Physical Activity in Adults with Cystic Fibrosis Receiving Intravenous Antibiotics in Hospital and in the Community§

Abstract

Introduction : Intravenous antibiotic therapy (IVAT) for CF acute pulmonary exacerbations (APE) can be delivered in hospital or in the community. This study aimed to compare physical activity in CF patients receiving hospital and community-delivered IVAT, as well as other health outcomes.Materials and Methods : This was a non-randomised parallel group prospective observational study. Hospitalised and community-treated CF adults receiving IVAT for APE were asked to wear ActiGraph® activity monitors, complete the habitual activity estimation scale (HAES), food diary, modified shuttle test (MST) and CFQ-R at the start and end of therapy. Nutritional and clinical outcomes were also compared between the cohorts. The primary outcomes was physical activity measured by the ActiGraph® activity monitors at the beginning and end of treatment in both cohorts. Results : Physical activity (measured and self-reported) was no different between the cohorts, with both hospitalised and community-treated subjects being generally sedentary. Body weight increased significantly in the hospitalised cohort, whereas no difference was seen in the community-treated cohort. FEV1 % predicted and FVC % predicted increased in community-treated subjects, whereas only FVC % predicted increased in hospitalised subjects. CFQ-R respiratory domain increased to a greater extent in community-treated subjects.Conclusion : CF adults receiving IVAT for APE, both in hospital and in the community, are generally sedentary and we found no difference in physical activity between the two groups. These findings suggests the need to further promote physical activity in suitable patients during APE where considered appropriate.

Activity monitors in pulmonary disease

“…Patients with > 2 exacerbations in the previous year spent less time in activity of mild intensity (> 3 METS) than patients with < 2 exacerbations (P 0.01). When accounting for confounding factors, physical activity was not related to exacerbation frequency in the previous year [63] Khiroya et al compared physical activity in CF patients receiving intravenous antibiotics for pulmonary infection in 22 inpatients and 23 outpatients during a 2 week treatment course. They found similar activity levels in the inpatient and outpatient treated groups, both being sedentary [64].…”

Association between habitual physical activity (HPA) and sleep quality in patients with cystic fibrosis

“…In adult CF patients, work and transport-related activities are obvious reasons for reduced PA in everyday life compared with healthier and younger people [ 36 ]. Furthermore, with progress of the lung disease by age a higher need for intravenous therapies during pulmonary exacerbations is associated with reduced PA and increased sedentary time [ 37 ]. In our cross-sectional study, we found that a decrease of PA occurs during adolescence and young adulthood—which has been shown before by Britto et al [ 38 ].…”

Telemedicine and remote monitoring in cystic fibrosis

“…Physical activity has been shown to improve sputum clearance and lung function [41,42]. Patients who have been hospitalized with acute pulmonary exacerbations show a reduction in activity [43]. In parallel to this, adults who have had two or more exacerbations in the preceding year have lower activity levels, possibly due to their more advanced respiratory disease [44].…”