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Ghanei M, Philip KEJ, Moghadam MRS, Hosseini H, Babaie A, Roustanezhad M, Hopkinson NS. Pulmonary rehabilitation in Iranian outpatients with mustard gas lung disease: a randomised controlled trial. BMJ Open 2024; 14:e083085. [PMID: 38806414 PMCID: PMC11138312 DOI: 10.1136/bmjopen-2023-083085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 05/15/2024] [Indexed: 05/30/2024] Open
Abstract
OBJECTIVE People with mustard gas lung disease experience cough, sputum, breathlessness and exercise limitation. We hypothesised that pulmonary rehabilitation (PR) would be beneficial in this condition. DESIGN An assessor-blind, two-armed, parallel-design randomised controlled clinical trial. SETTING Secondary care clinics in Iran. PARTICIPANTS 60 men with breathlessness due to respiratory disease caused by documented mustard gas exposure, mean (SD) age 52.7 (4.36) years, MRC dyspnoea score 3.5 (0.7), St. George's Respiratory Questionnaire (SGRQ) 72.3 (15.2). INTERVENTIONS Participants were allocated either to a 6-week course of thrice-weekly PR (n=31) or to usual care (n=29), with 6-week data for 28 and 26, respectively. OUTCOME MEASURES Primary endpoint was change in cycle endurance time at 70% baseline exercise capacity at 6 weeks. Secondary endpoints included 6 min walk distance, quadriceps strength and bulk, body composition and health status. For logistical reasons, blood tests that had been originally planned were not performed and 12-month follow-up was available for only a small proportion. RESULTS At 6 weeks, cycle endurance time increased from 377 (140) s to 787 (343) s with PR vs 495 (171) s to 479 (159) s for usual care, effect size +383 (231) s (p<0.001). PR also improved 6 min walk distance+103.2 m (63.6-142.9) (p<0.001), MRC dyspnoea score -0.36 (-0.65 to -0.07) (p=0.016) and quality of life; SGRQ -8.43 (-13.38 to -3.48) p<0.001, as well as quadriceps strength+9.28 Nm (1.89 to 16.66) p=0.015. CONCLUSION These data suggest that PR can improve exercise capacity and quality of life in people with breathlessness due to mustard gas lung disease and support the wider provision of this form of care. TRIAL REGISTRATION NUMBER IRCT2016051127848N1.
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Affiliation(s)
- Mostafa Ghanei
- Chemical Injuries Research Center, Systems Biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
| | - Keir E J Philip
- National Heart and Lung Institute, Imperial College London, London, UK
| | | | - Hamed Hosseini
- Clinical Trial Center, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
| | - Aliakbar Babaie
- Janbazan Medical and Engineering Research Center, Tehran, Iran (the Islamic Republic of)
| | - Mohammad Roustanezhad
- Janbazan Medical and Engineering Research Center, Tehran, Iran (the Islamic Republic of)
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Aljama C, Granados G, Ramon M, Barrecheguren M, Loeb E, Nuñez A, Pleguezuelos E, García-Río F, Miravitlles M. Motivation and Confidence about Physical Activity in Chronic Obstructive Pulmonary Disease Patients: Health Benefits Matter to Patients. Respiration 2024; 103:378-387. [PMID: 38735281 DOI: 10.1159/000539206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 05/01/2024] [Indexed: 05/14/2024] Open
Abstract
INTRODUCTION Physical activity (PA) has shown great benefits in patients with chronic obstructive pulmonary disease (COPD); however, their PA is below average. Motivational factors associated with PA in COPD have not been widely studied and could be a target for improving adherence to PA. The objective of our study was to identify and understand the different motivational and confidence factors related to low levels of PA in a COPD cohort. METHOD Observational, prospective, multicenter study of COPD patients. Sociodemographic data, respiratory symptoms, comorbidities, spirometry, and exercise capacity were collected. PA was measured using the Dynaport accelerometer and patient motivation and confidence in PA were assessed by a questionnaire previously used in a COPD population in the USA. RESULTS Eighty six COPD patients were included, 68.6% being male, with a mean (SD) age of 66.6 (8.5) years and a mean forced expiratory volume in the first second (%) of 50.9% (17.3%). The mean walking time was 82.8 (37.8) minutes/day. Questions related to health benefits and enjoying exercise were ranked highest in the motivation questionnaire and statistically significant differences were found in PA measures between patients with low and high motivation. A lack of confidence regarding hot weather and health-related issues significantly influenced PA levels. Advice from third parties, including healthcare providers, was not associated with higher PA levels. CONCLUSIONS Improving the health of COPD patients is their main motivation to perform PA. Lack of confidence when it is hot or when they fear for their health is related to low levels of PA. Advice from third parties, including healthcare professionals, is not associated with higher PA. These results are relevant for developing strategies to increase the adherence of COPD patients to PA programs.
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Affiliation(s)
- Cristina Aljama
- Pneumology Department, Hospital Universitari Vall d´Hebron/Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, CIBER de Enfermedades Respiratorias (CIBERES), Barcelona, Spain,
| | - Galo Granados
- Pneumology Department, Hospital Universitari Vall d´Hebron/Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, CIBER de Enfermedades Respiratorias (CIBERES), Barcelona, Spain
| | - Marian Ramon
- Pneumology Department, Hospital Universitari Vall d´Hebron/Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, CIBER de Enfermedades Respiratorias (CIBERES), Barcelona, Spain
| | - Miriam Barrecheguren
- Pneumology Department, Hospital Universitari Vall d´Hebron/Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, CIBER de Enfermedades Respiratorias (CIBERES), Barcelona, Spain
| | - Eduardo Loeb
- Pneumology Department, Centro Médico Teknon, Grupo Quironsalud, Barcelona, Spain
| | - Alexa Nuñez
- Pneumology Department, Hospital Universitari Vall d´Hebron/Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, CIBER de Enfermedades Respiratorias (CIBERES), Barcelona, Spain
| | - Eulogio Pleguezuelos
- Physical Medicine and Rehabilitation Department, Hospital de Mataró, Barcelona, Spain
- Department of Experimental Science and Healthcare, Faculty of Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - Francisco García-Río
- Servicio de Neumología, Hospital Universitario La Paz-IdiPAZ, Universidad Autónoma de Madrid, Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Marc Miravitlles
- Pneumology Department, Hospital Universitari Vall d´Hebron/Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, CIBER de Enfermedades Respiratorias (CIBERES), Barcelona, Spain
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3
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Philip KEJ, Buttery SC, Bowen S, Lewis A, Jeffery E, Alghamdi SM, Williams P, Alasmari AM, Alsulayyim AS, Orton CM, Conway F, Chan L, Vijayakumar B, Tana A, Tonkin J, Perkins A, Garner JL, Srikanthan K, Sadaka A, Pavitt MJ, Banya W, Lound A, Elkin S, Polkey MI, Man WDC, Lewis K, Cave P, Fancourt D, Hopkinson NS. Singing for lung health in COPD: a multicentre randomised controlled trial of online delivery. BMJ Open Respir Res 2024; 11:e002365. [PMID: 38697677 PMCID: PMC11086531 DOI: 10.1136/bmjresp-2024-002365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 03/25/2024] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND Singing for lung health (SLH) is an arts-based breathing control and movement intervention for people with long-term respiratory conditions, intended to improve symptoms and quality of life. Online, remotely delivered programmes might improve accessibility; however, no previous studies have assessed the effectiveness of this approach. METHODS We conducted an assessor-blind randomised controlled trial comparing the impact of 12 weeks of once-weekly online SLH sessions against usual care on health-related quality of life, assessed using the RAND 36-Item Short Form Health Survey (SF-36) Mental Health Composite (MHC) and Physical Health Composite (PHC) scores. RESULTS We enrolled 115 people with stable chronic obstructive pulmonary disease (COPD), median (IQR) age 69 (62-74), 56.5% females, 80% prior pulmonary rehabilitation, Medical Research Council dyspnoea scale 4 (3-4), forced expiratory volume in 1 s % predicted 49 (35-63). 50 participants in each arm completed the study. The intervention arm experienced improvements in physical but not mental health components of RAND SF-36; PHC (regression coefficient (95% CI): 1.77 (95% CI 0.11 to 3.44); p=0.037), but not MHC (0.86 (95% CI -1.68 to 3.40); p=0.504). A prespecified responder analysis based on achieving a 10% improvement from baseline demonstrated a response rate for PHC of 32% in the SLH arm and 12.7% for usual care (p=0.024). A between-group difference in responder rate was not found in relation to the MHC (19.3% vs 25.9%; p=0.403). DISCUSSION AND CONCLUSION A 12-week online SLH programme can improve the physical component of quality of life for people with COPD, but the overall effect is relatively modest compared with the impact seen in research using face-to-face group sessions. Further work on the content, duration and dose of online interventions may be useful. TRIAL REGISTRATION NUMBER NCT04034212.
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Affiliation(s)
- Keir E J Philip
- National Heart and Lung Institute, Imperial College London, London, UK
- Respiratory Medicine, Royal Brompton and Harefield Hospitals, London, UK
| | - Sara C Buttery
- National Heart and Lung Institute, Imperial College London, London, UK
- Respiratory Medicine, Royal Brompton and Harefield Hospitals, London, UK
| | - Sarah Bowen
- Hywel Dda University Health Board, Carmarthen, UK
| | - Adam Lewis
- Department of Health Sciences, Brunel University London, Uxbridge, UK
| | - Edmund Jeffery
- Respiratory Medicine, Royal Brompton and Harefield Hospitals, London, UK
| | - Saeed M Alghamdi
- National Heart and Lung Institute, Imperial College London, London, UK
- Clinical Technology Department, Faculty of Applied Medical Sciences, Umm Al-Qura University College of Applied Medical Science, Makkah, Saudi Arabia
| | - Parris Williams
- National Heart and Lung Institute, Imperial College London, London, UK
- Respiratory Medicine, Royal Brompton and Harefield Hospitals, London, UK
| | - Ali M Alasmari
- National Heart and Lung Institute, Imperial College London, London, UK
- Department of Respiratory Therapy, College of Medical Rehabilitation, Taibah University, Madinah, Al Madinah, Saudi Arabia
| | - Abdullah S Alsulayyim
- National Heart and Lung Institute, Imperial College London, London, UK
- Respiratory Therapy Department, Faculty of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia
| | - Christopher M Orton
- National Heart and Lung Institute, Imperial College London, London, UK
- Respiratory Medicine, Royal Brompton and Harefield Hospitals, London, UK
| | - Francesca Conway
- National Heart and Lung Institute, Imperial College London, London, UK
- Respiratory Medicine, Royal Brompton and Harefield Hospitals, London, UK
| | - Ley Chan
- National Heart and Lung Institute, Imperial College London, London, UK
- Respiratory Medicine, Royal Brompton and Harefield Hospitals, London, UK
| | - Bavithra Vijayakumar
- National Heart and Lung Institute, Imperial College London, London, UK
- Respiratory Medicine, Royal Brompton and Harefield Hospitals, London, UK
| | - Anand Tana
- National Heart and Lung Institute, Imperial College London, London, UK
- Respiratory Medicine, Royal Brompton and Harefield Hospitals, London, UK
| | - James Tonkin
- National Heart and Lung Institute, Imperial College London, London, UK
- Respiratory Medicine, Royal Brompton and Harefield Hospitals, London, UK
| | - Alexis Perkins
- National Heart and Lung Institute, Imperial College London, London, UK
- Respiratory Medicine, Royal Brompton and Harefield Hospitals, London, UK
| | - Justin L Garner
- National Heart and Lung Institute, Imperial College London, London, UK
- Respiratory Medicine, Royal Brompton and Harefield Hospitals, London, UK
| | - Karthikan Srikanthan
- National Heart and Lung Institute, Imperial College London, London, UK
- Respiratory Medicine, Royal Brompton and Harefield Hospitals, London, UK
| | - Ahmed Sadaka
- National Heart and Lung Institute, Imperial College London, London, UK
- Respiratory Medicine, Royal Brompton and Harefield Hospitals, London, UK
| | - Matthew J Pavitt
- National Heart and Lung Institute, Imperial College London, London, UK
- Respiratory Medicine, Royal Brompton and Harefield Hospitals, London, UK
| | - Winston Banya
- Respiratory Medicine, Royal Brompton and Harefield Hospitals, London, UK
| | - Adam Lound
- Patient Experience Research Centre, Imperial College, London, UK
| | - Sarah Elkin
- Respiratory Medicine, Imperial College Healthcare NHS Trust, London, UK
| | - Michael I Polkey
- National Heart and Lung Institute, Imperial College London, London, UK
- Respiratory Medicine, Royal Brompton and Harefield Hospitals, London, UK
| | - William D-C Man
- National Heart and Lung Institute, Imperial College London, London, UK
- Respiratory Medicine, Royal Brompton and Harefield Hospitals, London, UK
| | - Keir Lewis
- Hywel Dda University Health Board, Carmarthen, UK
| | - Phoene Cave
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Daisy Fancourt
- Department of Behavioural Science and Health, University College London, London, London, UK
| | - Nicholas S Hopkinson
- National Heart and Lung Institute, Imperial College London, London, UK
- Respiratory Medicine, Royal Brompton and Harefield Hospitals, London, UK
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Antão J, Rebelo P, Almeida S, Franssen FME, Spruit MA, Marques A. Effects of ActiGraph's filter, epoch length and non-wearing time algorithm on step counts in people with COPD. J Sports Sci 2024; 42:9-16. [PMID: 38394032 DOI: 10.1080/02640414.2024.2319448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 02/08/2024] [Indexed: 02/25/2024]
Abstract
The influence of the ActiGraph® processing criteria on estimating step counts in chronic obstructive pulmonary disease (COPD) remains uncertain. This study aimed to assess the influence of filters, epoch lengths and non-wearing time (NWT) algorithms on steps/day in people with COPD. ActiGraph GT3X+ was worn on the waist for seven days. Steps were detected using different filters (normal and low-frequency extension [LFE]), epoch lengths (15s and 60s), and NWT algorithms (Choi and Troiano). Linear mixed-effects model was applied to assess the effects of filter, epoch length, NWT algorithm on steps/day. Lin's concordance correlation and Bland-Altman were used to measure agreement. A total of 136 people with COPD (107 male; 69 ± 8 years; FEV1 51 ± 17% predicted) were included. Significant differences were found between filters (p < 0.001), but not between epoch lengths or NWT algorithms. The LFE increased, on average, approximately 7500 steps/day compared to the normal filter (p < 0.001). Agreement was poor (<0.3) and proportional bias was significant when comparing steps/day computed with different filters, regardless of the epoch length and NWT algorithm. Filter choice but not epoch lengths or NWT algorithms seem to impact measurement of steps/day. Future studies are needed to recommend the most accurate technique for measuring steps/day in people with COPD.
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Affiliation(s)
- Joana Antão
- Lab3R - Respiratory Research and Rehabilitation Laboratory, School of Health Sciences, University of Aveiro (ESSUA), Aveiro, Portugal
- iBiMED - Institute of Biomedicine, Department of Medical Sciences, University of Aveiro, Aveiro, Portugal
- Department of Research and Development, Horn, Ciro, The Netherlands
- Department of Respiratory Medicine, Maastricht University Medical Centre, NUTRIM School of Nutrition and Translational Research in Metabolism, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Patrícia Rebelo
- Lab3R - Respiratory Research and Rehabilitation Laboratory, School of Health Sciences, University of Aveiro (ESSUA), Aveiro, Portugal
- iBiMED - Institute of Biomedicine, Department of Medical Sciences, University of Aveiro, Aveiro, Portugal
| | - Sara Almeida
- Lab3R - Respiratory Research and Rehabilitation Laboratory, School of Health Sciences, University of Aveiro (ESSUA), Aveiro, Portugal
- iBiMED - Institute of Biomedicine, Department of Medical Sciences, University of Aveiro, Aveiro, Portugal
| | - Frits M E Franssen
- Department of Research and Development, Horn, Ciro, The Netherlands
- Department of Respiratory Medicine, Maastricht University Medical Centre, NUTRIM School of Nutrition and Translational Research in Metabolism, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Martijn A Spruit
- Department of Research and Development, Horn, Ciro, The Netherlands
- Department of Respiratory Medicine, Maastricht University Medical Centre, NUTRIM School of Nutrition and Translational Research in Metabolism, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Alda Marques
- Lab3R - Respiratory Research and Rehabilitation Laboratory, School of Health Sciences, University of Aveiro (ESSUA), Aveiro, Portugal
- iBiMED - Institute of Biomedicine, Department of Medical Sciences, University of Aveiro, Aveiro, Portugal
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5
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Esteban C, Antón-Ladislao A, Aramburu A, Chasco L, Orive M, Sobradillo P, López-Roldan L, Jiménez-Puente A, de Miguel J, García-Talavera I, Quintana JM. Physical activity and sedentary behaviour in patients admitted with COPD: Associated factors. Respir Med Res 2023; 84:101052. [PMID: 37897880 DOI: 10.1016/j.resmer.2023.101052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 07/22/2023] [Accepted: 09/26/2023] [Indexed: 10/30/2023]
Abstract
AIM To establish amongst a cohort of patients admitted with Chronic Obstructive Pulmonary Disease which factors were associated with their level of Physical Activity and Sedentary Behavior prior to the admission event. METHODS Prospective observational cohort study. Nine Spanish hospitals participated. Patients were recruited consecutively. Variables relating to the patients' clinical baseline status were recorded, including the COPD Assessment test, the HADS anxiety-depression test, comorbidities and the Yale Physical Activity Survey. Data relating to admission and up to two months after discharge were also recorded. RESULTS 1638 COPD patients were studied, with a mean age of 72.39 (SD 10.33), 76.56 % male, FEV1 49.41 % (SD19.19), Charlson index 2. The level of PA at baseline was 30.79 points (SD 22.43). Multivariable linear regression analysis identified the following as being associated with low PA: older age, obesity, higher level of hemoglobin, lower score of Barthel index, which means disability, health related quality of life (EuroQoL-5d and CAT) and dyspnea. Variables associated with sedentary behavior were: older age, presence of obstructive apnea syndrome, higher disability, presence of depressive symptoms and dyspnea. CONCLUSIONS In a cohort of hospitalized COPD patients, we have found several variables, some of them modifiable, associated with physical activity/inactivity and sedentary behavior.
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Affiliation(s)
- Cristóbal Esteban
- Respiratory Department, Hospital Galdakao, Galdakao, Bizkaia, Spain; BioCruces-Bizkaia Health Research Institute, Barakaldo, Spain; Health Services Research on Chronic Patients Network (REDISSEC), Spain; Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), Spain.
| | - Ane Antón-Ladislao
- Research Unit, Hospital Galdakao, Galdakao, Bizkaia, Spain; Health Services Research on Chronic Patients Network (REDISSEC), Spain
| | - Amaia Aramburu
- Respiratory Department, Hospital Galdakao, Galdakao, Bizkaia, Spain; BioCruces-Bizkaia Health Research Institute, Barakaldo, Spain
| | - Leyre Chasco
- Respiratory Department, Hospital Galdakao, Galdakao, Bizkaia, Spain; BioCruces-Bizkaia Health Research Institute, Barakaldo, Spain
| | - Miren Orive
- Departamento Psicología Social, Facultad Farmacia, UPV/EHU, Vitoria-Gasteiz, Spain; Health Services Research on Chronic Patients Network (REDISSEC), Spain; Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), Spain
| | - Patricia Sobradillo
- Servicio de Respiratorio, Hospital Cruces, Barakaldo, Spain; BioCruces-Bizkaia Health Research Institute, Barakaldo, Spain
| | | | - Alberto Jiménez-Puente
- Unidad de Evaluación, Hospital Costa del Sol, Marbella, Malaga, Spain; Health Services Research on Chronic Patients Network (REDISSEC), Spain; Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), Spain
| | - Javier de Miguel
- Servicio de Respiratorio, Hospital Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM)., Madrid, Spain; Health Services Research on Chronic Patients Network (REDISSEC), Spain; Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), Spain
| | - Ignacio García-Talavera
- Servicio de Respiratorio, Hospital Nuestra Señora de la Candelaria, Santa Cruz de Tenerife, Spain; Health Services Research on Chronic Patients Network (REDISSEC), Spain; Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), Spain
| | - José M Quintana
- Research Unit, Hospital Galdakao, Galdakao, Bizkaia, Spain; Health Services Research on Chronic Patients Network (REDISSEC), Spain; Kronikgune Research Institute, Barakaldo, Spain; Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), Spain
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Blondeel A, Hermans F, Breuls S, Wuyts M, De Maeyer N, Verniest T, Derom E, Van Calster B, Janssens W, Troosters T, Demeyer H. The association of weather conditions with day-to-day variability in physical activity in patients with COPD. ERJ Open Res 2023; 9:00314-2023. [PMID: 37965232 PMCID: PMC10641577 DOI: 10.1183/23120541.00314-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 08/04/2023] [Indexed: 11/16/2023] Open
Abstract
Background While patients with COPD often cite weather conditions as a reason for inactivity, little is known about the relationship between physical activity (PA) and weather conditions. The present study investigated the association of day-to-day weather changes on PA in patients with COPD and investigated patient characteristics related to being more or less influenced by weather conditions. Methods In this longitudinal analysis, device-based day-by-day step counts were objectively measured in COPD patients for up to 12 months. Daily meteorological data (temperature, precipitation, wind speed, hours of sunlight and daylight) were linked to the daily step count and individual and multivariable relationships were investigated using mixed-model effects. Individual R2 was calculated for every subject to investigate the estimated influence of weather conditions on a patient level and its relationship with patient characteristics. Results We included 50 patients with a mean±sd follow-up time of 282±93 days, totalling 14 117 patient-days. Daily temperature showed a positive linear pattern up until an inflexion point, after which a negative association with increasing temperature was observed (p<0.0001). Sunshine and daylight time had a positive association with PA (p<0.0001). Precipitation and wind speed were negatively associated with PA (p<0.0001). The median per-patient R2 for overall weather conditions was 0.08, ranging from 0.00 to 0.42. No strong associations between patient characteristics and per-patient R2 were observed. Conclusion Weather conditions are partly associated with PA in patients with COPD, yet the overall explained variance of PA due to weather conditions is rather low and varied strongly between individuals.
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Affiliation(s)
- Astrid Blondeel
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Fien Hermans
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - Sofie Breuls
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Marieke Wuyts
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Nikolaas De Maeyer
- Clinical Department of Respiratory Diseases, Regional Hospital Heilig Hart Leuven, Leuven, Belgium
| | - Thessa Verniest
- Clinical Department of Respiratory Diseases, Regional Hospital Heilig Hart Leuven, Leuven, Belgium
| | - Eric Derom
- Clinical Department of Respiratory Medicine, University Hospital Ghent, Ghent, Belgium
| | - Ben Van Calster
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium
| | - Wim Janssens
- Department of Chronic Diseases, Metabolism and Aging (CHROMETA) – BREATHE, KU Leuven, Leuven, Belgium
- Clinical Department of Respiratory Diseases, University Hospitals Leuven, Leuven, Belgium
| | - Thierry Troosters
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
- These authors contributed equally
| | - Heleen Demeyer
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
- These authors contributed equally
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7
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Timm I, Reichert M, Ebner-Priemer UW, Giurgiu M. Momentary within-subject associations of affective states and physical behavior are moderated by weather conditions in real life: an ambulatory assessment study. Int J Behav Nutr Phys Act 2023; 20:117. [PMID: 37777773 PMCID: PMC10541720 DOI: 10.1186/s12966-023-01507-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 08/28/2023] [Indexed: 10/02/2023] Open
Abstract
BACKGROUND Physical behavior (PB) is a key lifestyle factor in regulating and preventing diseases across the lifespan. Researchers identified affective, cognitive, and contextual factors like weather conditions, as significant contributors in determining if individuals are physically active. However, there is scarce empirical evidence about potential associations between PB and affective states influenced by weather conditions in daily life. Therefore, we explored if weather conditions moderated the within-subject association between momentary affective states and subsequent PB. METHODS Utilizing ambulatory assessment, 79 participants completed electronic diaries about their affective states (i.e., valence, energetic arousal, and calmness) up to six times a day over five days, and their PB (i.e., physical activity and sedentariness) was simultaneously recorded via accelerometers. Weather conditions (i.e., temperature and precipitation) recorded near participants' locations served as moderators in the multilevel analyses. RESULTS We confirmed earlier findings associating affective states with PB. Increased valence and energetic arousal were positively associated with physical activity (β = 0.007; p < .001), whereas calmness predicted lower levels of physical activity (β = -0.006; p < .001). Higher levels of calmness showed a positive association with sedentary behavior (β = 0.054; p = .003). In addition, we revealed a significant positive association between temperature, as a momentary weather condition, and physical activity (β = 0.025; p = .015). Furthermore, we showed that the association of affective states and physical activity was moderated by temperature. Higher temperatures enhanced the positive effects of valence on physical activity (β = .001, p = .023) and attenuated the negative effects of calmness on physical activity (β = .001, p = .021). Moreover, higher temperatures enhanced the positive effects of valence on reduced sedentary behavior (β = -0.011, p = .043). CONCLUSIONS Temperature alterations appeared to have an impact on subsequent physical activity. Furthermore, temperature alterations moderated the influence of affective states on conducted physical activity. This might offer the opportunity for just-in-time adaptive interventions to intervene in individually appropriate environmental conditions for promoting physical activity.
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Affiliation(s)
- Irina Timm
- Mental mHealth Lab, Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Hertzstr. 16, Karlsruhe, 76187, Germany.
| | - Markus Reichert
- Mental mHealth Lab, Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Hertzstr. 16, Karlsruhe, 76187, Germany
- Department of eHealth and Sports Analytics, Faculty of Sport Science, Ruhr University Bochum, Gesundheitscampus-Nord 10, Bochum, 44801, Germany
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, J5, 68159, Mannheim, Germany
| | - Ulrich W Ebner-Priemer
- Mental mHealth Lab, Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Hertzstr. 16, Karlsruhe, 76187, Germany
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, J5, 68159, Mannheim, Germany
| | - Marco Giurgiu
- Mental mHealth Lab, Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Hertzstr. 16, Karlsruhe, 76187, Germany
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, J5, 68159, Mannheim, Germany
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8
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Oostrik L, Bourbeau J, Doiron D, Ross B, Zhi-Li P, Aaron SD, Chapman KR, Hernandez P, Maltais F, Marciniuk DD, O'Donnell D, Tan WC, Sin DD, Walker B, Janaudis-Ferreira T. Physical Activity and Symptom Burden in COPD: The Canadian Obstructive Lung Disease Study. CHRONIC OBSTRUCTIVE PULMONARY DISEASES (MIAMI, FLA.) 2023; 10:89-101. [PMID: 36563057 PMCID: PMC9995232 DOI: 10.15326/jcopdf.2022.0349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Background The relationship between symptom burden and physical activity (PA) in chronic obstructive pulmonary disease (COPD) remains poorly understood with limited data on undiagnosed individuals and those with mild to moderate disease. Objective The primary objective was to evaluate the relationship between symptom burden and moderate-to-vigorous intensity PA (MVPA) in individuals from a random population-based sampling mirroring the population at large. Methods Baseline participants of the Canadian Cohort Obstructive Lung Disease (n=1558) were selected for this cross-sectional sub-study. Participants with mild COPD (n=406) and moderate COPD (n=331), healthy individuals (n=347), and those at risk of developing COPD (n=474) were included. The Community Healthy Activities Model Program for Seniors (CHAMPS) questionnaire was used to estimate MVPA in terms of energy expenditure. High symptom burden was classified using the COPD Assessment Test ([CAT] ≥10). Results Significant associations were demonstrated between high symptom burden and lower MVPA levels in the overall COPD sample (β=-717.09; 95% confidence interval [CI]=-1079.78, -354.40; p<0.001) and in the moderate COPD subgroup (β=-694.1; 95% CI=-1206.54, -181.66; p=0.006). A total of 72% of the participants with COPD were previously undiagnosed. The undiagnosed participants had significantly higher MVPA than those with physician diagnosed COPD (β=-592.41 95% CI=-953.11, -231.71; p=0.001). Conclusion MVPA was found to be inversely related to symptom burden in a large general population sample that included newly diagnosed individuals, most with mild to moderate COPD. Assessment of symptom burden may help identify patients with lower MVPA, especially for moderate COPD and for relatively inactive individuals with mild COPD.
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Affiliation(s)
- Loes Oostrik
- Physical Therapy Sciences, Program in Clinical Health Sciences, University Medical Center Utrecht, Utrecht University, Netherlands
| | - Jean Bourbeau
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada.,Respiratory Epidemiology and Clinical Research Unit, Research Institute, McGill University Health Center, Montreal, Quebec, Canada.,Montreal Chest Institute, McGill University Health Centre, Montreal, Quebec, Canada
| | - Dany Doiron
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada.,Respiratory Epidemiology and Clinical Research Unit, Research Institute, McGill University Health Center, Montreal, Quebec, Canada
| | - Bryan Ross
- Montreal Chest Institute, McGill University Health Centre, Montreal, Quebec, Canada
| | - Pei Zhi-Li
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada.,Respiratory Epidemiology and Clinical Research Unit, Research Institute, McGill University Health Center, Montreal, Quebec, Canada
| | - Shawn D Aaron
- Ottawa Hospital Research Institute, Ottawa University, Ottawa, Canada
| | - Kenneth R Chapman
- Toronto General Hospital Research Institute, University of Toronto, Toronto, Canada
| | - Paul Hernandez
- Division of Respirology, Faculty of Medicine, Dalhousie University, Halifax, Canada
| | - Francois Maltais
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Quebec, Canada
| | - Darcy D Marciniuk
- Respiratory Research Centre, University of Saskatchewan, Saskatoon, Canada
| | - Denis O'Donnell
- Division of Respiratory and Critical Care Medicine, Queen's University, Kingston, Canada
| | - Wan C Tan
- Centre for Heart Lung Innovation, University of British Columbia, St Paul's Hospital, Vancouver, Canada
| | - Don D Sin
- Centre for Heart Lung Innovation, University of British Columbia, St Paul's Hospital, Vancouver, Canada
| | - Brandie Walker
- Department of Medicine, University of Calgary, Alberta, Canada
| | - Tania Janaudis-Ferreira
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada.,Respiratory Epidemiology and Clinical Research Unit, Research Institute, McGill University Health Center, Montreal, Quebec, Canada.,School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada
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9
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Boutou A, Konstantinidou M, Rampiadou C. Promotion of physical activity after hospitalization for
COPD
exacerbation: Aids and barriers. Respirology 2022; 28:409-410. [PMID: 36470588 DOI: 10.1111/resp.14429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 11/07/2022] [Indexed: 12/12/2022]
Affiliation(s)
- Afroditi Boutou
- Department of Respiratory Medicine Hippokration Hospital Thessaloniki Greece
| | | | - Christina Rampiadou
- Department of Respiratory Medicine G. Papanikolaou Hospital Thessaloniki Greece
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10
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Tian J, Zhou F, Zhang XG, Wang HY, Peng SH, Li X, Cao J, Zhang H. Experience of physical activity in patients with COPD: A systematic review and qualitative meta-synthesis. Geriatr Nurs 2022; 47:211-219. [PMID: 35940039 DOI: 10.1016/j.gerinurse.2022.07.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 07/13/2022] [Accepted: 07/15/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To systematically evaluate and integrate the qualitative research on physical activity (PA) experience of patients with chronic obstructive pulmonary disease (COPD). METHODS Web of Science, Cochrane Library, Embase, CINAHL and other databases were searched, and the qualitative research on PA experience of patients with COPD was collected. The systematic review was conducted in line with Joanna Briggs Institute (JBI) methodology for systematic reviews of qualitative evidence. RESULTS 12 studies were included and 3 themes were summarized, included: COPD patients experience more barriers while participating in physical activities than facilitators; COPD patients experience more positive effects post-physical activities than negative effects; Guaranteeing safety, goal setting, and establishing a professional support group improve compliance in COPD patients. CONCLUSION Health care professionals should help patients overcome the obstacles of PA, pay attention to the PA experience of patients, adopt diversified PA methods, improve PA participation and compliance, and make patients develop good PA habits.
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Affiliation(s)
- Jing Tian
- College of Nursing,Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 610075, China
| | - Fan Zhou
- College of Nursing,Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 610075, China
| | - Xian Geng Zhang
- Sichuan Nursing Vocational College, No.173 Longdu South Road, Longquanyi District, Chengdu, Sichuan 610100, China.
| | - Hong Yan Wang
- Sichuan Nursing Vocational College, No.173 Longdu South Road, Longquanyi District, Chengdu, Sichuan 610100, China
| | - Si Han Peng
- Affiliated hospital of Chengdu University of Traditional Chinese Medicine,Chengdu, Sichuan 610032, China
| | - Xin Li
- College of Nursing,Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 610075, China
| | - Jun Cao
- Sichuan Nursing Vocational College, No.173 Longdu South Road, Longquanyi District, Chengdu, Sichuan 610100, China
| | - Hong Zhang
- College of Nursing,Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 610075, China
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11
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Chaplin E, Barnes A, Newby C, Houchen-Wolloff L, Singh SJ. Comparison of the Impact of Conventional and Web-Based Pulmonary Rehabilitation on Physical Activity in Patients With Chronic Obstructive Pulmonary Disease: Exploratory Feasibility Study. JMIR Rehabil Assist Technol 2022; 9:e28875. [PMID: 35266871 PMCID: PMC8949713 DOI: 10.2196/28875] [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: 03/17/2021] [Revised: 08/24/2021] [Accepted: 11/30/2021] [Indexed: 11/13/2022] Open
Abstract
Background Pulmonary Rehabilitation (PR) increases exercise capacity, with less clear evidence regarding physical activity (PA). The World Health Organization recommends at least 150-300 minutes of moderate-intensity or 75-150 minutes of vigorous-intensity aerobic PA per week to reduce the risks of chronic disease. Objective The objective of this study was to assess the effectiveness of conventional PR versus web-based PR with respect to changes in PA. Methods Patients with COPD were randomized to either conventional PR classes (n=51) or a web-based PR program (n=52) for 7 weeks in a feasibility study. Accelerometers (Sensewear) were worn before and after the intervention, and PA was measured as steps per day and mean bouts of moderate activity for ≥2, ≥5, ≥10, and ≥20 minutes. Measures were derived for patients with ≥8 hours of data per day for ≥4 days, using the R package for statistical analysis. Variables were explored to examine their relationships with bouts of activity. Results Baseline characteristics did not differ significantly between groups. Complete PA data were available for the groups receiving web-based (n=20) and conventional (n=34) PR interventions. The web-based PR group demonstrated a nonsignificant increase in the number of steps per day, which mainly comprised short bouts of moderate to vigorous intensity PA when compared to the conventional PR group (P=.20). The conventional PR group demonstrated increased 20-minute bouts of PA by 49.1%, although this was not significant (P=.07). At baseline, age (r=–0.21, P=.04), BMI (r=–0.311, P=.004), and FEV1 (forced expiratory volume in 1 second; % predicted; r=–0.248, P=.048) were significantly correlated with 10-minute bouts of PA; however, this was not observed post intervention. Conclusions The analysis revealed a nonsignificant difference in the pattern of PA between groups receiving conventional vs web-based PR—the former being associated with an increase in 20-minute bouts, while the latter having demonstrated an increase in the number of steps per day. There appears to be a differing response emerging between the two interventions. Trial Registration International Clinical Trials Registry ISRCTN03142263; https://tinyurl.com/y4dmfyrb
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Affiliation(s)
- Emma Chaplin
- Centre for Exercise and Rehabilitation Science, National Institute for Health Research Leicester Biomedical Research Centre- Respiratory, University Hospitals of Leicester National Health Service Trust, Leicester, United Kingdom
| | - Amy Barnes
- Centre for Exercise and Rehabilitation Science, National Institute for Health Research Leicester Biomedical Research Centre- Respiratory, University Hospitals of Leicester National Health Service Trust, Leicester, United Kingdom
| | - Chris Newby
- School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Linzy Houchen-Wolloff
- Centre for Exercise and Rehabilitation Science, National Institute for Health Research Leicester Biomedical Research Centre- Respiratory, University Hospitals of Leicester National Health Service Trust, Leicester, United Kingdom.,Respiratory Sciences, University of Leicester, Leicester, United Kingdom
| | - Sally J Singh
- Centre for Exercise and Rehabilitation Science, National Institute for Health Research Leicester Biomedical Research Centre- Respiratory, University Hospitals of Leicester National Health Service Trust, Leicester, United Kingdom.,Respiratory Sciences, University of Leicester, Leicester, United Kingdom
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12
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Mendoza L, de Oca MM, López Varela MV, Casas A, Ramírez-Venegas A, López A, Ugalde L, Wehrmeister FC, Surmonti F, Menezes AMB, Miravitlles M. Physical Activity Levels and Associated Factors in a Latin American COPD Population of Patients. The LASSYC Study. COPD 2021; 18:393-400. [PMID: 34180756 DOI: 10.1080/15412555.2021.1937090] [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: 10/21/2022]
Abstract
Reduced physical activity (PA) is an independent risk factor for lung function decline, hospitalization and mortality in chronic obstructive pulmonary disease (COPD) and affects a large proportion of patients from Europe and the United States. However, little is known of the level of PA of COPD patients in Latin America. The aim of this study was to provide information of the level of PA and its determinants in COPD patients in Latin America. This is an observational, cross-sectional study on patients with COPD in seven Latin American countries. PA level was evaluated with the short version of the International Physical Activity Questionnaire (IPAQ) and the association between PA and other variables was investigated. Complete information of PA level was obtained in 734 COPD patients consecutively recruited from specialized outpatient clinics; 448 (61%) were men, with a mean age of 69.6 years (standard deviation [SD] = 8.7) and a mean FEV1 (% predicted) = 49.1% (17.5%). In 37.9% the level of PA was low, and the average sitting time was 36.1 h per week. Patients with low levels of PA were older, with higher levels of dyspnea and higher CAT scores. Additionally, we found that patients with low level of PA presented more symptoms during the day. Low levels of PA have been observed in a large proportion of COPD patients of Latin America, which is higher in women and older patients and it is related with worse functional and clinical characteristics.
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Affiliation(s)
- Laura Mendoza
- Neumology Unit, Hospital Clínico Universidad de Chile, Santiago de Chile, Chile
| | - María Montes de Oca
- Hospital Universitario de Caracas, Universidad Central de Venezuela, Caracas, Venezuela
| | | | - Alejandro Casas
- Pneumology Department, Fundación Neumológica Colombiana, Universidad del Rosario, Bogotá, Colombia
| | | | - Ana López
- Hospital Privado Universitario de Córdoba, Córdoba, Argentina
| | | | | | | | - Ana M B Menezes
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Marc Miravitlles
- Department of Pneumology. Hospital Universitari Vall d´Hebron, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus; CIBER de Enfermedades Respiratorias (CIBERES), Barcelona, Spain
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13
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Frykholm E, Gephine S, Saey D, Lemson A, Klijn P, Bij de Vaate E, Maltais F, van Hees H, Nyberg A. Isotonic quadriceps endurance is better associated with daily physical activity than quadriceps strength and power in COPD: an international multicentre cross-sectional trial. Sci Rep 2021; 11:11557. [PMID: 34078960 PMCID: PMC8172909 DOI: 10.1038/s41598-021-90758-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 05/12/2021] [Indexed: 11/24/2022] Open
Abstract
Knowledge about modifiable determinants of daily physical activity (PA) in patients with chronic obstructive pulmonary disease (COPD) is crucial to design effective PA interventions. The present study aimed to determine the contribution of quadriceps strength, power and endurance to daily PA in COPD. Additionally, for quadriceps endurance, we also aimed to determine to what extent the association varies according to the mode of movement (isotonic, isometric, or isokinetic). Using a multicentre cross-sectional trial design we determined the contribution of quadriceps function to daily PA (steps, sedentary time and time spent doing moderate-to-very-vigorous physical activity [MVPA]) using bivariate and partial Pearson correlation analysis (r) and multiple linear regression models (ΔR2). Pre-determined controlling factors were sex, age, body mass index (BMI), COPD-assessment test, forced expiratory volume in one second in percent of the predicted value (FEV1pred), and distance walked on the 6-minute walk test. Eighty-one patients with COPD (mean ± SD: age 67 ± 8 years, FEV1pred 57 ± 19%, daily steps 4968 ± 3319, daily sedentary time 1016 ± 305 min, and MVPA time 83 ± 45 min) were included. Small to moderate bivariate correlations (r = .225 to .452, p < .05) were found between quadriceps function and measures of PA. The best multiple linear regression models explained 38–49% of the variance in the data. Isotonic endurance was the only muscle contributor that improved all PA models; daily steps (ΔR2 = .04 [relative improvement 13%] p = .026), daily sedentary time (ΔR2 = .07 [23%], p = .005) and MVPA-minutes (ΔR2 = .08 [20%], p = .001). Isotonic endurance was also independently associated with most PA variables, even when controlling for strength, power or isometric-isokinetic endurance properties of the muscle (r = .246 to .384, p < .05). In contrast, neither strength, power, isometric-or isokinetic endurance properties of the muscle was independently associated with PA measures when controlling for isotonic endurance (r = .037 to .219, p > .05). To conclude, strength, power, and endurance properties of the quadriceps were low to moderately associated with PA in patients with COPD. Isotonic quadriceps endurance was the only quadriceps property that was independently associated with the different measures of PA after controlling for a basic set of known determinants of PA, quadriceps strength or power, or isometric or isokinetic quadriceps endurance. Future longitudinal studies should investigate its potential as a modifiable determinant of PA.
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Affiliation(s)
- Erik Frykholm
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University , Umeå, Sweden.
| | - Sarah Gephine
- Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Quebec, Canada.,Univ. Lille, Univ. Artois, Univ. Littoral Côte D'opale, ULR 7369-Urepsss, Lille, France
| | - Didier Saey
- Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Quebec, Canada
| | - Arthur Lemson
- Department of Pulmonary Diseases, Radboud UMC, Nijmegen, The Netherlands
| | - Peter Klijn
- Department of Pulmonary Rehabilitation, Merem Medical Rehabilitation, Hilversum, The Netherlands.,Department of Pulmonary Medicine, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Eline Bij de Vaate
- Department of Pulmonary Rehabilitation, Merem Medical Rehabilitation, Hilversum, The Netherlands
| | - François Maltais
- Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Quebec, Canada
| | | | - André Nyberg
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University , Umeå, Sweden
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14
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Ho JY, Zijlema WL, Triguero-Mas M, Donaire-Gonzalez D, Valentín A, Ballester J, Chan EYY, Goggins WB, Mo PKH, Kruize H, van den Berg M, Gražuleviciene R, Gidlow CJ, Jerrett M, Seto EYW, Barrera-Gómez J, Nieuwenhuijsen MJ. Does surrounding greenness moderate the relationship between apparent temperature and physical activity? Findings from the PHENOTYPE project. ENVIRONMENTAL RESEARCH 2021; 197:110992. [PMID: 33705766 DOI: 10.1016/j.envres.2021.110992] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 02/21/2021] [Accepted: 03/04/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Physical activity can be affected by both meteorological conditions and surrounding greenness, but few studies have evaluated the effects of these environmental factors on physical activity simultaneously. This multi-city comparative study aimed to assess the synergetic effects of apparent temperature and surrounding greenness on physical activity in four European cities. Specifically, we aimed to identify an interaction between surrounding greenness and apparent temperature in the effects on physical activity. METHODS Data were collected from 352 adult residents of Barcelona (Spain), Stoke-on-Trent (United Kingdom), Doetinchem (The Netherlands), and Kaunas (Lithuania) as part of the PHENOTYPE study. Participants wore a smartphone for seven consecutive days between May-December 2013 and provided additional sociodemographic survey data. Hourly average physical activity (Metabolic Equivalent of Task (MET)) and surrounding greenness (NDVI) were derived from the Calfit mobile application collecting accelerometer and location data. Hourly apparent temperature was calculated from temperature and relative humidity, which were obtained from local meteorological stations along with other meteorological covariates (rainfall, windspeed, and sky darkness). We assessed the interaction effects of apparent temperature and surrounding greenness on hourly physical activity for each city using linear mixed models, while adjusting for meteorological, demographic, and time-related variables. RESULTS We found significant interactions between apparent temperature and surrounding greenness on hourly physical activity in three of four cities, aside from the coastal city of Barcelona. Significant quadratic effects of apparent temperature were found in the highest level of surrounding greenness for Stoke-on-Trent and Doetinchem, with 4% decrease in median MET observed for a 10°C departure from optimal temperature (15.2°C and 14.6°C, respectively). Significant linear effects were found for higher levels of surrounding greenness in Kaunas, whereby an increase of 10°C was associated with ∼4% increase in median MET. CONCLUSION Apparent temperature and surrounding greenness interacted in the effect on hourly physical activity across three of four European cities, with varying effect between cities. While quadratic effects of temperature suggest diminishing levels of physical activity in the highest greenness levels in cities of temperate climates, the variation in surrounding greenness between cities could be further explored, particularly by looking at indoor-outdoor locations. The study findings support the need for evidence-based physical activity promotion and urban design.
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Affiliation(s)
- Janice Y Ho
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Wilma L Zijlema
- Instituto de Salud Global Barcelona (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Margarita Triguero-Mas
- Instituto de Salud Global Barcelona (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Universitat Autònoma de Barcelona, Barcelona, Spain; Institute for Environmental Science and Technology, Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Barcelona Lab for Urban Environmental Justice and Sustainability, Barcelona, Spain
| | - David Donaire-Gonzalez
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia; Institute for Risk Assessment Sciences (IRAS), Division of Environmental Epidemiology (EEPI), Utrecht University, Utrecht, the Netherlands
| | - Antònia Valentín
- Instituto de Salud Global Barcelona (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Joan Ballester
- Instituto de Salud Global Barcelona (ISGlobal), Barcelona, Spain
| | - Emily Y Y Chan
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - William B Goggins
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Phoenix K H Mo
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Hanneke Kruize
- Centre for Sustainability, Environment and Health, RIVM, Bilthoven, the Netherlands
| | | | | | - Christopher J Gidlow
- Centre for Sport, Health and Exercise Research, Staffordshire University, Stoke-on-Trent, UK
| | - Michael Jerrett
- Department of Environmental Health Sciences, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA
| | - Edmund Y W Seto
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Jose Barrera-Gómez
- Instituto de Salud Global Barcelona (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Mark J Nieuwenhuijsen
- Instituto de Salud Global Barcelona (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
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15
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Ramsey KA, Rojer AGM, D'Andrea L, Otten RHJ, Heymans MW, Trappenburg MC, Verlaan S, Whittaker AC, Meskers CGM, Maier AB. The association of objectively measured physical activity and sedentary behavior with skeletal muscle strength and muscle power in older adults: A systematic review and meta-analysis. Ageing Res Rev 2021; 67:101266. [PMID: 33607291 DOI: 10.1016/j.arr.2021.101266] [Citation(s) in RCA: 99] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 01/04/2021] [Accepted: 02/02/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND Engaging in physical activity (PA) and avoiding sedentary behavior (SB) are important for healthy ageing with benefits including the mitigation of disability and mortality. Whether benefits extend to key determinants of disability and mortality, namely muscle strength and muscle power, is unclear. AIMS This systematic review aimed to describe the association of objective measures of PA and SB with measures of skeletal muscle strength and muscle power in community-dwelling older adults. METHODS Six databases were searched from their inception to June 21st, 2020 for articles reporting associations between objectively measured PA and SB and upper body or lower body muscle strength or muscle power in community dwelling adults aged 60 years and older. An overview of associations was visualized by effect direction heat maps, standardized effect sizes were estimated with albatross plots and summarized in box plots. Articles reporting adjusted standardized regression coefficients (β) were included in meta-analyses. RESULTS A total of 112 articles were included representing 43,796 individuals (range: 21 to 3726 per article) with a mean or median age from 61.0 to 88.0 years (mean 56.4 % female). Higher PA measures and lower SB were associated with better upper body muscle strength (hand grip strength), upper body muscle power (arm curl), lower body muscle strength, and lower body muscle power (chair stand test). Median standardized effect sizes were consistently larger for measures of PA and SB with lower compared to upper body muscle strength and muscle power. The meta-analyses of adjusted β coefficients confirmed the associations between total PA (TPA), moderate-to-vigorous PA (MVPA) and light PA (LPA) with hand grip strength (β = 0.041, β = 0.057, and β = 0.070, respectively, all p ≤ 0.001), and TPA and MVPA with chair stand test (β = 0.199 and β = 0.211, respectively, all p ≤ 0.001). CONCLUSIONS Higher PA and lower SB are associated with greater skeletal muscle strength and muscle power, particularly with the chair stand test.
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Affiliation(s)
- Keenan A Ramsey
- Department of Human Movement Sciences, @AgeAmsterdam, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, the Netherlands
| | - Anna G M Rojer
- Department of Human Movement Sciences, @AgeAmsterdam, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, the Netherlands
| | - Luke D'Andrea
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Victoria, Australia
| | - René H J Otten
- Medical Library, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Martijn W Heymans
- Department of Epidemiology and Biostatistics, Amsterdam University Medical Center, VU University Medical Center, Amsterdam, the Netherlands
| | - Marijke C Trappenburg
- Department of Internal Medicine, Section of Gerontology and Geriatrics, Amsterdam University Medical Center, VU University Medical Center, Amsterdam, the Netherlands; Department of Internal Medicine, Amstelland Hospital, Amstelveen, the Netherlands
| | - Sjors Verlaan
- Department of Rehabilitation Medicine, Amsterdam University Medical Center, VU University Medical Center, Amsterdam Movement Sciences, Amsterdam, the Netherlands
| | - Anna C Whittaker
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, England, United Kingdom; Faculty of Health Sciences and Sport, University of Stirling, Scotland, United Kingdom
| | - Carel G M Meskers
- Department of Human Movement Sciences, @AgeAmsterdam, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, the Netherlands; Department of Rehabilitation Medicine, Amsterdam University Medical Center, VU University Medical Center, Amsterdam Movement Sciences, Amsterdam, the Netherlands
| | - Andrea B Maier
- Department of Human Movement Sciences, @AgeAmsterdam, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, the Netherlands; Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Victoria, Australia; Healthy Longevity Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Centre for Healthy Longevity, National University Health System, Singapore.
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16
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Buttery SC, Zysman M, Vikjord SAA, Hopkinson NS, Jenkins C, Vanfleteren LEGW. Contemporary perspectives in COPD: Patient burden, the role of gender and trajectories of multimorbidity. Respirology 2021; 26:419-441. [PMID: 33751727 DOI: 10.1111/resp.14032] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 02/21/2021] [Indexed: 12/13/2022]
Abstract
An individual's experience of COPD is determined by many factors in addition to the pathological features of chronic bronchitis and emphysema and the symptoms that derive directly from them. Multimorbidity is the norm rather than the exception, so most people with COPD are living with a range of other medical problems which can decrease overall quality of life. COPD is caused by the inhalation of noxious particles or gases, in particular tobacco smoke, but also by early life disadvantage impairing lung development and by occupations where inhaled exposures are common (e.g. industrial, farming and cleaning work). Wealthy people are therefore relatively protected from developing COPD and people who do develop the condition may have reduced resources to cope. COPD is also no longer a condition that predominantly affects men. The prevalence of COPD among women has equalled that of men since 2008 in many high-income countries, due to increased exposure to tobacco, and in low-income countries due to biomass fuels. COPD is one of the leading causes of death in women in the USA, and death rates attributed to COPD in women in some countries are predicted to overtake those of men in the next decade. Many factors contribute to this phenomenon, but in addition to socioeconomic and occupational factors, there is increasing evidence of a higher susceptibility of females to smoking and pollutants. Quality of life is also more significantly impaired in women. Although most medications (bronchodilators and inhaled corticosteroids) used to treat COPD demonstrate similar trends for exacerbation prevention and lung function improvement in men and women, this is an understudied area and clinical trials frequently have a preponderance of males. A better understanding of gender-based predictors of efficacy of all therapeutic interventions is crucial for comprehensive patient care. There is an urgent need to recognize the increasing burden of COPD in women and to facilitate global improvements in disease prevention and management in this specific population. Many individuals with COPD follow a trajectory of both lung function decline and also multimorbidity. Unfavourable lung function trajectories throughout life have implications for later development of other chronic diseases. An enhanced understanding of the temporal associations underlying the development of coexisting diseases is a crucial first step in unravelling potential common disease pathways. Lessons can be learned from exploring disease trajectories of other NCD as well as multimorbidity development. Further research will be essential to explain how early life risk factors commonly influence trajectories of COPD and other diseases, how different diseases develop in relation to each other in a temporal way and how this ultimately leads to different multimorbidity patterns in COPD. This review integrates new knowledge and ideas pertaining to three broad themes (i) the overall burden of disease in COPD, (ii) an unappreciated high burden in women and (iii) the contrast of COPD trajectories and different multimorbidity patterns with trajectories of other NCD. The underlying pathology of COPD is largely irreversible, but many factors noted in the review are potentially amenable to intervention. Health and social care systems need to ensure that effective treatment is accessible to all people with the condition. Preventive strategies and treatments that alter the course of disease are crucial, particularly for patients with COPD as one of many problems.
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Affiliation(s)
- Sara C Buttery
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Maéva Zysman
- Centre de Recherche cardio-thoracique de Bordeaux, Univ-Bordeaux, Pessac, France.,Service des Maladies Respiratoires, CHU Bordeaux, Pessac, France
| | - Sigrid A A Vikjord
- Department of Medicine and Rehabilitation, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway.,HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Levanger, Norway
| | | | - Christine Jenkins
- Respiratory Group, The George Institute for Global Health, Sydney, NSW, Australia
| | - Lowie E G W Vanfleteren
- COPD Center, Department of Respiratory Medicine and Allergology, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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17
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Turrisi TB, Bittel KM, West AB, Hojjatinia S, Hojjatinia S, Mama SK, Lagoa CM, Conroy DE. Seasons, weather, and device-measured movement behaviors: a scoping review from 2006 to 2020. Int J Behav Nutr Phys Act 2021; 18:24. [PMID: 33541375 PMCID: PMC7863471 DOI: 10.1186/s12966-021-01091-1] [Citation(s) in RCA: 71] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 01/22/2021] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND This scoping review summarized research on (a) seasonal differences in physical activity and sedentary behavior, and (b) specific weather indices associated with those behaviors. METHODS PubMed, CINAHL, and SPORTDiscus were searched to identify relevant studies. After identifying and screening 1459 articles, data were extracted from 110 articles with 118,189 participants from 30 countries (almost exclusively high-income countries) on five continents. RESULTS Both physical activity volume and moderate-to-vigorous physical activity (MVPA) were greater in summer than winter. Sedentary behavior was greater in winter than either spring or summer, and insufficient evidence existed to draw conclusions about seasonal differences in light physical activity. Physical activity volume and MVPA duration were positively associated with both the photoperiod and temperature, and negatively associated with precipitation. Sedentary behavior was negatively associated with photoperiod and positively associated with precipitation. Insufficient evidence existed to draw conclusions about light physical activity and specific weather indices. Many weather indices have been neglected in this literature (e.g., air quality, barometric pressure, cloud coverage, humidity, snow, visibility, windchill). CONCLUSIONS The natural environment can influence health by facilitating or inhibiting physical activity. Behavioral interventions should be sensitive to potential weather impacts. Extreme weather conditions brought about by climate change may compromise health-enhancing physical activity in the short term and, over longer periods of time, stimulate human migration in search of more suitable environmental niches.
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Affiliation(s)
- Taylor B Turrisi
- Department of Kinesiology, The Pennsylvania State University, University Park, PA, 16802, USA
| | - Kelsey M Bittel
- Department of Kinesiology, The Pennsylvania State University, University Park, PA, 16802, USA
| | - Ashley B West
- Department of Kinesiology, The Pennsylvania State University, University Park, PA, 16802, USA
| | | | - Sahar Hojjatinia
- Department of Electrical Engineering & Computer Science, The Pennsylvania State University, University Park, PA, USA
| | - Scherezade K Mama
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Constantino M Lagoa
- Department of Electrical Engineering & Computer Science, The Pennsylvania State University, University Park, PA, USA
| | - David E Conroy
- Department of Kinesiology, The Pennsylvania State University, University Park, PA, 16802, USA.
- Department of Preventive Medicine, Northwestern University, Chicago, IL, USA.
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18
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Fettes L, Bayly J, de Bruin LM, Patel M, Ashford S, Higginson IJ, Maddocks M. Relationships between prolonged physical and social isolation during the COVID-19 pandemic, reduced physical activity and disability in activities of daily living among people with advanced respiratory disease. Chron Respir Dis 2021; 18:14799731211035822. [PMID: 34382888 PMCID: PMC8370888 DOI: 10.1177/14799731211035822] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
In people with advanced respiratory disease, we examined (i) the impact of COVID-19-related physical and social isolation on physical activity and (ii) relationships between time spent in isolation and disability in activities of daily living. Cross-sectional analysis was conducted in adults with advanced non-small cell lung cancer, chronic obstructive lung disease or interstitial lung disease. Measures included change in physical activity since physically and socially isolating (Likert scale) and disability (Barthel Index and Lawton-Brody IADL scale) or difficulty (World Health Organisation Disability Assessment Schedule-2.0) in daily activities. Multiple logistic regression was used to examine factors associated with disability in daily activities. 194/201 participants were isolating for a median [IQR] 5 [3-8]-month period, often leading to lower levels of physical activity at home (n = 94, 47%), and outside home (n = 129, 65%). 104 (52%) and 142 (71%) were not fully independent in basic and instrumental activities of daily living, respectively. 96% reported some degree of difficulty in undertaking daily activities. Prolonged physical and social isolation related to increased disability in basic (r = -0.28, p < 0.001) and instrumental (r = -0.24, p < 0.001) activities of daily living, and greater difficulty in daily activities (r = 0.22, p = 0.002). Each month spent in physical or social isolation was independently related to disability in basic activities of daily living (odds ratio [OR], 1.17 [95% CI: 1.03-1.33], p = 0.013). These findings suggest disability in daily activities is associated with prolonged physical or social isolation, which may present as difficulty in people who are fully independent. Post-isolation recovery and rehabilitation needs should be considered for all people deemed extremely clinically vulnerable.
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Affiliation(s)
- Lucy Fettes
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, 4616King's College London, London, UK
| | - Joanne Bayly
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, 4616King's College London, London, UK
| | - Leonora Michelle de Bruin
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, 4616King's College London, London, UK
| | - Malini Patel
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, 4616King's College London, London, UK
| | - Stephen Ashford
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, 4616King's College London, London, UK.,Regional Hyper-acute Rehabilitation Unit, Northwick Park Hospital, London North West University Healthcare NHS Trust, Harrow, London, UK.,Centre for Nursing Midwifery and Allied health Research and the National Hospital for Neurology and Neurosurgery, 8964University College London Hospitals, Holborn, London, UK
| | - Irene J Higginson
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, 4616King's College London, London, UK
| | - Matthew Maddocks
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, 4616King's College London, London, UK
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19
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Hume E, Armstrong M, Manifield J, McNeillie L, Chambers F, Wakenshaw L, Burns G, Heslop Marshall K, Vogiatzis I. Impact of COVID-19 shielding on physical activity and quality of life in patients with COPD. Breathe (Sheff) 2020; 16:200231. [PMID: 33447283 PMCID: PMC7792782 DOI: 10.1183/20734735.0231-2020] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
COVID-19 is a highly infectious disease that can cause severe respiratory illness, particularly in patients with pre-existing lung conditions such as COPD [1]. To prevent infection during the peak of the pandemic, patients considered to be clinically extremely vulnerable were instructed to “shield” at home, resulting in significant restrictions to usual daily activities and social interaction. In the absence of a preventative vaccine, these public health measures are imperative to reduce transmission of the virus. However, despite this positive aspect, there are likely to be harmful repercussions on people's physical and mental health. In response to #COVID19, healthcare professionals should scale up virtual consultations for assessing core patient-reported outcomes and providing home-based rehabilitation programmes #COPDhttps://bit.ly/30gQEpG
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Affiliation(s)
- Emily Hume
- Dept of Sport, Exercise and Rehabilitation, Faculty of Health & Life Sciences, Northumbria University Newcastle, Newcastle, UK
| | - Matthew Armstrong
- Dept of Sport, Exercise and Rehabilitation, Faculty of Health & Life Sciences, Northumbria University Newcastle, Newcastle, UK
| | - James Manifield
- Dept of Sport, Exercise and Rehabilitation, Faculty of Health & Life Sciences, Northumbria University Newcastle, Newcastle, UK
| | - Laura McNeillie
- Physiotherapy Dept, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK
| | - Francesca Chambers
- Physiotherapy Dept, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK
| | - Lynsey Wakenshaw
- Physiotherapy Dept, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK
| | - Graham Burns
- Chest Clinic, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK
| | | | - Ioannis Vogiatzis
- Dept of Sport, Exercise and Rehabilitation, Faculty of Health & Life Sciences, Northumbria University Newcastle, Newcastle, UK
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20
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Philip KE, Lewis A, Jeffery E, Buttery S, Cave P, Cristiano D, Lound A, Taylor K, Man WDC, Fancourt D, Polkey MI, Hopkinson NS. Moving singing for lung health online in response to COVID-19: experience from a randomised controlled trial. BMJ Open Respir Res 2020; 7:e000737. [PMID: 33239406 PMCID: PMC7689537 DOI: 10.1136/bmjresp-2020-000737] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 09/29/2020] [Accepted: 10/21/2020] [Indexed: 01/07/2023] Open
Abstract
INTRODUCTION Singing for lung health (SLH) is a popular arts-in-health activity for people with long-term respiratory conditions. Participants report biopsychosocial benefits, however, research on impact is limited. The 'SLH: Improving Experiences of Lung Disease trial', a randomised controlled, single (assessor) blind, trial of 12 weeks SLH versus usual care for people with chronic obstructive pulmonary disease (COPD) (n=120) was setup to help to address this. The first group (n=18, nine singing and nine controls) started face-to-face (five sessions) before changing to online delivery (seven sessions) due to COVID-19-related physical distancing measures. As such, the experience of this group is here reported as a pilot study to inform further research in this area. METHODS We conducted semistructured interviews and thematic analysis regarding barriers, facilitators and key considerations for transitioning from face-to-face to online delivery. Pilot quantitative outcomes include attendance, premeasures and postmeasures of quality of life and disease impact (Short Form 36 Health Survey, COPD Assessment Test score), breathlessness (Medical Research Council breathlessness scale, Dyspnoea-12), depression (Patient Health Questionnaire-9, PHQ-9), anxiety (Generalised Anxiety Disorder-7), balance confidence (Activity specific Balance Confidence, ABC scale) and physical activity (clinical visit PROactive physical activity in COPD tool, combining subjective rating and actigraphy). RESULTS Attendance was 69% overall, (90% of the face-to-face sessions, 53% online sessions). Analysis of semistructured interviews identified three themes regarding participation in SLH delivered face to face and online, these where (1) perceived benefits; (2) digital barriers (online) and (3) digital facilitators (online). Findings were summarised into key considerations for optimising transitioning singing groups from face-to-face to online delivery. Pilot quantitative data suggested possible improvements in depression (treatment effect -4.78 PHQ-9 points, p<0.05, MCID 5) and balance confidence (treatment effect +17.21 ABC scale points, p=0.04, MCID 14.2). DISCUSSION This study identifies key considerations regarding the adaptation of SLH from face-to-face to online delivery. Pilot data suggest online group singing for people with COPD may deliver benefits related to reducing depression and improved balance confidence.
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Affiliation(s)
- Keir Ej Philip
- National Heart and Lung Institute, Imperial College London, London, UK
- Respiratory Medicine, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | | | - Edmund Jeffery
- Respiratory Medicine, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Sara Buttery
- National Heart and Lung Institute, Imperial College London, London, UK
- Respiratory Medicine, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Phoene Cave
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Daniele Cristiano
- Respiratory Medicine, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Adam Lound
- Respiratory Medicine, Imperial College Healthcare NHS Trust, London, UK
| | - Karen Taylor
- Respiratory Medicine, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - William D-C Man
- National Heart and Lung Institute, Imperial College London, London, UK
- Respiratory Medicine, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Daisy Fancourt
- Department of Behavioural Science and Health, University College London, London, UK
| | - Michael I Polkey
- National Heart and Lung Institute, Imperial College London, London, UK
- Respiratory Medicine, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Nicholas S Hopkinson
- National Heart and Lung Institute, Imperial College London, London, UK
- Respiratory Medicine, Royal Brompton and Harefield NHS Foundation Trust, London, UK
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21
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Koreny M, Demeyer H, Benet M, Arbillaga-Etxarri A, Balcells E, Barberan-Garcia A, Gimeno-Santos E, Hopkinson NS, De Jong C, Karlsson N, Louvaris Z, Polkey MI, Puhan MA, Rabinovich RA, Rodríguez-Roisin R, Vall-Casas P, Vogiatzis I, Troosters T, Garcia-Aymerich J. Patterns of Physical Activity Progression in Patients With COPD. Arch Bronconeumol 2020; 57:214-223. [PMID: 33041107 DOI: 10.1016/j.arbres.2020.08.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 07/24/2020] [Accepted: 08/06/2020] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Although mean physical activity in COPD patients declines by 400-500steps/day annually, it is unknown whether the natural progression is the same for all patients. We aimed to identify distinct physical activity progression patterns using a hypothesis-free approach and to assess their determinants. METHODS We pooled data from two cohorts (usual care arm of Urban Training [NCT01897298] and PROactive initial validation [NCT01388218] studies) measuring physical activity at baseline and 12 months (Dynaport MoveMonitor). We identified clusters (patterns) of physical activity progression (based on levels and changes of steps/day) using k-means, and compared baseline sociodemographic, interpersonal, environmental, clinical and psychological characteristics across patterns. RESULTS In 291 COPD patients (mean±SD 68±8 years, 81% male, FEV1 59±19%pred) we identified three distinct physical activity progression patterns: Inactive (n=173 [59%], baseline: 4621±1757 steps/day, 12-month change (Δ): -487±1201 steps/day), ActiveImprovers (n=49 [17%], baseline: 7727±3275 steps/day, Δ:+3378±2203 steps/day) and ActiveDecliners (n=69 [24%], baseline: 11 267±3009 steps/day, Δ: -2217±2085 steps/day). After adjustment in a mixed multinomial logistic regression model using Active Decliners as reference pattern, a lower 6-min walking distance (RRR [95% CI] 0.94 [0.90-0.98] per 10m, P=.001) and a higher mMRC dyspnea score (1.71 [1.12-2.60] per 1 point, P=.012) were independently related with being Inactive. No baseline variable was independently associated with being an Active Improver. CONCLUSIONS The natural progression in physical activity over time in COPD patients is heterogeneous. While Inactive patients relate to worse scores for clinical COPD characteristics, Active Improvers and Decliners cannot be predicted at baseline.
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Affiliation(s)
- Maria Koreny
- ISGlobal, Barcelona, Spain; Pompeu Fabra University (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Heleen Demeyer
- Department of Rehabilitation Sciences, KU Leuven - University of Leuven, Leuven, Belgium; Department of Respiratory Diseases, University Hospitals KU Leuven, Leuven, Belgium; Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - Marta Benet
- ISGlobal, Barcelona, Spain; Pompeu Fabra University (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Ane Arbillaga-Etxarri
- Physical Activity and Sports Sciences, Faculty of Psychology and Education, University of Deusto, Donostia-San Sebastián, Spain
| | - Eva Balcells
- Pompeu Fabra University (UPF), Barcelona, Spain; CIBER Enfermedades Respiratorias (CIBERES), Madrid, Spain; Pneumology Department, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Hospital del Mar, Barcelona, Spain
| | - Anael Barberan-Garcia
- University of Barcelona, Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), CIBER Enfermedades Respiratorias (CIBERES), Hospital Clínic, Barcelona, Spain
| | - Elena Gimeno-Santos
- University of Barcelona, Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), CIBER Enfermedades Respiratorias (CIBERES), Hospital Clínic, Barcelona, Spain
| | - Nicholas S Hopkinson
- National Heart and Lung Institute, Imperial College, Royal Brompton Hospital Campus, London UK
| | - Corina De Jong
- Department of General Practice, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; Groningen Research Institute for Asthma and COPD (GRIAC), University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Niklas Karlsson
- Patient Centered Science, BioPharmaceuticals, AstraZeneca R&D, Gothenburg, Sweden
| | - Zafeiris Louvaris
- Department of Rehabilitation Sciences, KU Leuven - University of Leuven, Leuven, Belgium; First Department of Respiratory Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Michael I Polkey
- National Heart and Lung Institute, Imperial College, Royal Brompton Hospital Campus, London UK
| | - Milo A Puhan
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Roberto A Rabinovich
- ELEGI Colt Laboratory, Centre for Inflammation Research, The Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Robert Rodríguez-Roisin
- University of Barcelona, Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), CIBER Enfermedades Respiratorias (CIBERES), Hospital Clínic, Barcelona, Spain
| | - Pere Vall-Casas
- Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - Ioannis Vogiatzis
- First Department of Respiratory Medicine, National and Kapodistrian University of Athens, Athens, Greece; Department of Sport, Exercise and Rehabilitation, Northumbria University Newcastle, Newcastle UK
| | - Thierry Troosters
- Department of Rehabilitation Sciences, KU Leuven - University of Leuven, Leuven, Belgium; Department of Respiratory Diseases, University Hospitals KU Leuven, Leuven, Belgium
| | - Judith Garcia-Aymerich
- ISGlobal, Barcelona, Spain; Pompeu Fabra University (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
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22
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Wallaert B, Grosbois JM. Pulmonary rehabilitation and daily life physical activity in patients with stage IV sarcoidosis. Respir Med Res 2020; 78:100775. [PMID: 32622327 DOI: 10.1016/j.resmer.2020.100775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Accepted: 05/19/2020] [Indexed: 11/30/2022]
Affiliation(s)
- B Wallaert
- Service de pneumologie et immunoallergologie, Centre de référence constitutif des maladies rares, CHU de Lille, hôpital Calmette, 59037 Lille, France; University of Lille, 59000 Lille, France.
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23
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Boutou AK, Pitsiou G, Kioumis I, Papakosta D, Stanopoulos I. Impact of pulmonary rehabilitation on daily physical activity in sarcoidosis: Further investigation needed. Respir Med Res 2020; 78:100772. [PMID: 32502936 DOI: 10.1016/j.resmer.2020.100772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 05/11/2020] [Accepted: 05/17/2020] [Indexed: 10/24/2022]
Affiliation(s)
- A K Boutou
- Department of Respiratory Medicine, G. Papanikolaou Hospital, Exohi, 57010 Thessaloniki, Greece.
| | - G Pitsiou
- Respiratory Failure Department, Aristotle University of Thessaloniki, G. Gapanikolaou Hospital, Thessaloniki, Greece
| | - I Kioumis
- Respiratory Failure Department, Aristotle University of Thessaloniki, G. Gapanikolaou Hospital, Thessaloniki, Greece
| | - D Papakosta
- Department of Respiratory Medicine, Aristotle University of Thessaloniki, G. Papanikolaou Hospital, Thessaloniki, Greece
| | - I Stanopoulos
- Respiratory Failure Department, Aristotle University of Thessaloniki, G. Gapanikolaou Hospital, Thessaloniki, Greece
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24
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Mueller A, Hoefling HA, Muaremi A, Praestgaard J, Walsh LC, Bunte O, Huber RM, Fürmetz J, Keppler AM, Schieker M, Böcker W, Roubenoff R, Brachat S, Rooks DS, Clay I. Continuous Digital Monitoring of Walking Speed in Frail Elderly Patients: Noninterventional Validation Study and Longitudinal Clinical Trial. JMIR Mhealth Uhealth 2019; 7:e15191. [PMID: 31774406 PMCID: PMC6906618 DOI: 10.2196/15191] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 09/09/2019] [Accepted: 09/24/2019] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Digital technologies and advanced analytics have drastically improved our ability to capture and interpret health-relevant data from patients. However, only limited data and results have been published that demonstrate accuracy in target indications, real-world feasibility, or the validity and value of these novel approaches. OBJECTIVE This study aimed to establish accuracy, feasibility, and validity of continuous digital monitoring of walking speed in frail, elderly patients with sarcopenia and to create an open source repository of raw, derived, and reference data as a resource for the community. METHODS Data described here were collected as a part of 2 clinical studies: an independent, noninterventional validation study and a phase 2b interventional clinical trial in older adults with sarcopenia. In both studies, participants were monitored by using a waist-worn inertial sensor. The cross-sectional, independent validation study collected data at a single site from 26 naturally slow-walking elderly subjects during a parcours course through the clinic, designed to simulate a real-world environment. In the phase 2b interventional clinical trial, 217 patients with sarcopenia were recruited across 32 sites globally, where patients were monitored over 25 weeks, both during and between visits. RESULTS We have demonstrated that our approach can capture in-clinic gait speed in frail slow-walking adults with a residual standard error of 0.08 m per second in the independent validation study and 0.08, 0.09, and 0.07 m per second for the 4 m walk test (4mWT), 6-min walk test (6MWT), and 400 m walk test (400mWT) standard gait speed assessments, respectively, in the interventional clinical trial. We demonstrated the feasibility of our approach by capturing 9668 patient-days of real-world data from 192 patients and 32 sites, as part of the interventional clinical trial. We derived inferred contextual information describing the length of a given walking bout and uncovered positive associations between the short 4mWT gait speed assessment and gait speed in bouts between 5 and 20 steps (correlation of 0.23) and longer 6MWT and 400mWT assessments with bouts of 80 to 640 steps (correlations of 0.48 and 0.59, respectively). CONCLUSIONS This study showed, for the first time, accurate capture of real-world gait speed in slow-walking older adults with sarcopenia. We demonstrated the feasibility of long-term digital monitoring of mobility in geriatric populations, establishing that sufficient data can be collected to allow robust monitoring of gait behaviors outside the clinic, even in the absence of feedback or incentives. Using inferred context, we demonstrated the ecological validity of in-clinic gait assessments, describing positive associations between in-clinic performance and real-world walking behavior. We make all data available as an open source resource for the community, providing a basis for further study of the relationship between standardized physical performance assessment and real-world behavior and independence.
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Affiliation(s)
- Arne Mueller
- Novartis Institutes for BioMedical Research, Basel, Switzerland
| | | | - Amir Muaremi
- Novartis Institutes for BioMedical Research, Basel, Switzerland
| | - Jens Praestgaard
- Biostatistics and Pharmacometrics, Novartis Pharmaceuticals Corporation, East Hannover, NJ, United States
| | - Lorcan C Walsh
- Novartis Business Services, Novartis Ireland Ltd, Dublin, Ireland
| | - Ola Bunte
- Novartis Institutes for BioMedical Research, Basel, Switzerland
| | | | - Julian Fürmetz
- University Hospital, Ludwigs-Maximillians Universität, Munich, Germany
| | | | - Matthias Schieker
- Novartis Institutes for BioMedical Research, Basel, Switzerland
- University Hospital, Ludwigs-Maximillians Universität, Munich, Germany
| | - Wolfgang Böcker
- University Hospital, Ludwigs-Maximillians Universität, Munich, Germany
| | | | - Sophie Brachat
- Novartis Institutes for BioMedical Research, Basel, Switzerland
| | - Daniel S Rooks
- Novartis Institutes for BioMedical Research, Cambridge, MA, United States
| | - Ieuan Clay
- Novartis Institutes for BioMedical Research, Basel, Switzerland
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