Daily Physical Activity in Patients with Chronic Obstructive Pulmonary Disease Is Mainly Associated with Dynamic Hyperinflation

García‐Río, Francisco; Lores, Vanesa; Mediano, Olga; Rojo, Blas; Hernánz, Ángel; López-Collazo, Eduardo; Álvarez-Sala, R

doi:10.1164/rccm.200812-1873oc

Cited by 241 publications

(194 citation statements)

References 44 publications

(48 reference statements)

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“…In addition, recent data have highlighted physical activity as a strong predictor of all-cause mortality in COPD [11], emphasising its importance in this patient group, although that study compared activity to measures of whole-body FFM and BMI, rather than quadriceps muscle bulk or strength. Consistent with previous work [14,32], we found that lung function is associated with the level of physical activity in COPD and RV/TLC ratio, rather than FEV1 % pred, is an independent predictor of physical activity level in stage II-IV disease. USRF CSA was also independently associated with RV/TLC ratio and IC, but not FEV1 % pred, highlighting that although FEV1 can be used for classifying the severity of airflow obstruction [33] it does not reflect the true severity of the disease.…”

Section: Significance Of the Findingssupporting

confidence: 92%

Quadriceps wasting and physical inactivity in patients with COPD

et al. 2012

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Section: Significance Of the Findingssupporting

confidence: 92%

Quadriceps wasting and physical inactivity in patients with COPD

et al. 2012

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“…24,25 Several studies have shown that dynamic lung hyperinfl ation is associated with 6MWD and daily physical activity in COPD. 31,34,44,45 However, only a few studies examined the association of CT scan fi ndings with exercise tolerance. [14][15][16]18 Two reports studied only 20 subjects with COPD.…”

Section: Discussionmentioning

confidence: 99%

Six-Minute Walk Distance Predictors, Including CT Scan Measures, in the COPDGene Cohort

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et al. 2012

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Background: Exercise tolerance in COPD is only moderately well predicted by airfl ow obstruction assessed by FEV 1 . We determined whether other phenotypic characteristics, including CT scan measures, are independent predictors of 6-min walk distance (6MWD) in the COPDGene cohort. Methods: COPDGene recruits non-Hispanic Caucasian and African American current and ex-smokers. Phenotyping measures include postbronchodilator FEV 1 % predicted and inspiratory and expiratory CT lung scans. We defi ned % emphysema as the percentage of lung voxels , 2 950 Hounsfi eld units on the inspiratory scan and % gas trapping as the percentage of lung voxels , 2 856 Hounsfi eld units on the expiratory scan. Results: Data of the fi rst 2,500 participants of the COPDGene cohort were analyzed. Participant age was 61 Ϯ 9 years; 51% were men; 76% were non-Hispanic Caucasians, and 24% were African Americans. Fifty-six percent had spirometrically defi ned COPD, with 9.3%, 23.4%, 15.0%, and 8.3% in GOLD (Global Initiative for Chronic Obstructive Lung Disease) stages I to IV, respectively. Higher % emphysema and % gas trapping predicted lower 6MWD ( P , .001). However, in a given spirometric group, after adjustment for age, sex, race, and BMI, neither % emphysema nor % gas trapping, or their interactions with FEV 1 % predicted, remained a signifi cant 6MWD predictor. In a given spirometric group, only 16% to 27% of the variance in 6MWD could be explained by age, male sex, Caucasian race, and lower BMI as signifi cant predictors of higher 6MWD. Conclusions:In this large cohort of smokers in a given spirometric stage, phenotypic characteristics were only modestly predictive of 6MWD. CT scan measures of emphysema and gas trapping were not predictive of 6MWD after adjustment for other phenotypic characteristics. CHEST 2012; 141(4):867 -875Abbreviations: 6MWD 5 6-min walk distance; 6MWT 5 6-min walk test; GOLD 5 Global Initiative for Chronic Obstructive Lung Disease; HU 5 Hounsfi eld unit; LOWESS 5 locally weighted scatterplot smoothing

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“…On the one hand, the development of dynamic hyperinflation plays an important role in limiting exercise capacity 2 and may explain the reduction in the patient's daily physical activities, regardless of the severity of the COPD. 3 Indeed, these subjects breathe in before achieving a full exhalation and, as a consequence, trap air within the lungs with each further breath, with serious mechanical and sensory repercussions. 4 Furthermore, the ventilatory constraints occurring during exercise have the potential for significant negative effects on cardiovascular function.…”

Section: Introductionmentioning

confidence: 99%

Fat-Free Mass Depletion Is Associated With Poor Exercise Capacity Irrespective of Dynamic Hyperinflation in COPD Patients

et al. 2013

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BACKGROUND:In patients with COPD, we investigated the effect of the fat-free mass (FFM) on maximal exercise capacity and the relationship with changes in operational lung volumes during exercise. METHODS: In a cross-sectional study 57 patients (16 females; age 65 ؎ 8 y) were consecutively assessed by resting lung function, symptom-limited cardiopulmonary exercise test, and body composition by means of bioelectrical impedance analysis to measure the FFM index (FFMI; in kilograms per square meter). RESULTS: Patients were categorized as depleted (n ‫؍‬ 14) or nondepleted (n ‫؍‬ 43) according to FFMI. No significant difference in gender, age, and resting lung function was found between depleted and nondepleted patients. When compared with nondepleted COPD patients, the depleted COPD patients had a significantly lower O 2 uptake at the peak of exercise and at anaerobic threshold as well as at peak oxygen pulse, oxygen uptake efficiency slope (OUES), and heart rate recovery (HRR) (P < .05 for all comparisons), but similar inspiratory capacity/total lung capacity at the peak of exercise. Moreover, they also reported significantly higher leg fatigue (P < .05), but not dyspnea on exertion. In all patients, significant correlations (P < .01) were found between FFMI and peak oxygen pulse, OUES, HRR, and leg fatigue. CONCLUSIONS: This study shows that FFM depletion plays a part in the reduction of exercise capacity in COPD patients, regardless of dynamic hyperinflation, and is strictly associated with poor cardiovascular response to exercise and to leg fatigue, but not with dyspnea.

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Daily Physical Activity in Patients with Chronic Obstructive Pulmonary Disease Is Mainly Associated with Dynamic Hyperinflation

Abstract: Daily physical activity of patients with COPD is mainly associated with dynamic hyperinflation, regardless of severity classification.

Cited by 241 publications

References 44 publications

Quadriceps wasting and physical inactivity in patients with COPD

Quadriceps wasting and physical inactivity in patients with COPD

Six-Minute Walk Distance Predictors, Including CT Scan Measures, in the COPDGene Cohort

Fat-Free Mass Depletion Is Associated With Poor Exercise Capacity Irrespective of Dynamic Hyperinflation in COPD Patients

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