Daily physical activity in subjects with newly diagnosed COPD

Abstract

RationaleInformation about daily physical activity levels (PAL) in subjects with undiagnosed chronic obstructive pulmonary disease (COPD) is scarce. This study aims to assess PA and to investigate the associations between PA and clinical characteristics in subjects with newly diagnosed COPD.MethodsFifty-nine subjects with a new spirometry-based diagnosis of mild (n=38) and moderate (n=21) COPD (63±6 years, 68% male) were matched with 65 smoking controls (62±7 years, 75% male). PA (daily steps, time spent in moderate-to-vigorous intense physical activities (MVPA) and PAL) was measured by accelerometry. Dyspnoea, complete pulmonary function tests, peripheral muscle strength and exercise capacity served as clinical characteristics.ResultsPA was significantly lower in COPD versus smoking controls (7986±2648 vs 9765±3078 steps, 64 (27–120) vs 110 (55–164) min of MVPA, 1.49±0.21 vs 1.62±0.24 PAL respectively, all p<0.05). Subjects with COPD with either mild symptoms of dyspnoea (mMRC 1), those with lower diffusion capacity (TL,co), low 6 min walking distance (6MWD) or low maximal oxygen uptake (VO2 peak) had significantly lower PA. Multiple regression analysis identified 6 MWD and TL,co as independent predictors of PA in COPD.ConclusionsThe reduction in PA starts early in the disease, even when subjects are not yet diagnosed with COPD. Inactivity is more pronounced in subjects with mild symptoms of dyspnoea, lower levels of diffusion capacity and exercise capacity.

Pulmonary rehabilitation

“…Patients with chronic obstructive pulmonary disease (COPD) are physically less active compared to their peers [31,32], resulting in a loss of lower limb muscle mass and muscle function [33][34][35][36]. Indeed, approximately 40% of patients with COPD do not achieve the recommended quantity and/or quality of physical activity [37][38][39].…”

The knowledge level of chest physicians about the pulmonary rehabilitation topic

“…Başlangıçta PR stabil dö-nemdeki hastalara uygulanmaktayken son yıllarda atak sırasında veya atak sonrası taburculuğun erken döneminde uygulanan PR programlarının gü-venli ve etkili olduğu gösterilmiştir. Kronik obstrüktif akciğer hastalığı olan hastalar akranlarına kıyasla fiziksel olarak daha az aktiftirler [13,14], ve bu da alt ekstremitede kas kütlesi ve kas fonksiyonu kaybına yol açar. KOAH'lı hastalarda kilo /kas kaybı; periferik kas fonksiyonlarını egzersiz kapasitesini yaşam kalitesini olumsuz yönde etkilemektedir [15,16].…”

Réhabilitation respiratoire dans la broncho-pneumopathie chronique obstructive (BPCO) : l’androgénothérapie, pourquoi ? Pour qui ? Comment ?

“…Comme la perte musculaire touche l'ensemble des muscles squelettiques y compris respiratoires, la dénutrition chronique et la perte musculaire du patient BPCO conduisent à l'inactivité physique [4,12], au déconditionnement à l'exercice [13], et à la dégradation de la fonction respiratoire [14]. Cela aboutit à une altération de la qualité de vie [4,12], une augmentation des infections bronchiques, du recours au médecin généraliste [15], et de la mortalité [4,12,[16][17][18][19][20][21][22][23][24][25][26]. Le corollaire est une augmentation des coûts de santé de la BPCO même si les études médico-économiques sont largement manquantes.…”