Patterns and predictors of low physical activity in patients with stable COPD: a longitudinal study

Background: Despite the frequency and negative impact of low physical activity among patients with chronic obstructive pulmonary disease (COPD), little is known about how it persists and remits over time or the factors predicting new states of low physical activity. The aim of the study was to determine the probability of a transition between states of low and nonlow physical activity in a cohort of patients with stable COPD followed for 2 years. We also investigated different potentially modifiable factors to determine whether they can predict new states of low physical activity. Methods: We prospectively included 137 patients with stable COPD (mean age 66.9 ± 8.3 years). Physical activity was measured at baseline and at 1 and 2 years of follow up. Low physical activity was defined according to energy expenditure by cut-off points from the Fried frailty model. The likelihood of annual transition towards new states and recovery was calculated. We evaluated demographic, frailty, nonrespiratory, and respiratory variables as potential predictors, using generalized estimating equations. Results: At baseline, 37 patients (27%) presented with low physical activity. During the study period, a total of 179 annual transitions were identified with nonlow physical activity at the beginning of the year; 17.5% transitioned to low physical activity. In contrast, 34.3% of the 67 transitions that started with low physical activity recovered. Predictors of transition to new states of low physical activity were dyspnea ⩾2 (odds ratio = 3.21; 95% confidence interval: 1.20–8.61) and poor performance on the five sit-to-stand test (odds ratio = 4.75; 95% confidence interval: 1.30–17.47). Conclusions: The change between levels of low and nonlow physical activity is dynamic, especially for recovery. Annual transitions toward new states of low physical activity are likely among patients with dyspnea or poor performance on the five sit-to-stand test. The reviews of this paper are available via the supplemental material section.

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Physical Activity in Older Cancer Survivors: What Role Do Multimorbidity and Perceived Disability Play?

Journal of Aging and Physical Activity ◽

10.1123/japa.2019-0086 ◽

2020 ◽

Vol 28 (2) ◽

pp. 311-319 ◽

Cited By ~ 1

Author(s):

Shirley M. Bluethmann ◽

Wayne Foo ◽

Renate M. Winkels ◽

Scherezade K. Mama ◽

Kathryn H. Schmitz

Keyword(s):

Physical Activity ◽

Confidence Interval ◽

Cancer Survivors ◽

Odds Ratio ◽

Age Groups ◽

Chronic Obstructive ◽

Behavioral Risk ◽

Obstructive Pulmonary Disease ◽

Exercise Interventions ◽

Perceived Disability

Purpose: (a) To describe the relationship of multimorbidity and physical activity (PA) in cancer survivors and (b) to explore perceived disability and PA in middle-aged and older survivors. Methods: The authors analyzed the data from cancer survivors (N = 566), identified using the Pennsylvania Cancer Registry, who responded to a Behavioral Risk Factor Surveillance System-derived questionnaire. They created age groups (e.g., 45–54 years, 55–64 years, 65–74 years, and 75 years and older) and calculated a composite score of eight common comorbidities (e.g., chronic obstructive pulmonary disease, heart disease) to assess multimorbidity. Logistic regression was used to estimate the association of demographic and behavioral/clinical risk factors (e.g., multimorbidity, perceived disability, body mass index) with PA. Results: Most respondents were females (62%), older (mean age = 68 years) and represented diverse cancer sites, including breast (n = 132), colorectal (n = 102), gynecologic (n = 106), prostate (n = 111), and lung (n = 80). PA participation was mixed; 44% of survivors reported achieving >150 min of aerobic PA, but half of lung and 37% of gynecologic survivors reported no PA (0 min/week). Higher multimorbidity (odds ratio = 0.82, confidence interval [0.69, 0.98], p < .05), obesity (odds ratio = 0.51, confidence interval [0.30, 0.86], p < .05), and perceived disability (odds ratio = 0.49, confidence interval [0.32, 0.77], p < .001) were negatively associated with PA participation. Strength training was suboptimal across all survivors. Conclusion: Most older survivors experienced comorbid conditions, and this was associated with less PA. Survivors who perceived themselves as disabled or who were obese were half as likely as others to participate in PA. This suggests an increasing need to address both physical and psychological limitations in designing PA interventions for real-world needs. Exercise interventions that address the unique needs of older survivors for multimorbidity, obesity, and perceived disability may strengthen opportunities for PA.

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Effectiveness of Text Messaging as an Incentive to Maintain Physical Activity after Cardiac Rehabilitation: A Randomized Controlled Pilot Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18126645 ◽

2021 ◽

Vol 18 (12) ◽

pp. 6645

Author(s):

Giulia Foccardi ◽

Marco Vecchiato ◽

Daniel Neunhaeuserer ◽

Michele Mezzaro ◽

Giulia Quinto ◽

...

Keyword(s):

Physical Activity ◽

Cardiac Rehabilitation ◽

Exercise Testing ◽

Text Messages ◽

Control Group ◽

Stand Test ◽

Randomized Controlled ◽

Sit To Stand ◽

Significant Difference

Although the efficacy of cardiac rehabilitation (CR) is proven, the need to improve patients’ adherence has emerged. There are only a few studies that have investigated the effect of sending text messages after a CR period to stimulate subjects’ ongoing engagement in regular physical activity (PA). A randomized controlled pilot trial was conducted after CR, sending a daily PA text message reminder to an intervention group (IG), which was compared with a usual care control group (CG) during three months of follow-up. Thirty-two subjects were assessed pre- and post-study intervention with GPAQ, submaximal iso-watt exercise testing, a 30 s sit-to-stand test, a bilateral arm curl test, and a final survey on a seven-point Likert scale. A statistically significant difference in the increase of moderate PA time (Δ 244.7 (95% CI 189.1, 300.4) minutes, p < 0.001) and in the reduction of sedentary behavior time (Δ −77.5 (95% CI 104.9, −50.1) minutes, p = 0.004) was shown when the IG was compared with the CG. This was associated with an improvement in heart rate, blood pressure, and patients’ Borg rating on the category ratio scale 10 (CR10) in iso-watt exercise testing (all p < 0.05). Furthermore, only the IG did not show a worsening of the strength parameters in the follow-up leading to a change of the 30 s sit-to-stand test with a difference of +2.2 (95% CI 1.23, 3.17) repetitions compared to CG (p = 0.03). The telemedical intervention has been appreciated by the IG, whose willingness to continue with regular PA emerged to be superior compared to the CG. Text messages are an effective and inexpensive adjuvant after phase 2 CR that improves adherence to regular PA. Further studies are needed to confirm these results in a larger patient population and in the long term.

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Pulmonary restriction predicts long-term pulmonary impairment in people with HIV and tuberculosis

BMC Pulmonary Medicine ◽

10.1186/s12890-020-01368-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Sara C. Auld ◽

Hardy Kornfeld ◽

Pholo Maenetje ◽

Mandla Mlotshwa ◽

William Chase ◽

...

Keyword(s):

Lung Function ◽

Confidence Interval ◽

Odds Ratio ◽

Adjusted Odds Ratio ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Logistic Regression Models ◽

Pulmonary Impairment ◽

Mixed Pattern

Abstract Background While tuberculosis is considered a risk factor for chronic obstructive pulmonary disease, a restrictive pattern of pulmonary impairment may actually be more common among tuberculosis survivors. We aimed to determine the nature of pulmonary impairment before and after treatment among people with HIV and tuberculosis and identify risk factors for long-term impairment. Methods In this prospective cohort study conducted in South Africa, we enrolled adults newly diagnosed with HIV and tuberculosis who were initiating antiretroviral therapy and tuberculosis treatment. We measured lung function and symptoms at baseline, 6, and 12 months. We compared participants with and without pulmonary impairment and constructed logistic regression models to identify characteristics associated with pulmonary impairment. Results Among 134 participants with a median CD4 count of 110 cells/μl, 112 (83%) completed baseline spirometry at which time 32 (29%) had restriction, 13 (12%) had obstruction, and 9 (7%) had a mixed pattern. Lung function was dynamic over time and 30 (33%) participants had impaired lung function at 12 months. Baseline restriction was associated with greater symptoms and with long-term pulmonary impairment (adjusted odds ratio 5.44, 95% confidence interval 1.16–25.45), while baseline obstruction was not (adjusted odds ratio 1.95, 95% confidence interval 0.28–13.78). Conclusions In this cohort of people with HIV and tuberculosis, restriction was the most common, symptomatic, and persistent pattern of pulmonary impairment. These data can help to raise awareness among clinicians about the heterogeneity of post-tuberculosis pulmonary impairment, and highlight the need for further research into mediators of lung injury in this vulnerable population.

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Is the 1-Minute Sit-To-Stand Test a Good Tool to Evaluate Exertional Oxygen Desaturation in Chronic Obstructive Pulmonary Disease?

Diagnostics ◽

10.3390/diagnostics11020159 ◽

2021 ◽

Vol 11 (2) ◽

pp. 159

Author(s):

Ana L. Fernandes ◽

Inês Neves ◽

Graciete Luís ◽

Zita Camilo ◽

Bruno Cabrita ◽

...

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Disease ◽

Intraclass Correlation ◽

Oxygen Desaturation ◽

Walking Distance ◽

Chronic Obstructive ◽

Cross Sectional ◽

Obstructive Pulmonary Disease ◽

Stand Test ◽

Sit To Stand

Background: Chronic obstructive pulmonary disease (COPD) is frequently associated with exertional oxygen desaturation, which may be evaluated using the 6-minute walking test (6MWT). However, it is a time-consuming test. The 1-minute sit-to-stand test (1STST) is a simpler test, already used to evaluate the functional status. The aim of this study was to compare the 1STST to the 6MWT in the evaluation of exertional desaturation. Methods: This was a cross-sectional study including 30 stable COPD patients who performed the 6MWT and 1STST on the same day. Six-minute walking distance (6MWD), number of 1STST repetitions (1STSTr), and cardiorespiratory parameters were recorded. Results: A significant correlation was found between the 6MWD and the number of 1STSTr (r = 0.54; p = 0.002). The minimum oxygen saturation (SpO2) in both tests showed a good agreement (intraclass correlation coefficient (ICC) 0.81) and correlated strongly (r = 0.84; p < 0.001). Regarding oxygen desaturation, the total agreement between the tests was 73.3% with a fair Cohen’s kappa (κ = 0.38; p = 0.018), and 93.33% of observations were within the limits of agreement for both tests in the Bland–Altman analysis. Conclusion: The 1STST seems to be a capable tool of detecting exercise-induced oxygen desaturation in COPD. Because it is a less time- and resources-consuming test, it may be applied during the outpatient clinic consultation to regularly evaluate the exercise capacity and exertional desaturation in COPD.

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Effect of clinical mastitis on reproductive targets achievement in cows

Veterinária e Zootecnia ◽

10.35172/rvz.2019.v26.135 ◽

2019 ◽

Vol 26 ◽

pp. 1-10

Author(s):

Hector Nava-Trujillo

Keyword(s):

Confidence Interval ◽

Odds Ratio ◽

Relative Frequency ◽

Negative Impact ◽

Clinical Mastitis ◽

Lower Odds ◽

Negative Effect

The aim of this study was to determine the effect of clinical mastitis occurring between calving and the first service on the percentage of cows that achieve two reproductive targets: be served before 70 days postpartum and be pregnant before 110 days postpartum (dpp). Relative frequency and odds ratio (OR) with the corresponding confidence interval (CI) were calculated. Fewer mastitic cows were served before 70 dpp than non-mastitic (24.86% vs 36.59% respectively P = 0.0137); mastitic cows had lower odds to be served than non-mastitic cows (OR: 0.57; 95% CI: 0.3679-0.8938, P = 0.0141). Fewer mastitic cows became pregnant before 110 dpp than non-mastitic cows (36.72% vs 50.73%, respectively, P = 0.006) and mastitic cows had lower odds to become pregnant than non-mastitic cows (OR: 0.56; 95% CI: 0.3739-0.8495, P = 0.0062). Negative effect of clinical mastitis on percentage of cows served only was observed in primiparous cows, with 4.76% of mastitic cows being served in comparison with 30.19% of non-mastitic cows (P = 0.0017); primiparous mastitic cows had lower odds (0.11; 95% CI: 0.0249-0.5374, P = 0.0059) to be served than non-mastitic primiparous cows. Percentage of primiparous mastitic cows pregnant before 110 dpp was lower than non-mastitic cows (16.67% vs 37.74%, P = 0.0245) and mastitic cows had only 0.3300 odds (95% CI: 0.1234-0.8822, P = 0.0271) to become pregnant that primiparous non-mastitic. In multiparous, 42.96% of mastitic and 55.26% of non-mastitic cows (P = 0.0378) became pregnant before 110 dpp and mastitic cows had 0.6098 odd (95% CI: 0.3821-0.9730, P = 0.0380) to become pregnant than non-mastitic. In conclusion, clinical mastitis reduced the possibility of cows to be served and become pregnant during the first 70 and 110 dpp respectively, and the negative impact of clinical mastitis was more harmful in primiparous cows.

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Prognostic Marker for Severe Acute Exacerbation of Chronic Obstructive Pulmonary Disease: Analysis of Diffusing Capacity of the Lung for Carbon Monoxide (DLCO) and Forced Expiratory Volume in One Second (FEV1)

10.21203/rs.3.rs-96162/v2 ◽

2021 ◽

Author(s):

Juwhan Choi ◽

Jae Kyeom Sim ◽

Jee Youn Oh ◽

Young Seok Lee ◽

Gyu Young Hur ◽

...

Keyword(s):

Prognostic Factors ◽

Confidence Interval ◽

Odds Ratio ◽

Length Of Hospital Stay ◽

Forced Expiratory Volume ◽

Curve Analysis ◽

Chronic Obstructive ◽

Diffusing Capacity ◽

Roc Curve Analysis ◽

Obstructive Pulmonary Disease

Abstract Background: It is important to assess the prognosis and classify patients in chronic obstructive pulmonary disease (COPD) and acute exacerbation of COPD (AECOPD) treatment. Recently, it was suggested that diffusing capacity of the lung for carbon monoxide (DLCO) should be added to multidimensional tools for assessing COPD. This study aimed to compare the DLCO and forced expiratory volume in one second (FEV1) to identify better prognostic factors for admitted patients with AECOPD.Methods: We retrospectively analyzed 342 patients with AECOPD receiving inpatient treatment. We classified 342 severe AECOPD events using DLCO and FEV1. We defined the prognostic factors of severe AECOPD as the length of hospital stay, mortality in hospital, experience of mechanical ventilation, and experience of intensive care unit (ICU) care. We analyzed the prognostic factors by multivariate analysis using logistic regression. In addition, we conducted a correlation analysis and receiver operating characteristic (ROC) curve analysis.Results: In univariate and multivariate analyses, DLCO was shown to predict mortality rate (odds ratio = 4.408; 95% confidence interval, 1.070–18.167; P = 0.040), experience of ventilator (odds ratio = 2.855; 95% confidence interval, 1.216–6.704; P = 0.016) and ICU (odds ratios = 2.685; 95% confidence interval, 1.290–5.590; P = 0.008). However, there was no statistically significant difference in mortality rate when using FEV1 classification (P = 0.075). In the correlation analysis, both DLCO and FEV1 showed a negative correlation with length of hospital stay. The correlation rate was more pronounced in the DLCO (DLCO; B = -0.103, P < 0.001) (FEV1; B = -0.075, P = 0.007). In addition, DLCO showed better predictive ability than FEV1 in ROC curve analysis. The area under the curve (AUC) of DLCO was greater than 0.68 for all prognostic factors, and in contrast, the AUC of FEV1 was less than 0.68.Conclusion: DLCO was likely to be as good as or better prognostic marker than FEV1 in severe AECOPD.

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Responses to the Physical Activity Guidelines and Dissemination Strategies for Behavior Change in a Representative Sample of US Adults

Journal of Physical Activity and Health ◽

10.1123/jpah.2021-0136 ◽

2021 ◽

pp. 1-10

Author(s):

Malorie Polster ◽

Erin E. Dooley ◽

Kate Olscamp ◽

Katrina L. Piercy ◽

April Oh

Keyword(s):

Physical Activity ◽

Confidence Interval ◽

Odds Ratio ◽

Adjusted Odds Ratio ◽

Information Source ◽

Population Based ◽

Multiple Sources ◽

Physical Activity Guidelines ◽

Logistic Regressions ◽

National Trends

Background: Dissemination of the Physical Activity Guidelines for Americans (Guidelines) is needed, but how individuals respond to the Guidelines is not well understood. This surveillance study describes US adults’ reported responses to and information sources for hearing about the Guidelines and explores relationships between how respondents heard about the Guidelines and their reported response(s). Methods: Data were analyzed from the population-based 2019 Health Information National Trends Survey 5 Cycle 3. Population-weighted proportions of response were calculated. Among those who had heard about the Guidelines, binary logistic regressions examined associations between the reported response(s) and the information source and number of sources reported. Results: The analytical sample included 5047 adults. Nearly 65% of US adults reported hearing about the Guidelines, and 29% reported a behavioral response (eg, increased physical activity). Hearing about the Guidelines through health professionals (adjusted odds ratio = 2.30, 95% confidence interval, 1.45–3.65) or social media (adjusted odds ratio = 1.89, 95% confidence interval, 1.20–2.96) (vs other sources) was associated with reporting increasing physical activity. Hearing from multiple sources (vs one source) was associated with reporting increasing physical activity (adjusted odds ratio = 1.97, 95% confidence interval, 1.18–3.31). Conclusion: Findings suggest dissemination of the Guidelines across multiple channels may promote greater changes in physical activity.

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Stability and Predictors of Poor 6-min Walking Test Performance over 2 Years in Patients with COPD

Journal of Clinical Medicine ◽

10.3390/jcm9041155 ◽

2020 ◽

Vol 9 (4) ◽

pp. 1155

Author(s):

Mª Piedad Sánchez-Martínez ◽

Roberto Bernabeu-Mora ◽

Mariano Martínez-González ◽

Mariano Gacto-Sánchez ◽

Rodrigo Martín San Agustín ◽

...

Keyword(s):

Test Performance ◽

Performance Status ◽

Prognostic Models ◽

Chronic Obstructive ◽

Discriminative Ability ◽

Stand Test ◽

Sit To Stand ◽

Copd Patients ◽

The Stability

Poor performance in the 6-min walk test (6MWT < 350 m) is an important prognostic indicator of mortality and risk of exacerbations in patients with chronic obstructive pulmonary disease (COPD). Little is known about the stability of this state over time and what factors might predict a poor 6MWT performance. To determine the stability of 6MWT performance over a 2-year period in COPD patients participating in annual medical follow-up visits, and to assess the ability of several clinical, pulmonary, and non-pulmonary factors to predict poor 6MWT performance, we prospectively included 137 patients with stable COPD (mean age, 66.9 ± 8.3 years). The 6MWT was scored at baseline and 2-year follow-up. To evaluate clinical, pulmonary, and non-pulmonary variables as potential predictors of poor 6MWT performance, we used multiple logistic regression models adjusted for age, sex, weight, height, and 6MWT performance at baseline. Poor 6MWT performance was stable over 2 years for 67.4% of patients. Predictors of poor 6MWT performance included a five-repetition sit-to-stand test score ≤2 (OR, 3.01; 95% CI, 1.22–7.42), the percentage of mobility activities with limitations (OR, 1.03; 95% CI, 1.00–1.07), and poor 6MWT performance at baseline (OR, 4.64; 95% CI, 1.88–11.43). Poor 6MWT performance status was stable for the majority of COPD patients. Lower scores on the five-repetition sit-to-stand test and a higher number of mobility activities with limitations were relevant predictors of poor 6MWT performance over 2 years. Prognostic models based on these non-pulmonary factors can provide non-inferior discriminative ability in comparison with prognostic models based on only pulmonary factors.

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Do physical activity levels differ by number of children at home in women aged 25–44 in the general population?

Women s Health ◽

10.1177/1745506519871186 ◽

2019 ◽

Vol 15 ◽

pp. 174550651987118 ◽

Cited By ~ 1

Author(s):

Laura P Abell ◽

Kelly A Tanase ◽

Madison L Gilmore ◽

Anna E Winnicki ◽

Victor L Holmes ◽

...

Keyword(s):

Physical Activity ◽

Confidence Interval ◽

Odds Ratio ◽

Adjusted Odds Ratio ◽

Activity Level ◽

Activity Levels ◽

Related Factors ◽

Number Of Children ◽

Physical Activity Levels ◽

At Home

Objectives: While physical activity is important for health, many women do not meet recommended levels, particularly mothers. The purpose of this study was to assess whether physical activity levels differ by number of children at home in women aged 25–44 in the general US population. Methods: This cross-sectional analysis used 2017 Behavioral Risk Factor Surveillance System data for females aged 25–44 (N = 6266) from California, Colorado, New York, Texas, and Utah. Ordered logistic regression analysis assessed the relationship between physical activity levels and number of children at home while controlling for state and demographic, socioeconomic, and health-related factors. Results: About half of participants reported “inactive” or “insufficiently active” physical activity levels and about two-thirds reported having one or more children at home. The results of adjusted analysis indicated that physical activity level was significantly related to having one child (adjusted odds ratio = 0.75, 95% confidence interval = 0.63, 0.89), two children (adjusted odds ratio = 0.79; 95% confidence interval = 0.67, 0.93), and three or more children (adjusted odds ratio = 0.80, 95% confidence interval = 0.67, 0.94) at home. Conclusion: Overall, physical activity levels were significantly related to presence of children at home for women aged 25–44, but increasing number of children at home did not impact effect size. For women aged 25–44 in a primary care setting, a moderate prevalence of inactive or insufficiently active physical activity may be expected. Providers should address physical activity with all patients in this target population during well-visits, but particularly for women with children at home; educate patients about the health benefits of regular physical activity; and provide resources that will help them integrate physical activity into their daily lifestyles.

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