistic adaptation of the tool to Portuguese, 110 patients (66.4 ± 9.6yrs, 72.7% male, FEV1 = 59.3 ± 25.5%predicted) completed the BPAAT and received an accelerometer. The BPAAT includes two questions assessing the weekly frequency and duration of vigorous- and moderate-intensity PA/walking, classifying individuals as insufficiently or sufficiently active. The BPAAT was correlated with accelerometry (moderate PA, MPA = 1952-5724 counts-per-min [CPM]); vigorous PA, VPA = 5725-∞CPM; moderate-to-vigorous PA, MVPA = 1952-∞CPM; daily steps), through: Spearman's correlations (ρ) for continuous data; %agreement, Kappa, sensitivity and specificity, positive and negative predictive values (PPV, NPV) for categorical data. RESULTS The BPAAT identified 73.6% patients as "insufficiently active" and 26.4% as "sufficiently active". The BPAAT was weakly to moderately correlated with accelerometry (0.394 ≤ ρ ≤ 0.435, P < 0.05), except for VPA (P = 0.440). This was also observed in age (<65/≥65yrs), COPD grades (GOLD 1-2/3-4) and in male patients (0.363 ≤ ρ ≤ 0.518, P < 0.05 except for VPA). No significant correlations were found in female patients (P > 0.05). Agreement was fair to moderate (0.36 ≤ κ ≤ 0.43; 73.6% ≤ %agreement ≤ 74.5%; 0.50 ≤ sensitivity ≤ 0.52; 0.84 ≤ specificity ≤ 0.91, 0.55 ≤ PPV ≤ 0.79, 0.72 ≤ NPV ≤ 0.82). CONCLUSION The BPAAT may be useful to screen patients' PA, independently of age and COPD grade, and identify male patients who are insufficiently active. Care should be taken when using this tool to assess vigorous PA or female patients.
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Affiliation(s)
- Joana Cruz
- Centre for Innovative Care and Health Technology (ciTechCare), School of Health Sciences (ESSLei), Polytechnic of Leiria, Leiria, Portugal.,Lab 3R - Respiratory Research and Rehabilitation Laboratory, School of Health Sciences, University of Aveiro (ESSUA), Aveiro, Portugal
| | - Cristina Jácome
- Lab 3R - Respiratory Research and Rehabilitation Laboratory, School of Health Sciences, University of Aveiro (ESSUA), Aveiro, Portugal.,CINTESIS -Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Ana Oliveira
- Lab 3R - Respiratory Research and Rehabilitation Laboratory, School of Health Sciences, University of Aveiro (ESSUA), Aveiro, Portugal.,Respiratory Medicine, West Park Healthcare Centre, Toronto, ON, Canada.,School of Rehabilitation Sciences, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Cátia Paixão
- Lab 3R - Respiratory Research and Rehabilitation Laboratory, School of Health Sciences, University of Aveiro (ESSUA), Aveiro, Portugal.,iBiMED - Institute of Biomedicine, University of Aveiro, Aveiro, Portugal
| | - Patrícia Rebelo
- Lab 3R - Respiratory Research and Rehabilitation Laboratory, School of Health Sciences, University of Aveiro (ESSUA), Aveiro, Portugal.,iBiMED - Institute of Biomedicine, University of Aveiro, Aveiro, Portugal
| | - Sofia Flora
- Centre for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, Leiria, Portugal
| | - Filipa Januário
- Serviço de Medicina Física e de Reabilitação - Centro Hospitalar de Leiria, Leiria, Portugal
| | - Carla Valente
- Pulmonology Department, Centro Hospitalar do Baixo Vouga, Aveiro, Portugal
| | - Lília Andrade
- Pulmonology Department, Centro Hospitalar do Baixo Vouga, Aveiro, Portugal
| | - Alda Marques
- Lab 3R - Respiratory Research and Rehabilitation Laboratory, School of Health Sciences, University of Aveiro (ESSUA), Aveiro, Portugal.,iBiMED - Institute of Biomedicine, University of Aveiro, Aveiro, Portugal
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11
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Gore S, Chindam T, Goldberg A, Huang MH, Shoemaker M, Blackwood J. Reliability and Validity of Patient-Reported, Rater-Based, and Hybrid Physical Activity Assessments in COPD: A Systematic Review. COPD 2020; 17:721-731. [PMID: 33054418 DOI: 10.1080/15412555.2020.1830963] [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: 10/23/2022]
Abstract
Selecting valid and reliable PA assessments in chronic obstructive pulmonary disease (COPD) is crucial to ensure that the information obtained is accurate, valuable, and meaningful. The purpose of this systematic review was to compare the validity and reliability among PA assessments in COPD. An electronic database search of PubMed and CINAHL was completed in December 2019 using MeSH terms on physical activity, COPD, validation, and questionnaires. Transparency in reporting was assessed with the STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) checklist while methodological quality was assessed with the modified Quality Appraisal tool for Reliability studies (QAREL) for reliability studies and the Quality Appraisal of Validity Studies (QAVALS) for validity studies. The search yielded fifteen different measures. The Stanford 7-day recall (PAR) demonstrated the strongest correlations with SenseWear Armband on energy expenditure (r = 0.83; p < 0.001) and moderate correlations for time spent in activity over 3 METs (r = 0.54, p < 0.001). The Multimedia Activity Recall (MARCA) also demonstrated moderate to good correlations with both SenseWear and Actigraph GT3X + accelerometers (r = 0.66-0.74). Assisted and computerized PRO measures (PAR and MARCA) and hybrid measures (C-PPAC and D-PPAC) demonstrate better psychometric properties as compared to other subjective measures and may be considered for quantification of PA in COPD. However, observations drawn from single validation studies limit strength of recommendations and further research is needed to replicate the findings.
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Affiliation(s)
- Shweta Gore
- School of Health and Rehabilitation Sciences, Department of Physical Therapy, MGH Institute of Health Professions, Boston, MA, USA
| | - Tirupathi Chindam
- Department of Rehabilitation, Genesis Rehabilitation Services, Richmond, VA, USA
| | - Allon Goldberg
- Physical Therapy Department, University of Michigan-Flint, Flint, MI, USA
| | - Min H Huang
- Physical Therapy Department, University of Michigan-Flint, Flint, MI, USA
| | - Michael Shoemaker
- Department of Physical Therapy, Grand Valley State University, Grand Rapids, MI, USA
| | - Jennifer Blackwood
- Physical Therapy Department, University of Michigan-Flint, Flint, MI, USA
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12
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Validity of the Global Physical Activity Questionnaire in Older Adults With Chronic Obstructive Pulmonary Disease: Results From the National Health and Nutrition Examination Survey. Cardiopulm Phys Ther J 2020. [DOI: 10.1097/cpt.0000000000000127] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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13
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Merlo C, Bernardi E, Bellotti F, Pomidori L, Cogo A. Supervised exercise training improves endothelial function in COPD patients: a method to reduce cardiovascular risk? ERJ Open Res 2020; 6:00304-2019. [PMID: 32714965 PMCID: PMC7369457 DOI: 10.1183/23120541.00304-2019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 05/19/2020] [Indexed: 12/19/2022] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is associated with an increased risk of cardiovascular diseases, particularly coronary artery disease (CAD) [1]. Endothelial dysfunction is a marker of cardiovascular risk [2]; a validated and standardised method to assess endothelial function is flow-mediated dilation (FMD) [3]. Supervised exercise training is key to health improvement in chronic obstructive pulmonary disease patientshttps://bit.ly/2AdfKvb
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Affiliation(s)
- Carlotta Merlo
- Center for Exercise and Sport Science, University of Ferrara, Ferrara, Italy
| | - Eva Bernardi
- Center for Exercise and Sport Science, University of Ferrara, Ferrara, Italy
| | - Federico Bellotti
- Center for Exercise and Sport Science, University of Ferrara, Ferrara, Italy
| | - Luca Pomidori
- Center for Exercise and Sport Science, University of Ferrara, Ferrara, Italy
| | - Annalisa Cogo
- Center for Exercise and Sport Science, University of Ferrara, Ferrara, Italy
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14
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Gore S, Blackwood J, Guyette M, Alsalaheen B. Validity and Reliability of Accelerometers in Patients With COPD: A SYSTEMATIC REVIEW. J Cardiopulm Rehabil Prev 2019; 38:147-158. [PMID: 29120966 DOI: 10.1097/hcr.0000000000000284] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
PURPOSE Reduced physical activity is associated with poor prognosis in chronic obstructive pulmonary disease (COPD). Accelerometers have greatly improved quantification of physical activity by providing information on step counts, body positions, energy expenditure, and magnitude of force. The purpose of this systematic review was to compare the validity and reliability of accelerometers used in patients with COPD. METHODS An electronic database search of MEDLINE and CINAHL was performed. Study quality was assessed with the Strengthening the Reporting of Observational Studies in Epidemiology checklist while methodological quality was assessed using the modified Quality Appraisal Tool for Reliability Studies. RESULTS The search yielded 5392 studies; 25 met inclusion criteria. The SenseWear Pro armband reported high criterion validity under controlled conditions (r = 0.75-0.93) and high reliability (ICC = 0.84-0.86) for step counts. The DynaPort MiniMod demonstrated highest concurrent validity for step count using both video and manual methods. DISCUSSION Validity of the SenseWear Pro armband varied between studies especially in free-living conditions, slower walking speeds, and with addition of weights during gait. A high degree of variability was found in the outcomes used and statistical analyses performed between studies, indicating a need for further studies to measure reliability and validity of accelerometers in COPD. CONCLUSION The SenseWear Pro armband is the most commonly used accelerometer in COPD, but measurement properties are limited by gait speed variability and assistive device use. DynaPort MiniMod and Stepwatch accelerometers demonstrated high validity in patients with COPD but lack reliability data.
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Affiliation(s)
- Shweta Gore
- Department of Physical Therapy, University of Michigan-Flint, Flint
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15
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Doma K, Speyer R, Parsons LA, Cordier R. Comparison of psychometric properties between recall methods of interview-based physical activity questionnaires: a systematic review. BMC Med Res Methodol 2019; 19:43. [PMID: 30823873 PMCID: PMC6396466 DOI: 10.1186/s12874-019-0684-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 02/14/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND This systematic review examined the methodological quality of studies and assessed the psychometric qualities of interview-administered Past-week and Usual-week Physical Activity Questionnaires (PAQs). Pubmed and Embase were used to retrieve data sources. METHODS The studies were selected using the following eligibility criteria: 1) psychometric properties of PAQs were assessed in adults; 2) the PAQs either consisted of recall periods of usual 7-days (Usual-week PAQs) within the past 12 months or during the past 7-days (Past-week PAQs); and 3) PAQs were interview-administered. The COSMIN taxonomy was utilised to critically appraise study quality and a previously established psychometric criteria employed to evaluate the overall psychometric qualities. RESULTS Following screening, 42 studies were examined to determine the psychometric properties of 20 PAQs, with the majority of studies demonstrating good to excellent ratings for methodological quality. For convergent validity (i.e., the relationship between PAQs and other measures), similar overall associations were found between Past-week PAQs and Usual-week PAQs. However, PAQs were more strongly associated with direct measures of physical activity (e.g., accelerometer) than indirect measures of physical activity (i.e., physical fitness), irrespective of recall methods. Very few psychometric properties were examined for each PAQ, with the majority exhibiting poor ratings in psychometric quality. Only a few interview-administered PAQs exhibited positive ratings for a single psychometric property, although the other properties were either rated as poor or questionable, demonstrating the limitations of current PAQs. CONCLUSION Accordingly, further research is necessary to explore a greater number of psychometric properties, or to develop new PAQs by addressing the psychometric limitations identified in the current review.
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Affiliation(s)
- Kenji Doma
- College of Healthcare Sciences, James Cook University, Townsville, Queensland, Australia.
| | - Renée Speyer
- Department Special needs Education, University of Oslo, Oslo, Norway.,School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Western Australia.,Department of Otorhinolaryngology and Head and Neck Surgery, Leiden University Medical Center, Leiden, the Netherlands
| | - Lauren Alese Parsons
- School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Western Australia
| | - Reinie Cordier
- School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Western Australia
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16
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Lareau SC, Blackstock FC. Functional status measures for the COPD patient: A practical categorization. Chron Respir Dis 2019; 16:1479973118816464. [PMID: 30789020 PMCID: PMC6318724 DOI: 10.1177/1479973118816464] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 10/25/2018] [Indexed: 01/22/2023] Open
Abstract
The objective of this study is to review available functional status measures (FSMs) validated for use in the chronic obstructive pulmonary disease (COPD) population and categorizing the measures by their commonalities to formulate a framework that supports clinicians in the selection and application of FSMs. A literature review identifying valid and reliable measures of functional status for people with COPD was undertaken. Measures were thematically analyzed and categorized to develop a framework for clinical application. A variety of measures of activity levels exist, with 35 included in this review. Thematic categorization identified five categories of measures: daily activity, impact, surrogate, performance-based, and disability-based measures. The vast variety of FSMs available for clinicians to apply with people who have COPD may be overwhelming, and selection must be thoughtfully based on the nature of the population being studied/evaluated, and aims of evaluation being conducted, not simply as a standard measure used at the institution. Psychometric testing is a critical feature to a strong instrument and issues of reliability, validity, and responsiveness need to be understood prior to measurement use. Contextual nature of measures such as language used and activities measured is also important. A categorical framework to support clinicians in the selection and application of FSMs has been presented in this article.
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Affiliation(s)
- Suzanne Claire Lareau
- College of Nursing, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA
| | - Felicity Clair Blackstock
- Department of Physiotherapy, School of Science and Health, Western Sydney University, Sydney, Australia
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17
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Soler-Cataluña JJ, Puente Maestu L, Román-Rodríguez M, Esteban C, Gea J, Bernabeu Mora R, Pleguezuelos Cobo E, Ancochea J, Monteagudo Ruiz G, Garcia Rio F. Creación del cuestionario SAQ-COPD (Spanish Physical Activity Questionnaire in COPD) para la medida de la actividad física de pacientes con EPOC en la práctica clínica. Arch Bronconeumol 2018; 54:467-475. [DOI: 10.1016/j.arbres.2018.01.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 01/16/2018] [Accepted: 01/23/2018] [Indexed: 10/17/2022]
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18
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Wan ES, Kantorowski A, Homsy D, Kadri R, Richardson CR, Mori D, Moy ML. Self-reported task-oriented physical activity: A comparison with objective daily step count in COPD. Respir Med 2018; 140:63-70. [PMID: 29957283 DOI: 10.1016/j.rmed.2018.05.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 03/22/2018] [Accepted: 05/13/2018] [Indexed: 11/15/2022]
Abstract
BACKGROUND Low physical activity (PA) is associated with adverse health outcomes independent of airflow limitation in COPD. Self-reported assessments are often limited to global estimates of PA and may not be directly translatable to patients' goals and motivations. We developed a task-oriented PA checklist and examined its performance relative to pedometer-assessed daily step count in two COPD cohorts. METHODS Task-oriented daily physical activity (DPA) was assessed in two COPD cohorts using either interviewer-administered recall questionnaire (DPA-R, Cohort 1, n = 109) or a self-administered diary-format daily checklist (DPA-C, Cohort 2, n = 175). Daily step count was measured in both cohorts using the Omron HJ-720 ITC pedometer. Univariate associations between individual DPA items and [a] cross-sectional and [b] longitudinal change (Cohort 1) in daily step count were assessed using a Pearson's correlation. Composite scores comprised of individual DPA items with univariate association p-values <0.1 were tested for association with daily step count using multivariate models. RESULTS Tasks associated with average daily step count in both cohorts included putting on shoes, showering, washing hair, walking for exercise, the frequency of walks >10 min, and walking on an incline (Pearson's rho range = 0.14-0.43). A composite score of these 6 DPA items demonstrated significant associations with baseline average daily step count in both cohorts (ρ = 0.5 & 0.47, Cohorts 1 & 2, respectively) and longitudinal change in daily step count (ρ = 0.46, Cohort 1). CONCLUSIONS Self-reported task-oriented assessments complement direct monitoring and have potential clinical utility in exercise counseling to increase PA among COPD patients. TRIAL REGISTRATION ClinicalTrials.gov NCT01772082.
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Affiliation(s)
- Emily S Wan
- Pulmonary and Critical Care Medicine Section, VA Boston Healthcare System, Boston, MA, USA; Channing Division of Network Medicine, Brigham & Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA; Department of Veterans Affairs, Rehabilitation Research and Development Service, USA
| | - Ana Kantorowski
- Pulmonary and Critical Care Medicine Section, VA Boston Healthcare System, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Diana Homsy
- Pulmonary and Critical Care Medicine Section, VA Boston Healthcare System, Boston, MA, USA
| | - Reema Kadri
- Department of Family Medicine, University of Michigan, Ann Arbor, MI, USA
| | | | - DeAnna Mori
- Behavioral Medicine Program, VA Boston Healthcare System, Boston, MA, USA; Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
| | - Marilyn L Moy
- Pulmonary and Critical Care Medicine Section, VA Boston Healthcare System, Boston, MA, USA; Harvard Medical School, Boston, MA, USA; Department of Veterans Affairs, Rehabilitation Research and Development Service, USA.
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19
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Sievi NA, Brack T, Brutsche MH, Frey M, Irani S, Leuppi JD, Thurnheer R, Kohler M, Clarenbach CF. Accelerometer- versus questionnaire-based assessment of physical activity and their changes over time in patients with COPD. Int J Chron Obstruct Pulmon Dis 2017; 12:1113-1118. [PMID: 28435244 PMCID: PMC5391993 DOI: 10.2147/copd.s130195] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background and objective Physical activity (PA) is an important outcome parameter in patients with COPD regarding hospitalizations and mortality. Both objective assessment by accelerometers and self-evaluation by questionnaires were used in studies investigating PA in COPD. Whether self-reported questionnaires can adequately reflect PA and its changes over time compared to objective assessments has not been thoroughly investigated in COPD. In this COPD cohort study, we evaluated whether PA measured by accelerometer and its annual changes can also be assessed by self-reported questionnaires. Methods In 178 COPD patients with at least two assessments of PA, the agreement between objectively measured and self-reported activity was analyzed by Bland–Altman plots. Daily PA was assessed by a triaxial activity monitor over 1 week and by the self-reported German PA questionnaire 50+. Results Comparison between the two methods of measurement revealed no convincing agreement with a mean difference and limits of agreement (±1.96 standard deviation [SD]) of time spent in at least moderate PA (>3 metabolic equivalent of task [MET]) of −77.6 (−340.3/185.2) min/day, indicating a self-reported overestimation of PA by the questionnaire. The mean difference and limits of agreement (±1.96SD) in the annual change of PA was 1.2 min/day (−208.2/282.6 min/day), showing also a poor agreement on an individual level. Conclusion Evaluation of objectively measured and self-reported PA and their annual changes revealed no agreement in patients with COPD. Therefore, the evaluated questionnaire seems not helpful for measurement of PA and its changes over time.
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Affiliation(s)
| | - Thomas Brack
- Pulmonary Division, Cantonal Hospital of Glarus, Glarus
| | | | | | - Sarosh Irani
- Pulmonary Division, Cantonal Hospital of Aarau, Aarau
| | - Jörg D Leuppi
- University Clinic of Internal Medicine, Cantonal Hospital Baselland
| | - Robert Thurnheer
- Pulmonary Division, Cantonal Hospital of Münsterlingen, Münsterlingen
| | - Malcolm Kohler
- Pulmonary Division, University Hospital of Zurich, Zurich.,Zurich Centre for Integrative Human Physiology, University of Zurich, Zurich, Switzerland
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20
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Doma K, Speyer R, Leicht AS, Cordier R. Comparison of psychometric properties between usual-week and past-week self-reported physical activity questionnaires: a systematic review. Int J Behav Nutr Phys Act 2017; 14:10. [PMID: 28137268 PMCID: PMC5282723 DOI: 10.1186/s12966-017-0470-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2016] [Accepted: 01/23/2017] [Indexed: 12/15/2022] Open
Abstract
The aim was to critically appraise the methodological quality of studies and determine the psychometric qualities of Past-week and Usual-week Physical Activity Questionnaires (PAQs). Data sources were obtained from Pubmed and Embase. The eligibility criteria for selecting studies included: 1) at least one psychometric property of PAQs was examined in adults; 2) the PAQs either had a recall period of usual 7-days (Usual-week PAQs) within the past 12 months or during the past 7-days (Past-week PAQs); and 3) PAQs were self-administered. Study quality was evaluated using the COSMIN taxonomy and the overall psychometric qualities evaluated using pre-established psychometric criteria. Overall, 45 studies were reviewed to assess the psychometric properties of 21 PAQs with the methodological quality of most studies showing good to excellent ratings. When the relationship between PAQs and other instruments (i.e., convergent validity) were compared between recall methods, Past-week PAQs appeared to have stronger correlations than Usual-week PAQs. For the overall psychometric quality, the Incidental and Planned Exercise Questionnaire for the Usual-week (IPEQ-WA) and for the Past-week (IPEQ-W) had the greatest number of positive ratings. For all included PAQs, very few psychometric properties were assessed with poor ratings for the majority of the overall qualities of psychometric properties indicating the limitation of current PAQs. More research that covers a greater spectrum of psychometric properties is required to gain a better understanding of the qualities of current PAQs.
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Affiliation(s)
- Kenji Doma
- College of Healthcare Sciences, James Cook University, Townsville, QLD, Australia.
| | - Renée Speyer
- College of Healthcare Sciences, James Cook University, Townsville, QLD, Australia.,Department of Otorhinolaryngology and Head and Neck Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Anthony S Leicht
- College of Healthcare Sciences, James Cook University, Townsville, QLD, Australia
| | - Reinie Cordier
- School of Occupational Therapy and Social Work, Curtin University, Perth, WA, Australia
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21
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Thyregod M, Bodtger U. Coherence between self-reported and objectively measured physical activity in patients with chronic obstructive lung disease: a systematic review. Int J Chron Obstruct Pulmon Dis 2016; 11:2931-2938. [PMID: 27932873 PMCID: PMC5135064 DOI: 10.2147/copd.s116422] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The beneficial effects of physical activity (PA) in patients with COPD, as well as the methods of their assessment, are well known and described. As objective measures of PA, such as the use of motion sensors, video recordings, exercise capacity testing, and indirect calorimetry, are not easily obtained in the daily clinical life, the reliability of the more accessible self-reported measurements of PA is important. In this review, we systematically identified original studies involving COPD patients and at least one parameter of self-reported and objective exercise testing, and analyzed every article for coherence between the objectively and self-reported measured PA. The studies are few, small, and very diverse, both in their use of questionnaires and objective measurements. Self-reported assessments were found to generally overestimate the level of PA compared to measurements made objectively by activity monitors; however, more studies are needed to rely solely on the use of PA questionnaires in COPD patients. The most accurate and valid questionnaires appear to be the self-completed Physical Activity Scale for the Elderly and the interviewer-completed Stanford Seven-Day Physical Activity Recall Questionnaire, but the ideal questionnaire still awaits construction. The motion sensors are accurate and validated in this patient group, especially SenseWear™, but not easily accessible in clinical practice, as they have various technical and adhesive difficulties.
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Affiliation(s)
- Mimi Thyregod
- Department of Respiratory Medicine, Naestved Hospital, Naestved; Institute for Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Uffe Bodtger
- Department of Respiratory Medicine, Naestved Hospital, Naestved; Institute for Regional Health Research, University of Southern Denmark, Odense, Denmark
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22
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Mak S, Soicher JE, Mayo NE, Wood-Dauphinee S, Bourbeau J. Cross-Cultural Adaptation of the CHAMPS Questionnaire in French Canadians with COPD. Can Respir J 2016; 2016:9304505. [PMID: 27445570 PMCID: PMC4906179 DOI: 10.1155/2016/9304505] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Revised: 05/05/2016] [Accepted: 05/09/2016] [Indexed: 11/18/2022] Open
Abstract
Physical activity is difficult to measure in individuals with COPD. The Community Healthy Activities Model Program for Seniors (CHAMPS) questionnaire demonstrated strong clinometric properties when used with the elderly and with those affected by chronic disease. Study objectives were to translate, culturally adapt the CHAMPS into French, and reexamine its test-retest reliability and construct validity in French and English Canadians with COPD. This paper presents the cross-cultural adaptation of the CHAMPS; results of its clinometric testing will be described in another article. The CHAMPS examines the degree of physical activity performed in a typical week through two summary scales, caloric expenditure and activity frequency. The CHAMPS was only in English; thus, a cross-cultural adaptation was needed to translate the CHAMPS into French for use in French Canadians with COPD. Cross-cultural adaptation consisted of forward and back translation, with expert review at each stage of translation: minor inconsistencies were uncovered and rectified. Five French participants with COPD completed the finalized Canadian French CHAMPS and participated in cognitive debriefing; no problematic items were identified. A structured and stepwise, cross-cultural adaptation process produced the Canadian French CHAMPS, with items of equivalent meaning to the English version, for use in French Canadians with COPD.
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Affiliation(s)
- Susanne Mak
- School of Physical & Occupational Therapy, McGill University, Montreal, QC, Canada H3G 1Y5
| | - Judith E. Soicher
- School of Physical & Occupational Therapy, McGill University, Montreal, QC, Canada H3G 1Y5
- Respiratory Epidemiology & Clinical Research Unit, McGill University, Montreal, QC, Canada H3H 2R9
| | - Nancy E. Mayo
- School of Physical & Occupational Therapy, McGill University, Montreal, QC, Canada H3G 1Y5
| | - Sharon Wood-Dauphinee
- School of Physical & Occupational Therapy, McGill University, Montreal, QC, Canada H3G 1Y5
| | - Jean Bourbeau
- Respiratory Epidemiology & Clinical Research Unit, McGill University, Montreal, QC, Canada H3H 2R9
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Meshe OF, Claydon LS, Bungay H, Andrew S. The relationship between physical activity and health status in patients with chronic obstructive pulmonary disease following pulmonary rehabilitation. Disabil Rehabil 2016; 39:746-756. [DOI: 10.3109/09638288.2016.1161842] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Affiliation(s)
- Oluwasomi Festus Meshe
- Department of Allied Health and Medicine, Faculty of Medical Science, Anglia Ruskin University, Chelmsford, Essex, UK
| | - Leica Sarah Claydon
- Department of Allied Health and Medicine, Faculty of Medical Science, Anglia Ruskin University, Chelmsford, Essex, UK
| | - Hilary Bungay
- Department of Allied and Public Health, Faculty of Medical Science, Anglia Ruskin University, Cambridge, UK
| | - Sharon Andrew
- Faculty of Health, Social Care & Education, Anglia Ruskin University, Chelmsford, Essex, UK
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Demeyer H, Gimeno-Santos E, Rabinovich RA, Hornikx M, Louvaris Z, de Boer WI, Karlsson N, de Jong C, Van der Molen T, Vogiatzis I, Janssens W, Garcia-Aymerich J, Troosters T, Polkey MI. Physical Activity Characteristics across GOLD Quadrants Depend on the Questionnaire Used. PLoS One 2016; 11:e0151255. [PMID: 26974332 PMCID: PMC4790973 DOI: 10.1371/journal.pone.0151255] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Accepted: 02/25/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The GOLD multidimensional classification of COPD severity combines the exacerbation risk with the symptom experience, for which 3 different questionnaires are permitted. This study investigated differences in physical activity (PA) in the different GOLD quadrants and patient's distribution in relation to the questionnaire used. METHODS 136 COPD patients (58±21% FEV1 predicted, 34F/102M) completed COPD assessment test (CAT), clinical COPD questionnaire (CCQ) and modified Medical Research Council (mMRC) questionnaire. Exacerbation history, spirometry and 6MWD were collected. PA was objectively measured for 2 periods of 1 week, 6 months apart, in 5 European centres; to minimise seasonal and clinical variation the average of these two periods was used for analysis. RESULTS GOLD quadrants C+D had reduced PA compared with A+B (3824 [2976] vs. 5508 [4671] steps.d-1, p<0.0001). The choice of questionnaire yielded different patient distributions (agreement mMRC-CAT κ = 0.57; CCQ-mMRC κ = 0.71; CCQ-CAT κ = 0.72) with different clinical characteristics. PA was notably lower in patients with an mMRC score ≥2 (3430 [2537] vs. 5443 [3776] steps.d-1, p <0.001) in both the low and high risk quadrants. CONCLUSIONS Using different questionnaires changes the patient distribution and results in different clinical characteristics. Therefore, standardization of the questionnaire used for classification is critical to allow comparison of different studies using this as an entry criterion. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov NCT01388218.
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Affiliation(s)
- Heleen Demeyer
- KU Leuven, Department of Rehabilitation Sciences, B-3000, Leuven, Belgium
- University Hospitals Leuven, Department of Respiratory Diseases, B-3000, Leuven, Belgium
| | - Elena Gimeno-Santos
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- CIBER Epidemiologia y Salud Publica (CIBERESP), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Roberto A. Rabinovich
- ELEGI/Colt laboratory, UoE/MRC Centre for Inflammation Research, The University of Edinburgh, Edinburgh, Scotland
| | - Miek Hornikx
- KU Leuven, Department of Rehabilitation Sciences, B-3000, Leuven, Belgium
- University Hospitals Leuven, Department of Respiratory Diseases, B-3000, Leuven, Belgium
| | - Zafeiris Louvaris
- Dept of Critical Care Medicine, Pulmonary Rehabilitation Centre, Evangelismos Hospital, M. Simou and G.P. Livanos Laboratories, National and Kapodistrian University of Athens, Thorax Foundation, Athens, Greece
| | - Willem I. de Boer
- Department of Pulmonology, Leiden University Medical Center, Leiden, Netherlands
| | | | - Corina de Jong
- Department of General Practice, University Medical Center Groningen, Groningen, Netherlands
| | - Thys Van der Molen
- Department of Primary Care, University of Groningen, University Medical Centre Groningen, Groningen, Netherlands
| | - Ioannis Vogiatzis
- Dept of Critical Care Medicine, Pulmonary Rehabilitation Centre, Evangelismos Hospital, M. Simou and G.P. Livanos Laboratories, National and Kapodistrian University of Athens, Thorax Foundation, Athens, Greece
| | - Wim Janssens
- University Hospitals Leuven, Department of Respiratory Diseases, B-3000, Leuven, Belgium
| | - Judith Garcia-Aymerich
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- CIBER Epidemiologia y Salud Publica (CIBERESP), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Thierry Troosters
- KU Leuven, Department of Rehabilitation Sciences, B-3000, Leuven, Belgium
- University Hospitals Leuven, Department of Respiratory Diseases, B-3000, Leuven, Belgium
- * E-mail:
| | - Michael I. Polkey
- NIHR Respiratory Biomedical Research Unit of the Royal Brompton and Harefield NHS foundation Trust and Imperial College London, London, United Kingdom
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Demeyer H, Dueñas-Espín I, De Jong C, Louvaris Z, Hornikx M, Gimeno-Santos E, Loeckx M, Vogiatzis I, Janssens W, Hopkinson NS, Rabinovich RA, Karlsson N, Garcia-Aymerich J, Troosters T. Can health status questionnaires be used as a measure of physical activity in COPD patients? Eur Respir J 2016; 47:1565-8. [PMID: 26917609 DOI: 10.1183/13993003.01815-2015] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Accepted: 01/01/2016] [Indexed: 11/05/2022]
Affiliation(s)
- Heleen Demeyer
- KU Leuven-University of Leuven, Department of Rehabilitation Sciences, Leuven, Belgium University Hospitals Leuven, Department of Respiratory Diseases, Leuven, Belgium
| | - Ivan Dueñas-Espín
- Centre for Research in Environmental Epidemiology, Barcelona, Spain CIBER Epidemiología y Salud Pública, Barcelona, Spain Universitat Pompeu Fabra, Barcelona, Spain
| | - Corina De Jong
- Dept of General Practice, University Medical Center Groningen, Groningen, Netherlands
| | - Zafeiris Louvaris
- Dept of Critical Care Medicine, Pulmonary Rehabilitation Centre, Evangelismos Hospital, M. Simou and G.P. Livanos Laboratories, National and Kapodistrian University of Athens, Thorax Foundation, Athens, Greece
| | - Miek Hornikx
- KU Leuven-University of Leuven, Department of Rehabilitation Sciences, Leuven, Belgium University Hospitals Leuven, Department of Respiratory Diseases, Leuven, Belgium
| | - Elena Gimeno-Santos
- Centre for Research in Environmental Epidemiology, Barcelona, Spain CIBER Epidemiología y Salud Pública, Barcelona, Spain Universitat Pompeu Fabra, Barcelona, Spain
| | - Matthias Loeckx
- KU Leuven-University of Leuven, Department of Rehabilitation Sciences, Leuven, Belgium University Hospitals Leuven, Department of Respiratory Diseases, Leuven, Belgium
| | - Ioannis Vogiatzis
- Dept of Critical Care Medicine, Pulmonary Rehabilitation Centre, Evangelismos Hospital, M. Simou and G.P. Livanos Laboratories, National and Kapodistrian University of Athens, Thorax Foundation, Athens, Greece
| | - Wim Janssens
- University Hospitals Leuven, Department of Respiratory Diseases, Leuven, Belgium
| | - Nicholas S Hopkinson
- NIHR Respiratory Biomedical Research Unit of the Royal Brompton and Harefield NHS foundation Trust and Imperial College London, London, UK
| | - Roberto A Rabinovich
- ELEGI/Colt laboratory, UoE/MRC Centre for Inflammation Research, The University of Edinburgh, Edinburgh, UK
| | | | - Judith Garcia-Aymerich
- Centre for Research in Environmental Epidemiology, Barcelona, Spain CIBER Epidemiología y Salud Pública, Barcelona, Spain Universitat Pompeu Fabra, Barcelona, Spain
| | - Thierry Troosters
- KU Leuven-University of Leuven, Department of Rehabilitation Sciences, Leuven, Belgium University Hospitals Leuven, Department of Respiratory Diseases, Leuven, Belgium
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26
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Huffman JC, Beale EE, Celano CM, Beach SR, Belcher AM, Moore SV, Suarez L, Motiwala SR, Gandhi PU, Gaggin HK, Januzzi JL. Effects of Optimism and Gratitude on Physical Activity, Biomarkers, and Readmissions After an Acute Coronary Syndrome: The Gratitude Research in Acute Coronary Events Study. Circ Cardiovasc Qual Outcomes 2016; 9:55-63. [PMID: 26646818 PMCID: PMC4720551 DOI: 10.1161/circoutcomes.115.002184] [Citation(s) in RCA: 74] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Accepted: 10/29/2015] [Indexed: 01/27/2023]
Abstract
BACKGROUND Positive psychological constructs, such as optimism, are associated with beneficial health outcomes. However, no study has separately examined the effects of multiple positive psychological constructs on behavioral, biological, and clinical outcomes after an acute coronary syndrome (ACS). Accordingly, we aimed to investigate associations of baseline optimism and gratitude with subsequent physical activity, prognostic biomarkers, and cardiac rehospitalizations in post-ACS patients. METHODS AND RESULTS Participants were enrolled during admission for ACS and underwent assessments at baseline (2 weeks post-ACS) and follow-up (6 months later). Associations between baseline positive psychological constructs and subsequent physical activity/biomarkers were analyzed using multivariable linear regression. Associations between baseline positive constructs and 6-month rehospitalizations were assessed via multivariable Cox regression. Overall, 164 participants enrolled and completed the baseline 2-week assessments. Baseline optimism was significantly associated with greater physical activity at 6 months (n=153; β=102.5; 95% confidence interval, 13.6-191.5; P=0.024), controlling for baseline activity and sociodemographic, medical, and negative psychological covariates. Baseline optimism was also associated with lower rates of cardiac readmissions at 6 months (n=164), controlling for age, sex, and medical comorbidity (hazard ratio, 0.92; 95% confidence interval, [0.86-0.98]; P=0.006). There were no significant relationships between optimism and biomarkers. Gratitude was minimally associated with post-ACS outcomes. CONCLUSIONS Post-ACS optimism, but not gratitude, was prospectively and independently associated with superior physical activity and fewer cardiac readmissions. Whether interventions that target optimism can successfully increase optimism or improve cardiovascular outcomes in post-ACS patients is not yet known, but can be tested in future studies. CLINICAL TRIAL REGISTRATION URL: http://www.clinicaltrials.gov. Unique identifier: NCT01709669.
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Affiliation(s)
- Jeff C Huffman
- From the Harvard Medical School, Boston, MA (J.C.H., C.M.C., S.R.B., L.S., S.R.M., P.U.G., H.K.G., J.L.J.); Department of Psychiatry (J.C.H., E.E.B., C.M.C., S.R.B., S.V.M., L.S.) and Division of Cardiology, Department of Medicine (A.M.B., P.U.G., H.G., J.L.J.), Massachusetts General Hospital, Boston; and Division of Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA (S.R.M.).
| | - Eleanor E Beale
- From the Harvard Medical School, Boston, MA (J.C.H., C.M.C., S.R.B., L.S., S.R.M., P.U.G., H.K.G., J.L.J.); Department of Psychiatry (J.C.H., E.E.B., C.M.C., S.R.B., S.V.M., L.S.) and Division of Cardiology, Department of Medicine (A.M.B., P.U.G., H.G., J.L.J.), Massachusetts General Hospital, Boston; and Division of Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA (S.R.M.)
| | - Christopher M Celano
- From the Harvard Medical School, Boston, MA (J.C.H., C.M.C., S.R.B., L.S., S.R.M., P.U.G., H.K.G., J.L.J.); Department of Psychiatry (J.C.H., E.E.B., C.M.C., S.R.B., S.V.M., L.S.) and Division of Cardiology, Department of Medicine (A.M.B., P.U.G., H.G., J.L.J.), Massachusetts General Hospital, Boston; and Division of Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA (S.R.M.)
| | - Scott R Beach
- From the Harvard Medical School, Boston, MA (J.C.H., C.M.C., S.R.B., L.S., S.R.M., P.U.G., H.K.G., J.L.J.); Department of Psychiatry (J.C.H., E.E.B., C.M.C., S.R.B., S.V.M., L.S.) and Division of Cardiology, Department of Medicine (A.M.B., P.U.G., H.G., J.L.J.), Massachusetts General Hospital, Boston; and Division of Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA (S.R.M.)
| | - Arianna M Belcher
- From the Harvard Medical School, Boston, MA (J.C.H., C.M.C., S.R.B., L.S., S.R.M., P.U.G., H.K.G., J.L.J.); Department of Psychiatry (J.C.H., E.E.B., C.M.C., S.R.B., S.V.M., L.S.) and Division of Cardiology, Department of Medicine (A.M.B., P.U.G., H.G., J.L.J.), Massachusetts General Hospital, Boston; and Division of Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA (S.R.M.)
| | - Shannon V Moore
- From the Harvard Medical School, Boston, MA (J.C.H., C.M.C., S.R.B., L.S., S.R.M., P.U.G., H.K.G., J.L.J.); Department of Psychiatry (J.C.H., E.E.B., C.M.C., S.R.B., S.V.M., L.S.) and Division of Cardiology, Department of Medicine (A.M.B., P.U.G., H.G., J.L.J.), Massachusetts General Hospital, Boston; and Division of Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA (S.R.M.)
| | - Laura Suarez
- From the Harvard Medical School, Boston, MA (J.C.H., C.M.C., S.R.B., L.S., S.R.M., P.U.G., H.K.G., J.L.J.); Department of Psychiatry (J.C.H., E.E.B., C.M.C., S.R.B., S.V.M., L.S.) and Division of Cardiology, Department of Medicine (A.M.B., P.U.G., H.G., J.L.J.), Massachusetts General Hospital, Boston; and Division of Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA (S.R.M.)
| | - Shweta R Motiwala
- From the Harvard Medical School, Boston, MA (J.C.H., C.M.C., S.R.B., L.S., S.R.M., P.U.G., H.K.G., J.L.J.); Department of Psychiatry (J.C.H., E.E.B., C.M.C., S.R.B., S.V.M., L.S.) and Division of Cardiology, Department of Medicine (A.M.B., P.U.G., H.G., J.L.J.), Massachusetts General Hospital, Boston; and Division of Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA (S.R.M.)
| | - Parul U Gandhi
- From the Harvard Medical School, Boston, MA (J.C.H., C.M.C., S.R.B., L.S., S.R.M., P.U.G., H.K.G., J.L.J.); Department of Psychiatry (J.C.H., E.E.B., C.M.C., S.R.B., S.V.M., L.S.) and Division of Cardiology, Department of Medicine (A.M.B., P.U.G., H.G., J.L.J.), Massachusetts General Hospital, Boston; and Division of Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA (S.R.M.)
| | - Hanna K Gaggin
- From the Harvard Medical School, Boston, MA (J.C.H., C.M.C., S.R.B., L.S., S.R.M., P.U.G., H.K.G., J.L.J.); Department of Psychiatry (J.C.H., E.E.B., C.M.C., S.R.B., S.V.M., L.S.) and Division of Cardiology, Department of Medicine (A.M.B., P.U.G., H.G., J.L.J.), Massachusetts General Hospital, Boston; and Division of Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA (S.R.M.)
| | - James L Januzzi
- From the Harvard Medical School, Boston, MA (J.C.H., C.M.C., S.R.B., L.S., S.R.M., P.U.G., H.K.G., J.L.J.); Department of Psychiatry (J.C.H., E.E.B., C.M.C., S.R.B., S.V.M., L.S.) and Division of Cardiology, Department of Medicine (A.M.B., P.U.G., H.G., J.L.J.), Massachusetts General Hospital, Boston; and Division of Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA (S.R.M.)
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27
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Kanao K, Shiraishi M, Higashimoto Y, Maeda K, Sugiya R, Okajima S, Chiba Y, Yamagata T, Terada K, Fukuda K, Tohda Y. Factors associated with the effect of pulmonary rehabilitation on physical activity in patients with chronic obstructive pulmonary disease. Geriatr Gerontol Int 2015; 17:17-23. [PMID: 26634413 DOI: 10.1111/ggi.12656] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2015] [Indexed: 11/28/2022]
Abstract
AIM Although the effects of pulmonary rehabilitation (PR) have been well defined for chronic obstructive pulmonary disease (COPD), it remains controversial whether PR improves physical activity (PA). The purpose of the present study was to identify factors associated with the effect of PR on PA. METHODS This was a prospective study of 29 patients with COPD. They underwent pulmonary rehabilitation twice weekly for 12 weeks, and were assessed using the hospital anxiety and depression score, 6-min walk distance (6MWD), and the St. George Respiratory Questionnaire (SGRQ) before and after they underwent PR. The PA of patients was measured by a three-axis accelerometer. Physical activity level (PAL) was calculated by dividing each patient's total energy expenditure by basal metabolic rate. Correlations between changes in PAL after PR and 6MWD, St. George Respiratory Questionnaire, and hospital anxiety and depression score scores, and clinical parameters, including forced expiratory volume in 1 s were determined. RESULTS 6MWD was significantly increased, but PAL was unchanged after PR. PAL was positively correlated with 6MWD, but not with percent predicted forced expiratory volume in 1 s nor St. George Respiratory Questionnaire scores before PR. The increase in PAL was negatively correlated with changes in hospital anxiety and depression score anxiety and depression scores, but was not correlated with the change in 6MWD. CONCLUSIONS A PR program for COPD patients improved results of the 6MWD, but not PAL. Increased PAL was associated with improvements in anxiety and depression, but not with increased exercise capacity. Treating the depression and anxiety of patients with COPD might not only reduce emotional distress, but also improve their PAL. Geriatr Gerontol Int 2017; 17: 17-23.
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Affiliation(s)
- Kenro Kanao
- Department of Respiratory Medicine and Allergology, Kinki University, Faculty of Medicine, Osakasayama, Japan.,Department of Physical Therapy, Morinomiya University of Medical Sciences, Osaka, Osaka, Japan
| | - Masashi Shiraishi
- Department of Rehabilitation Medicine, Kinki University, Faculty of Medicine, Osakasayama, Japan
| | - Yuji Higashimoto
- Department of Respiratory Medicine and Allergology, Kinki University, Faculty of Medicine, Osakasayama, Japan
| | - Kazushige Maeda
- Department of Rehabilitation Medicine, Kinki University, Faculty of Medicine, Osakasayama, Japan
| | - Ryuji Sugiya
- Department of Rehabilitation Medicine, Kinki University, Faculty of Medicine, Osakasayama, Japan
| | - Satoshi Okajima
- Department of Rehabilitation Medicine, Kinki University, Faculty of Medicine, Osakasayama, Japan
| | - Yasutaka Chiba
- Division of Biostatistics, Clinical Research Center, Kinki University, Faculty of Medicine, Osakasayama, Japan
| | - Toshiyuki Yamagata
- Department of Respiratory Medicine and Allergology, Kinki University, Faculty of Medicine, Osakasayama, Japan
| | - Katsuhiko Terada
- Department of Rehabilitation Medicine, Kinki University, Faculty of Medicine, Osakasayama, Japan
| | - Kanji Fukuda
- Department of Rehabilitation Medicine, Kinki University, Faculty of Medicine, Osakasayama, Japan
| | - Yuji Tohda
- Department of Respiratory Medicine and Allergology, Kinki University, Faculty of Medicine, Osakasayama, Japan
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28
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Ambrosino N, Casaburi R, Chetta A, Clini E, Donner CF, Dreher M, Goldstein R, Jubran A, Nici L, Owen CA, Rochester C, Tobin MJ, Vagheggini G, Vitacca M, ZuWallack R. 8th International conference on management and rehabilitation of chronic respiratory failure: the long summaries – part 2. Multidiscip Respir Med 2015. [PMCID: PMC4594967 DOI: 10.1186/s40248-015-0027-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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29
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Makovey J, Metcalf B, Zhang Y, Chen JS, Bennell K, March L, Hunter DJ. Web-Based Study of Risk Factors for Pain Exacerbation in Osteoarthritis of the Knee (SPARK-Web): Design and Rationale. JMIR Res Protoc 2015; 4:e80. [PMID: 26156210 PMCID: PMC4526980 DOI: 10.2196/resprot.4406] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Revised: 04/21/2015] [Accepted: 04/22/2015] [Indexed: 11/13/2022] Open
Abstract
Background Knee osteoarthritis (OA) is the most frequent cause of limited mobility and diminished quality of life. Pain is the main symptom that drives individuals with knee OA to seek medical care and a recognized antecedent to disability and eventually joint replacement. Many persons with symptomatic knee OA experience recurrent pain exacerbations. Knowledge and clarification of risk factors for pain exacerbation may allow those affected to minimize reoccurrence of these episodes. Objective The aim of this study is to use a Web-based case-crossover design to identify risk factors for knee pain exacerbations in persons with symptomatic knee OA. Methods Web-based case-crossover design is used to study persons with symptomatic knee OA. Participants with knee pain and radiographic knee OA will be recruited and followed for 90 days. Participants will complete an online questionnaire at the baseline and every 10 days thereafter (totaling up to 10 control-period questionnaires); participants will also be asked to report online when they experience an episode of increased knee pain. Pain exacerbation will be defined as an increase in knee pain severity of two points from baseline on a numeric rating scale (NRS 0-10). Physical activity, footwear, knee injury, medication use, climate, psychological factors, and their possible interactions will be assessed as potential triggers for pain exacerbation using conditional logistic regression models. Results This project has been funded by the National Health and Medical Research Council (NHMRC). The enrollment for the study has started. So far, 343 participants have been enrolled. The study is expected to be finished in October 2015. Conclusions This study will identify risk factors for pain exacerbations in knee OA. The identification and possible modification/elimination of such risk factors will help to prevent the reoccurrence of pain exacerbation episodes and therefore improve knee OA management.
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Affiliation(s)
- Joanna Makovey
- Northern Clinical School, Kolling Institute, Institute of Bone and Joint Research,, Department of Rheumatology, RNSH, University of Sydney, St Leonards, NSW, Australia.
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30
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Watz H, Pitta F, Rochester CL, Garcia-Aymerich J, ZuWallack R, Troosters T, Vaes AW, Puhan MA, Jehn M, Polkey MI, Vogiatzis I, Clini EM, Toth M, Gimeno-Santos E, Waschki B, Esteban C, Hayot M, Casaburi R, Porszasz J, McAuley E, Singh SJ, Langer D, Wouters EFM, Magnussen H, Spruit MA. An official European Respiratory Society statement on physical activity in COPD. Eur Respir J 2014; 44:1521-37. [PMID: 25359358 DOI: 10.1183/09031936.00046814] [Citation(s) in RCA: 336] [Impact Index Per Article: 33.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
This European Respiratory Society (ERS) statement provides a comprehensive overview on physical activity in patients with chronic obstructive pulmonary disease (COPD). A multidisciplinary Task Force of experts representing the ERS Scientific Group 01.02 "Rehabilitation and Chronic Care" determined the overall scope of this statement through consensus. Focused literature reviews were conducted in key topic areas and the final content of this Statement was agreed upon by all members. The current knowledge regarding physical activity in COPD is presented, including the definition of physical activity, the consequences of physical inactivity on lung function decline and COPD incidence, physical activity assessment, prevalence of physical inactivity in COPD, clinical correlates of physical activity, effects of physical inactivity on hospitalisations and mortality, and treatment strategies to improve physical activity in patients with COPD. This Task Force identified multiple major areas of research that need to be addressed further in the coming years. These include, but are not limited to, the disease-modifying potential of increased physical activity, and to further understand how improvements in exercise capacity, dyspnoea and self-efficacy following interventions may translate into increased physical activity. The Task Force recommends that this ERS statement should be reviewed periodically (e.g. every 5-8 years).
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Affiliation(s)
| | - Fabio Pitta
- For a full list of the authors' affiliations please refer to the Acknowledgements. Task Force co-chairs
| | - Carolyn L Rochester
- For a full list of the authors' affiliations please refer to the Acknowledgements. Task Force co-chairs
| | - Judith Garcia-Aymerich
- For a full list of the authors' affiliations please refer to the Acknowledgements. Task Force co-chairs
| | - Richard ZuWallack
- For a full list of the authors' affiliations please refer to the Acknowledgements. Task Force co-chairs
| | - Thierry Troosters
- For a full list of the authors' affiliations please refer to the Acknowledgements. Task Force co-chairs
| | - Anouk W Vaes
- For a full list of the authors' affiliations please refer to the Acknowledgements. Task Force co-chairs
| | - Milo A Puhan
- For a full list of the authors' affiliations please refer to the Acknowledgements. Task Force co-chairs
| | - Melissa Jehn
- For a full list of the authors' affiliations please refer to the Acknowledgements. Task Force co-chairs
| | - Michael I Polkey
- For a full list of the authors' affiliations please refer to the Acknowledgements. Task Force co-chairs
| | - Ioannis Vogiatzis
- For a full list of the authors' affiliations please refer to the Acknowledgements. Task Force co-chairs
| | - Enrico M Clini
- For a full list of the authors' affiliations please refer to the Acknowledgements. Task Force co-chairs
| | - Michael Toth
- For a full list of the authors' affiliations please refer to the Acknowledgements. Task Force co-chairs
| | - Elena Gimeno-Santos
- For a full list of the authors' affiliations please refer to the Acknowledgements. Task Force co-chairs
| | - Benjamin Waschki
- For a full list of the authors' affiliations please refer to the Acknowledgements. Task Force co-chairs
| | - Cristobal Esteban
- For a full list of the authors' affiliations please refer to the Acknowledgements. Task Force co-chairs
| | - Maurice Hayot
- For a full list of the authors' affiliations please refer to the Acknowledgements. Task Force co-chairs
| | - Richard Casaburi
- For a full list of the authors' affiliations please refer to the Acknowledgements. Task Force co-chairs
| | - Janos Porszasz
- For a full list of the authors' affiliations please refer to the Acknowledgements. Task Force co-chairs
| | - Edward McAuley
- For a full list of the authors' affiliations please refer to the Acknowledgements. Task Force co-chairs
| | - Sally J Singh
- For a full list of the authors' affiliations please refer to the Acknowledgements. Task Force co-chairs
| | - Daniel Langer
- For a full list of the authors' affiliations please refer to the Acknowledgements. Task Force co-chairs
| | - Emiel F M Wouters
- For a full list of the authors' affiliations please refer to the Acknowledgements. Task Force co-chairs
| | - Helgo Magnussen
- For a full list of the authors' affiliations please refer to the Acknowledgements. Task Force co-chairs
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Liao SY, Benzo R, Ries AL, Soler X. Physical Activity Monitoring in Patients with Chronic Obstructive Pulmonary Disease. CHRONIC OBSTRUCTIVE PULMONARY DISEASES-JOURNAL OF THE COPD FOUNDATION 2014; 1:155-165. [PMID: 28848818 DOI: 10.15326/jcopdf.1.2.2014.0131] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Reduced physical activity (PA) in patients with chronic obstructive pulmonary disease (COPD) is associated with increased morbidity and mortality (e.g. exacerbations) and eventually leads to disability, depression, and social and physical isolation. Measuring PA in this population is important to accurately characterize COPD and to help clinicians during a baseline evaluation and patient follow-up. Also, it may help increase adherence to PA programs. There are reliable objective and subjective methods available to measure PA. Recently, several new monitors have been developed that have improved accuracy of such measurements. Because these devices provide real-time feedback, they may help to improve participant self-motivation strategies and reinforce daily lifestyle modifications, one of the main goals in COPD management. This review focuses on describing available instruments to measure PA, specifically in patients with COPD. The reliability, validity, advantages, limitations, and clinical applications of questionnaires, pedometers, and accelerometers are discussed. Finally, based on current published literature, we propose recommendations about which methods may be most useful in different research or clinical settings.
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Affiliation(s)
- Shu-Yi Liao
- School of Medicine, University of California-Riverside
| | - Roberto Benzo
- Pulmonary and Critical Care Division, Mayo Clinic College of Medicine, Rochester, Minnesota
| | - Andrew L Ries
- Pulmonary and Critical Care and Sleep Division, University of California, San Diego
| | - Xavier Soler
- Pulmonary and Critical Care and Sleep Division, University of California, San Diego
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Troosters T. Physical inactivity in patients with COPD: the next step is … action. PRIMARY CARE RESPIRATORY JOURNAL : JOURNAL OF THE GENERAL PRACTICE AIRWAYS GROUP 2014; 22:391-2. [PMID: 24270366 PMCID: PMC6442872 DOI: 10.4104/pcrj.2013.00099] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Thierry Troosters
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium; Respiratory Rehabilitation Division, University Hospital Gasthuisberg, Leuven, Belgium
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Abstract
A comprehensive assessment is the foundation of a successful pulmonary rehabilitation programme. There is a broad selection of outcome measures that tend to be categorized into measures of exercise performance (including measures of strength) quality of life (health status), psychological well-being, nutritional status and more recently knowledge and self-efficacy. There is a growing interest in the measurement of physical activity too, although this is a current line of research activity. A sophisticated suite of outcomes allows the rehabilitation program to be personalised to the individual and deliver effective rehabilitation.
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Affiliation(s)
- Sally Singh
- Centre for Exercise and Rehabilitation Science, University Hospitals of Leicester NHS Trust, Groby Road, Leicester LE3 9QP, UK.
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34
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Aguilaniu B, Roche N. The difficulties of measuring and improving physical activity in COPD. NPJ Prim Care Respir Med 2014; 24:14014. [PMID: 24841568 PMCID: PMC4373312 DOI: 10.1038/npjpcrm.2014.14] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- Bernard Aguilaniu
- Faculté de Médecine de Grenoble-Université Joseph Fourrier, Grenoble, France
| | - Nicolas Roche
- Department of Respiratory and Intensive Care Medicine, Groupe Hospitalier Cochin, AP-HP and Université Paris Descartes (EA2511), Paris, France
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35
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Troosters T, van der Molen T, Polkey M, Rabinovich RA, Vogiatzis I, Weisman I, Kulich K. Improving physical activity in COPD: towards a new paradigm. Respir Res 2013; 14:115. [PMID: 24229341 PMCID: PMC4176094 DOI: 10.1186/1465-9921-14-115] [Citation(s) in RCA: 100] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2013] [Accepted: 08/22/2013] [Indexed: 11/20/2022] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is a debilitating disease affecting patients in daily life, both physically and emotionally. Symptoms such as dyspnea and muscle fatigue, lead to exercise intolerance, which, together with behavioral issues, trigger physical inactivity, a key feature of COPD. Physical inactivity is associated with adverse clinical outcomes, including hospitalization and all-cause mortality. Increasing activity levels is crucial for effective management strategies and could lead to improved long-term outcomes. In this review we summarize objective and subjective instruments for evaluating physical activity and focus on interventions such as pulmonary rehabilitation or bronchodilators aimed at increasing activity levels. To date, only limited evidence exists to support the effectiveness of these interventions. We suggest that a multimodal approach comprising pulmonary rehabilitation, pharmacotherapy, and counselling programs aimed at addressing emotional and behavioural aspects of COPD may be an effective way to increase physical activity and improve health status in the long term.
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Affiliation(s)
- Thierry Troosters
- Pulmonary Rehabilitation and Respiratory Division, UZ Gasthuisberg, Herestraat 49, B3000 Leuven, Belgium.
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36
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Goldstein RS, Hill K, Brooks D, Dolmage TE. Pulmonary rehabilitation: a review of the recent literature. Chest 2013; 142:738-749. [PMID: 22948578 DOI: 10.1378/chest.12-0188] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Pulmonary rehabilitation (PR) is an evidence-based, multidisciplinary, comprehensive intervention that can be integrated into the management of individuals with chronic lung disease. It aims to reduce symptoms, optimize function, increase participation in daily life, and reduce health-care resource utilization. In this review, we summarize the new developments in PR over the past 5 years. Issues related to patient assessment include a comparison of cycle- and walking-based measures of exercise capacity, the emergence of multidimensional indices, the refinement of the minimal clinically important difference, and the importance of assessing physical activity. Issues related to exercise training focus on strategies to optimize the training load. We also comment on the acquisition of self-management skills, balance training, optimizing access, and maintaining gains following completion of PR.
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Affiliation(s)
- Roger S Goldstein
- Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, ON, Canada; Department of Physical Therapy, University of Toronto, Toronto, ON, Canada; Department of Medicine, University of Toronto, Toronto, ON, Canada.
| | - Kylie Hill
- School of Physiotherapy and Curtin Health Innovation Research Institute, Curtin University, Bentley, WA, Australia; Lung Institute of Western Australia and Centre for Asthma, Allergy and Respiratory Research, University of Western Australia, Crawley, WA, Australia
| | - Dina Brooks
- Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, ON, Canada; Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
| | - Thomas E Dolmage
- Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, ON, Canada; Respiratory Diagnostic and Evaluation Services, West Park Healthcare Centre, Toronto, ON, Canada
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