scholarly journals The ability of physical activity in reducing mortality risks and cardiovascular loading and in extending life expectancy in patients with COPD

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Chin-Chung Shu ◽  
June-Han Lee ◽  
Min-Kuang Tsai ◽  
Ta-Chen Su ◽  
Chi Pang Wen
Keyword(s):  
Physical Activity ◽  
Heart Rate ◽  
Life Expectancy ◽  
Kidney Diseases ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Mortality Risks ◽  
Systemic Nature ◽  
Causes Of Deaths

AbstractFor chronic obstructive pulmonary disease (COPD), the role of physical activity in reducing COPD mortality and heart loading and in extending life expectancy remains unclear. Participants in comprehensive medical screening were recruited with spirometry on everyone. We analyzed physical activity volume calculated from intensity, duration and frequency of self-reported exercise history. Deaths were identified from the National Death File. The impacts of physical activity on mortality, heart rate and life expectancy were analyzed. Among the cohort of 483,603 adults, 32,535 had spirometry-determined COPD, indicating an adjusted national prevalence of 11.4% (male) and 9.8% (female). On the average, COPD increased all-cause mortality with a hazard ratio of 1.44 and loss of 6.0 years in life expectancy. Almost two thirds (65%) of the causes of deaths were extra-pulmonary, such as cardiovascular disease, diabetes, cancer and kidney diseases. In addition, COPD was associated with increases in heart rate proportionate to its severity, which led to higher mortality. Participants with COPD who were fully active physically could reduce mortality and have improved heart rates as compared with those without physical activity. In addition, their life expectancy could be extended close to those of the no COPD but inactive cohort. Fully active physical activity can help patients with COPD overcome most of the mortality risks, decrease heart rate, and achieve a life expectancy close to that of patients without COPD. The effectiveness of physical activity on COPD is facilitated by its systemic nature beyond lung disease.

scholarly journals Targeting exertional breathlessness to improve physical activity: the role of primary care

2021 ◽  
Vol 31 (1) ◽  
Author(s):  
Miguel Román-Rodríguez ◽  
Janwillem W. H. Kocks
Keyword(s):  
Physical Activity ◽  
Primary Care ◽  
Primary Care Physicians ◽  
Holistic Approach ◽  
Pharmacological Therapy ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Downward Spiral

AbstractPrimary care physicians (PCPs) play a crucial role in the diagnosis and management of chronic obstructive pulmonary disease (COPD). By working together with patients to target exertional breathlessness and increase physical activity, PCPs have an important role to play, early in the disease course, in improving patient outcomes in both the short and long term. In this article, we consider how physical activity affects disease progression from the PCP perspective. We discuss the role of pharmacological therapy, the importance of an holistic approach and the role of PCPs in assessing and promoting physical activity. The complexity and heterogeneity of COPD make it a challenging disease to treat. Patients’ avoidance of activity, and subsequent decline in capacity to perform it, further impacts the management of the disease. Improving patient tolerance of physical activity, increasing participation in daily activities and helping patients to remain active are clear goals of COPD management. These may require an holistic approach to management, including pulmonary rehabilitation and psychological programmes in parallel with bronchodilation therapy, in order to address both physiological and behavioural factors. PCPs have an important role to optimise therapy, set goals and communicate the importance of maintaining physical activity to their patients. In addition, optimal treatment that addresses activity-related breathlessness can help prevent the downward spiral of inactivity and get patients moving again, to improve their overall health and long-term prognosis.

scholarly journals Current data on improvement in physical tolerance and a role of physical activity in patients with chronic obstructive pulmonary disease

2019 ◽  
Vol 29 (2) ◽  
pp. 207-215
Author(s):  
Zaurbek R. Aisanov ◽  
Yuliya G. Belotserkovskaya ◽  
Sergey N. Avdeev ◽  
Andrey S. Belevskiy
Keyword(s):  
Physical Activity ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Underlying Mechanism ◽  
Current Data ◽  
Airflow Limitation ◽  
Chronic Obstructive ◽  
Published Data ◽  
Obstructive Pulmonary Disease

Physical activity plays an important prognostic role in patients with chronic obstructive pulmonary disease (COPD). According to published data, decreased physical activity is associated with higher frequency of COPD exacerbations, higher mortality, and lower quality of life in COPD patients. As the airflow limitation is an underlying mechanism of COPD, double bronchodilators can reduce lung hyperinflation and improve exercise tolerance in patients with COPD. According to the robust evidence on the efficacy of tiotropium/olodaterol combination, double bronchodilators can increase exercise duration and time before dyspnea occurrence on exertion. However, further studies are needed in the field of rehabilitation and a role of physical activity in the management of patients with COPD.

Sensitivity, Accuracy, and Reproducibility of Biosensing (mHealth) Devices in Monitoring of Physical Activity and Respiratory Function in Smokers with and Without Respiratory Symptoms or Chronic Obstructive Pulmonary Disease (Preprint)

2020 ◽  
Author(s):  
Almaz Sharman ◽  
Baurzhan Zhussupov ◽  
Saule Nurakysh
Keyword(s):  
Physical Activity ◽  
Chronic Obstructive Pulmonary Disease ◽  
Heart Rate ◽  
Pulmonary Disease ◽  
Respiratory Function ◽  
Respiratory Symptoms ◽  
Chronic Obstructive ◽  
Grey Zone ◽  
Obstructive Pulmonary Disease ◽  
Home Setting

BACKGROUND Chronic obstructive pulmonary disease (COPD) is a global public health problem, and continuous monitoring is essential for both its management as well as the management of other chronic diseases. Telemonitoring using mobile health (mHealth) devices has the potential to promote self-management, improve control, increase quality of life, and prevent hospital admissions. OBJECTIVE This feasibility and proof-of-concept study aims to assess utility (sensitivity, accuracy, and reproducibility) of biosensing (mHealth) devices in monitoring of physical activity and respiratory function in smokers with and without respiratory symptoms/COPD. METHODS A total of 3 cohorts, with 9 participants in each, used mHealth devices for 90 days while undergoing the current standard of care. These groups were: 9 “non-COPD,” otherwise healthy, smokers; 9 “grey zone” smokers (forced expiratory volume in 1 second/ forced vital capacity ≥0.70 after bronchodilator treatment; COPD Assessment Test ≥10); and 9 smokers diagnosed with Stage 1-3 COPD. Rates of recruitment, retention, and adherence will be measured. Overall, two mHealth devices were utilized in the study: (1) the AnaMed Original Equipment Manufacturer device (OEM) that measures distance, energy expenditure, heart rate, and heart rate variability by using photoplethysmographic method and displays the results on a watchface, smartphone or a tablet, and (2) the Air Next mobile spirometry device portable device that performs spirometric measurements (FEV1, FVC and FEV1/FVC) ratio by a turbine mechanism and displays the results on a smartphone or a tablet. The mHealth devices were compared against industry standards. Additionally, a questionnaire will be administered to assess the participants’ perceptions of the mHealth technologies used. RESULTS The AnaMed device was demonstrated as precise in measuring heart rate, and less so when measuring number of steps and meters. It is unreliable in measuring SpO2. It is easy to use, requires no significant technical support. The Air-Next Spirometer is a simple and very precise instrument for detecting obstructive airway diseases which was confirmed when compared with the industry standard. It is easy to use, which could make it especially useful non-specialized care and in-home setting and other areas. CONCLUSIONS We demonstrated that both devices, AnaMed and AirNext can provide precise measurements or heart rate and spirometric data, and it is feasible to incorporate them into a large-scale study. However, such task would require serious efforts to hire technical staff and to provide additional training for the clinical investigators to take care of technical and logistical issues, i.e. sending reminders, synching devices with smartphones, communication efforts. CLINICALTRIAL ClinicalTrials.gov NCT04081961; https://clinicaltrials.gov/ct2/show/NCT04081961

scholarly journals Feasibility of Using a Smartwatch to Intensively Monitor Patients With Chronic Obstructive Pulmonary Disease: Prospective Cohort Study (Preprint)

2018 ◽  
Author(s):  
Robert Wu ◽  
Daniyal Liaqat ◽  
Eyal de Lara ◽  
Tatiana Son ◽  
Frank Rudzicz ◽  
...  
Keyword(s):  
Physical Activity ◽  
Chronic Obstructive Pulmonary Disease ◽  
Heart Rate ◽  
Pulmonary Disease ◽  
Predictive Analytics ◽  
Sensor Data ◽  
Chronic Obstructive ◽  
Activity Data ◽  
Obstructive Pulmonary Disease ◽  
Technical Issues

BACKGROUND Acute exacerbations of chronic obstructive pulmonary disease (COPD) are associated with accelerated decline in lung function, diminished quality of life, and higher mortality. Proactively monitoring patients for early signs of an exacerbation and treating them early could prevent these outcomes. The emergence of affordable wearable technology allows for nearly continuous monitoring of heart rate and physical activity as well as recording of audio which can detect features such as coughing. These signals may be able to be used with predictive analytics to detect early exacerbations. Prior to full development, however, it is important to determine the feasibility of using wearable devices such as smartwatches to intensively monitor patients with COPD. OBJECTIVE We conducted a feasibility study to determine if patients with COPD would wear and maintain a smartwatch consistently and whether they would reliably collect and transmit sensor data. METHODS Patients with COPD were recruited from 3 hospitals and were provided with a smartwatch that recorded audio, heart rate, and accelerations. They were asked to wear and charge it daily for 90 days. They were also asked to complete a daily symptom diary. At the end of the study period, participants were asked what would motivate them to regularly use a wearable for monitoring of their COPD. RESULTS Of 28 patients enrolled, 16 participants completed the full 90 days. The average age of participants was 68.5 years, and 36% (10/28) were women. Survey, heart rate, and activity data were available for an average of 64.5, 65.1, and 60.2 days respectively. Technical issues caused heart rate and activity data to be unavailable for approximately 13 and 17 days, respectively. Feedback provided by participants indicated that they wanted to actively engage with the smartwatch and receive feedback about their activity, heart rate, and how to better manage their COPD. CONCLUSIONS Some patients with COPD will wear and maintain smartwatches that passively monitor audio, heart rate, and physical activity, and wearables were able to reliably capture near-continuous patient data. Further work is necessary to increase acceptability and improve the patient experience.

Role of exhaled nitric oxide in predicting steroid response in chronic obstructive pulmonary disease

2010 ◽  
Vol 151 (51) ◽  
pp. 2083-2088 ◽  
Author(s):  
Balázs Antus
Keyword(s):  
Nitric Oxide ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Exhaled Nitric Oxide ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Steroid Response

A kilégzett levegőben mérhető nitrogén-monoxid a legszélesebb körben vizsgált légúti biomarker. A stabil állapotú krónikus obstruktív tüdőbetegségben a kilégzett nitrogén-monoxid-szint hasonló vagy csak kismértékben emelkedett az egészségesekhez képest. Mivel a nitrogén-monoxid-szint szoros összefüggést mutat a légúti eosinophilia mértékével, és mivel az eosinophil típusú légúti gyulladás szteroidokra érzékenyebb, az emelkedett nitrogén-monoxid-szinttel rendelkező betegek jobb válaszkészséget mutatnak az inhalációs vagy szisztémás kortikoszteroidkezelésre. A krónikus obstruktív tüdőbetegség akut exacerbatiója során a kilégzett nitrogén-monoxid szintje megemelkedik, majd ennek kezelése után csökken. Mivel a nitrogén-monoxid-szint és a kezelés során elért légzésfunkciós javulás szoros korrelációt mutat egymással, a nitrogén-monoxid-méréssel a terápiás válasz megjósolható. Összefoglalva: a nitrogén-monoxid-méréssel a krónikus obstruktív tüdőbetegségben szenvedő betegek olyan alcsoportját lehet elkülöníteni, amelynek szteroidérzékenysége nagyobb. Orv. Hetil., 2010, 151, 2083–2088.

Participation of ABCA1 transporter in development of chronic obstructive pulmonary disease

2020 ◽  
Vol 28 (3) ◽  
pp. 360-370
Author(s):  
Stanislav N. Kotlyarov ◽  
Anna A. Kotlyarova
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Significant Contribution ◽  
Modern Medicine ◽  
Lipid Homeostasis ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Reverse Transport ◽  
Current Paradigm

Despite all achievements of the modern medicine, the problem of chronic obstructive pulmonary disease (COPD) does not lose its relevance. The current paradigm suggests a key role of macrophages in inflammation in COPD. Macrophages are known to be heterogeneous in their functions. This heterogeneity is determined by their immunometabolic profile and also by peculiarities of lipid homeostasis of cells. Aim. To analyze the role of the ABCA1 transporter, a member of the ABC A subfamily, in the pathogenesis of COPD. The expression of ABCA1 in lung tissues is on the second place after the liver, which shows the important role of the carrier and of lipid homeostasis in the function of lungs. Analysis of the literature shows that participation of the transporter in inflammation consists in regulation of the content of cholesterol in the lipid rafts of the membranes, in phagocytosis and apoptosis. Conclusion. Through regulation of the process of reverse transport of cholesterol in macrophages of lungs, ABCA1 can change their inflammatory response, which makes a significant contribution to the pathogenesis of COPD.

scholarly journals Association between Physical Activity and Comorbidities in Spanish People with Asthma-COPD Overlap

2021 ◽  
Vol 13 (14) ◽  
pp. 7580
Author(s):  
Sheila Sánchez Castillo ◽  
Lee Smith ◽  
Arturo Díaz Suárez ◽  
Guillermo Felipe López Sánchez
Keyword(s):  
Physical Activity ◽  
Short Form ◽  
National Health Survey ◽  
Lumbar Pain ◽  
Chronic Obstructive ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
Logistic Regression Models ◽  
Adjusted Model ◽  
Activity Questionnaire

Asthma and chronic obstructive pulmonary disease (COPD) are important conditions which often coexist. Higher rates of comorbidities among people with asthma-COPD overlap (ACO) may complicate clinical management. The aim of this study was to determine the prevalence of 30 different comorbidities and to analyze associations between these comorbidities and physical activity (PA) in Spanish people with ACO. Cross-sectional data from the Spanish National Health Survey 2017 were analyzed. A total of 198 Spanish people with ACO aged 15–69 years (60.6% women) were included in this study. PA was measured with the International Physical Activity Questionnaire (IPAQ) short form. Diagnosis of chronic conditions were self-reported. Associations between PA and comorbidities were analyzed using multivariable logistic regression models. The most prevalent comorbidities were chronic allergy (58.1%), chronic lumbar pain (42.4%), chronic cervical pain (38.4%), hypertension (33.3%) and arthrosis (31.8%). A PA level lower than 600 MET·min/week was significantly associated with urinary incontinence (OR = 3.499, 95% CI = 1.369–8.944) and osteoporosis (OR = 3.056, 95% CI = 1.094–8.538) in the final adjusted model. Therefore, the potential influence of PA on reducing the risk of these conditions among people with ACO should be considered, not only because of the health benefits, but also because PA can contribute to a more sustainable world.

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