Respiratory Research | |
Physical activity level and its clinical correlates in chronic obstructive pulmonary disease: a cross-sectional study | |
Margareta Emtner1  Christer Janson1  Ulla Svantesson2  Anne Marie Grönberg3  Frode Slinde3  Mikael Andersson1  | |
[1] Department of Medical Science, Respiratory Medicine and Allergology, Uppsala University, Uppsala, Sweden;Department of Clinical Neuroscience and Rehabilitation, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden;Department of Internal medicine and Clinical Nutrition, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden | |
关键词: Body composition; Physical function; COPD; Activity monitor; Physical activity; | |
Others : 792313 DOI : 10.1186/1465-9921-14-128 |
|
received in 2013-08-12, accepted in 2013-11-07, 发布年份 2013 | |
【 摘 要 】
Background
Decreased physical activity is associated with higher mortality in subjects with COPD. The aim of this study was to assess clinical characteristics and physical activity levels (PALs) in subjects with COPD.
Methods
Seventy-three subjects with COPD (67 ± 7 yrs, 44 female) with one-second forced expiratory volume percentage (FEV1%) predicted values of 43 ± 16 were included. The ratio of total energy expenditure (TEE) and resting metabolic rate (RMR) was used to define the physical activity level (PAL) (PAL = TEE/RMR). TEE was assessed with an activity monitor (ActiReg), and RMR was measured by indirect calorimetry. Walking speed (measured over 30-meters), maximal quadriceps muscle strength, fat-free mass and systemic inflammation were measured as clinical characteristics. Hierarchical linear regression was applied to investigate the explanatory values of the clinical correlates to PAL.
Results
The mean PAL was 1.47 ± 0.19, and 92% of subjects were classified as physically very inactive or sedentary. The walking speed was 1.02 ± 0.23 m/s, the quadriceps strength was 31.3 ± 11.2 kg, and the fat-free mass index (FFMI) was 15.7 ± 2.3 kg/m2, identifying 42% of subjects as slow walkers, 21% as muscle-weak and 49% as FFM-depleted. The regression model explained 45.5% (p < 0.001) of the variance in PAL. The FEV1% predicted explained the largest proportion (22.5%), with further improvements in the model from walking speed (10.1%), muscle strength (7.0%) and FFMI (3.0%). Neither age, gender nor systemic inflammation contributed to the model.
Conclusions
Apart from lung function, walking speed and muscle strength are important correlates of physical activity. Further explorations of the longitudinal effects of the factors characterizing the most inactive subjects are warranted.
【 授权许可】
2013 Andersson et al.; licensee BioMed Central Ltd.
【 预 览 】
Files | Size | Format | View |
---|---|---|---|
20140705030028562.pdf | 427KB | download | |
20140826112059476.pdf | 1567KB | download | |
Figure 2. | 33KB | Image | download |
Figure 1. | 26KB | Image | download |
【 图 表 】
Figure 1.
Figure 2.
【 参考文献 】
- [1]Vestbo J, Hurd SS, Agustí AG, Jones PW, Vogelmeier C, Anzueto A, Barnes PJ, Fabbri LM, Martinez FJ, Nishimura M, Stockley RA, Sin DD, Rodriguez-Roisin R: Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. Am J Respir Crit Care Med 2013, 187:347-365.
- [2]Watz H, Waschki B, Boehme C, Claussen M, Meyer T, Magnussen H: Extrapulmonary effects of chronic obstructive pulmonary disease on physical activity: a cross-sectional study. Am J Respir Crit Care Med 2008, 177:743-751.
- [3]Barnes PJ, Celli BR: Systemic manifestations and comorbidities of COPD. Eur Respir J 2009, 33:1165-1185.
- [4]Laveneziana P, Palange P: Physical activity, nutritional status and systemic inflammation in COPD. Eur Respir J 2012, 40:522-529.
- [5]Vermeeren MAP, Creutzberg EC, Schols AMWJ, Postma DS, Pieters WR, Roldaan AC, Wouters EFM: Prevalence of nutritional depletion in a large out-patient population of patients with COPD. Respir Med 2006, 100:1349-1355.
- [6]Bossenbroek L, de Greef MHG, Wempe JB, Krijnen WP, Ten Hacken NHT: Daily physical activity in patients with chronic obstructive pulmonary disease: a systematic review. COPD 2011, 8:306-319.
- [7]Mador MJ, Patel AN, Nadler J: Effects of pulmonary rehabilitation on activity levels in patients with chronic obstructive pulmonary disease. J Cardiopulm Rehabil Prev 2011, 31:52-59.
- [8]Egan C, Deering BM, Blake C, Fullen BM, McCormack NM, Spruit MA, Costello RW: Short term and long term effects of pulmonary rehabilitation on physical activity in COPD. Respir Med 2012, 106:1671-1679.
- [9]Casanova C, Cote CG, Marin JM, de Torres JP, Aguirre-Jaime A, Mendez R, Dordelly L, Celli BR: The 6-min walking distance: long-term follow up in patients with COPD. European Respiratory Journal 2007, 29:535-540.
- [10]Waschki B, Kirsten A, Holz O, Müller K-C, Meyer T, Watz H, Magnussen H: Physical activity is the strongest predictor of all-cause mortality in patients with COPD: a prospective cohort study. Chest 2011, 140:331-342.
- [11]Garcia-Rio F, Rojo B, Casitas R, Lores V, Madero R, Romero D, Galera R, Villasante C: Prognostic value of the objective measurement of daily physical activity in patients with COPD. Chest 2012, 142:338-346.
- [12]Bauman AE, Sallis JF, Dzewaltowski DA, Owen N: Toward a better understanding of the influences on physical activity: The role of determinants, correlates, causal variables, mediators, moderators, and confounders. Am J Prev Med 2002, 23(2, Supplement 1):5-14.
- [13]Bauman AE, Reis RS, Sallis JF, Wells JC, Loos RJF, Martin BW: Correlates of physical activity: why are some people physically active and others not? Lancet 2012, 380:258-271.
- [14]Miller MR, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A, Crapo R, Enright P, van der Grinten CP, Gustafsson P, Jensen R, Johnson DC, MacIntyre N, McKay R, Navajas D, Pedersen OF, Pellegrino R, Viegi G, Wanger J: Standardisation of spirometry. Eur Respir J 2005, 26:319-338.
- [15]Quanjer PH, Tammeling GJ, Cotes JE, Pedersen OF, Peslin R, Yernault JC: Lung volumes and forced ventilatory flows. Report Working Party Standardization of Lung Function Tests, European Community for Steel and Coal. Official Statement of the European Respiratory Society. Eur Respir J Suppl 1993, 16:5-40.
- [16]Hustvedt B-E, Christophersen A, Johnsen LR, Tomten H, McNeill G, Haggarty P, Løvø A: Description and validation of the ActiReg: a novel instrument to measure physical activity and energy expenditure. Br J Nutr 2004, 92:1001-1008.
- [17]Human energy requirements: Report of a Joint FAO/WHO/UNU Expert Consultation. Rome; 2001.
- [18]Arvidsson D, Slinde F, Nordenson A, Larsson S, Hulthén L: Validity of the ActiReg system in assessing energy requirement in chronic obstructive pulmonary disease patients. Clin Nutr 2006, 25:68-74.
- [19]Andersson M, Moberg L, Svantesson U, Sundbom A, Johansson H, Emtner M: Measuring walking speed in COPD: test-retest reliability of the 30-metre walk test and comparison with the 6-minute walk test. Prim Care Respir J 2011, 20:434-440.
- [20]Cesari M, Kritchevsky SB, Penninx BW, Nicklas BJ, Simonsick EM, Newman AB, Tylavsky FA, Brach JS, Satterfield S, Bauer DC, Visser M, Rubin SM, Harris TB, Pahor M: Prognostic value of usual gait speed in well-functioning older people–results from the Health, Aging and Body Composition Study. J Am Geriatr Soc 2005, 53:1675-1680.
- [21]Seymour J, Spruit M, Hopkinson N, Natanek S, Man W, Jackson A, Gosker H, Schols A, Moxham J, Polkey M, Wouters E: The prevalence of quadriceps weakness in COPD and the relationship with disease severity. Eur Respir J 2010, 36:81-88.
- [22]Mahler D, Wells C: Evaluation of clinical methods for rating dyspnea. Chest 1988, 93:580-586.
- [23]Watz H, Waschki B, Meyer T, Magnussen H: Physical activity in patients with COPD. Eur Respir J 2009, 33:262-272.
- [24]Jehn M, Schmidt-Trucksäss A, Meyer A, Schindler C, Tamm M, Stolz D: Association of daily physical activity volume and intensity with COPD severity. Respir Med 2011, 105:1846-1852.
- [25]Pitta F, Troosters T, Probst VS, Lucas S, Decramer M, Gosselink R: Potential consequences for stable chronic obstructive pulmonary disease patients who do not get the recommended minimum daily amount of physical activity. J Bras Pneumol 2006, 32:301-308.
- [26]Walker PP, Burnett A, Flavahan PW, Calverley PMA: Lower limb activity and its determinants in COPD. Thorax 2008, 63:683-689.
- [27]Garcia-Rio F, Lores V, Mediano O, Rojo B, Hernanz A, López-Collazo E, Alvarez-Sala R: Daily physical activity in patients with chronic obstructive pulmonary disease is mainly associated with dynamic hyperinflation. Am J Respir Crit Care Med 2009, 180:506-512.
- [28]Thomas M, Decramer M, O’Donnell DE: No room to breathe: the importance of lung hyperinflation in COPD. Prim Care Respir J 2013, 22:101-111.
- [29]Polkey MI, Moxham J: Attacking the disease spiral in chronic obstructive pulmonary disease. Clin Med 2006, 6:190-196.
- [30]Belza B, Steele BG, Hunziker J, Lakshminaryan S, Holt L, Buchner DM: Correlates of physical activity in chronic obstructive pulmonary disease. Nurs Res 2001, 50:195-202.
- [31]Pitta F, Troosters T, Spruit MA, Probst VS, Decramer M, Gosselink R: Characteristics of physical activities in daily life in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2005, 171:972-977.
- [32]DePew ZS, Karpman C, Novotny PJ, Benzo RP: Correlations between gait speed, six-minute walk, physical activity, and self-efficacy in severe chronic lung disease. Respir Care 2013.
- [33]Kon SS, Patel MS, Canavan JL, Clark AL, Jones SE, Nolan CM, Cullinan P, Polkey MI, Man WD-C: Reliability and validity of the four metre gait speed in COPD. Eur Respir J 2012.
- [34]Coronell C, Orozco-Levi M, Méndez R, Ramírez-Sarmiento A, Gáldiz JB, Gea J: Relevance of assessing quadriceps endurance in patients with COPD. Eur Respir J 2004, 24:129-136.
- [35]van den Borst B, Slot IGM, Hellwig VACV, Vosse BAH, Kelders MCJM, Barreiro E, Schols AMWJ, Gosker HR: Loss of quadriceps muscle oxidative phenotype and decreased endurance in patients with mild-to-moderate COPD. J Appl Physiol 2013, 114:1319-1328.
- [36]Remoortel HV, Hornikx M, Demeyer H, Langer D, Burtin C, Decramer M, Gosselink R, Janssens W, Troosters T: Daily physical activity in subjects with newly diagnosed COPD. Thorax 2013.
- [37]Decramer M, Lacquet LM, Fagard R, Rogiers P: Corticosteroids contribute to muscle weakness in chronic airflow obstruction. Am J Respir Crit Care Med 1994, 150:11-16.
- [38]Eagan TML, Aukrust P, Ueland T, Hardie JA, Johannessen A, Mollnes TE, Damås JK, Bakke PS, Wagner PD: Body composition and plasma levels of inflammatory biomarkers in COPD. Eur Respir J 2010, 36:1027-1033.
- [39]Evans RA, Hill K, Dolmage TE, Blouin M, O’Hoski S, Brooks D, Goldstein RS: Properties of self-paced walking in chronic respiratory disease: A patient goal-oriented assessment. Chest 2011, 140:737-743.
- [40]Dolmage TE, Evans RA, Hill K, Blouin M, Brooks D, Goldstein RS: The effect of pulmonary rehabilitation on critical walk speed in patients with COPD: a comparison with self-paced walks. Chest 2012, 141:413-419.
- [41]Pitta F, Troosters T, Probst VS, Langer D, Decramer M, Gosselink R: Are patients with COPD more active after pulmonary rehabilitation? Chest 2008, 134:273-280.