Behavioural interventions targeting physical activity improve psychocognitive outcomes in COPD

This study explored the impact of a self-management behaviour modification (SMBM) programme with/without bronchodilators and with/without exercise training (ExT) to improve daily physical activity on psychological and cognitive outcomes in COPD patients as a secondary analysis of the PHYSACTO trial.A 12-week, four-group, randomised, partially double-blind, placebo-controlled, parallel-group trial of SMBM in addition to tiotropium 5 µg, tiotropium/olodaterol 5/5 µg, tiotropium/olodaterol 5/5 µg plus ExT, or placebo was conducted in 304 patients. Outcomes included anxiety (Hospital Anxiety and Depression Scale (HADS)-A), depression (HADS-D and Patient-Health Questionnaire (PHQ)-9) and cognitive function (Montreal Cognitive Assessment (MoCA)).All outcomes showed statistically and clinically significant improvements after 12 weeks independent of treatment group. However, greater improvements in HADS-A and MoCA were seen in patients who exhibited greater increases in physical activity and exercise capacity, respectively, whereas greater improvements in HADS-D and PHQ-9 were seen in patients who exhibited increases in either physical activity or exercise capacity.The results indicate that SMBM with/without bronchodilators or ExT was associated with improved psychological and cognitive functioning. Anxiety reduced with increased physical activity, cognitive function improved with increased exercise capacity, and depression reduced with increases in either physical activity or exercise capacity. Interventions that increase daily physical activity or exercise capacity may improve psychological and cognitive outcomes in COPD.

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Pain in Veterans with COPD: relationship with physical activity and exercise capacity

BMC Pulmonary Medicine ◽

10.1186/s12890-021-01601-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Rebecca A. Raphaely ◽

Maria A. Mongiardo ◽

Rebekah L. Goldstein ◽

Stephanie A. Robinson ◽

Emily S. Wan ◽

...

Keyword(s):

Physical Activity ◽

Exercise Capacity ◽

Bodily Pain ◽

Secondary Analysis ◽

Chronic Obstructive ◽

Daily Step ◽

Step Counts ◽

Pain Scores ◽

6Mwt Distance ◽

The Impact

Abstract Background Pain is a common but underappreciated symptom experienced by people with Chronic Obstructive Pulmonary Disease (COPD). The relationships between pain and physical activity (PA) and exercise capacity are poorly understood. Methods This retrospective secondary analysis includes three cohorts of Veterans with COPD who participated in longitudinal studies evaluating PA and exercise capacity with objective measures of daily step counts and 6-min walk test (6MWT) distance, respectively. Pain was assessed using the bodily pain domain of the Veterans RAND-36. In two cohorts, participants were randomly assigned to a web-based, pedometer-mediated PA intervention which has previously been demonstrated to improve PA. Results Three-hundred and seventy-three (373) unique study participants were included in this analysis. Eighty-three percent (n = 311) of the population reported at least mild pain and/or at least a little bit of interference due to pain at baseline. Cross-sectionally, greater bodily pain was associated with lower 6MWT distance (β = 0.51; 95% CI 0.20, 0.82; p = 0.0013). Longitudinally, worsening bodily pain was associated with a decline in 6MWT distance (β = 0.30; 95% CI 0.03, 0.58; p = 0.0312). There was no association between baseline bodily pain and baseline daily step counts, baseline bodily pain and change in PA, or change in bodily pain and change in PA. Compared to usual care, our PA intervention improved bodily pain scores (β = 6.17; 95% CI 1.84, 10.45; p = 0.0054). Bodily pain scores did not affect the impact of the intervention on daily step counts. Conclusion Pain is highly prevalent and significantly associated with lower exercise capacity among Veterans with COPD. Worsening pain co-occurred with decline in exercise capacity but not PA. Our intervention reduced pain, although pain did not affect the impact of the intervention on PA.

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Pain in Veterans with COPD: Relationship with Physical Activity and Exercise Capacity

10.21203/rs.3.rs-380820/v1 ◽

2021 ◽

Author(s):

Rebecca Raphaely ◽

Maria Mongiardo ◽

Rebekah L. Goldstein ◽

Stephanie A. Robinson ◽

Emily S. Wan ◽

...

Keyword(s):

Physical Activity ◽

Exercise Capacity ◽

Bodily Pain ◽

Secondary Analysis ◽

Chronic Obstructive ◽

Daily Step ◽

Obstructive Pulmonary Disease ◽

Step Counts ◽

6Mwt Distance ◽

The Impact

Abstract Background: Pain is a common but underappreciated symptom experienced by people with Chronic Obstructive Pulmonary Disease (COPD). The relationships between pain and physical activity (PA) and exercise capacity are poorly understood. Methods: This retrospective secondary analysis included three cohorts of Veterans with COPD and objective measures of PA (daily step counts) and exercise capacity (6-minute walk test [6MWT] distance) who participated in longitudinal studies evaluating PA. Pain was assessed using the Bodily Pain (BP) domain of the Veterans RAND-36. In two cohorts, participants were randomly assigned to a web-based, pedometer-mediated PA intervention which has previously been demonstrated to improve PA. Results: Three-hundred and seventy-three (373) unique study participants were included in this analysis. Eighty-three percent (n=311) of the population reported at least mild pain and/or at least a little bit of interference due to pain at baseline. Cross-sectionally, greater BP was associated with lower 6MWT distance (β=0.51; 95% CI 0.20, 0.82; p=0.0013). Longitudinally, worsening BP was associated with a decline in 6MWT distance (β=0.30; 95% CI 0.03, 0.58; p=0.0312). There was no association between baseline BP and baseline daily step counts, baseline BP and change in PA, or change in BP and change in PA. Compared to usual care, our PA intervention improved BP scores (β=6.17; 95% CI 1.84, 10.45; p=0.0054). BP scores did not affect the impact of the intervention on daily step counts.Conclusion: Pain is highly prevalent and significantly associated with lower exercise capacity among Veterans with COPD. Worsening pain co-occurred with decline in exercise capacity but not PA. Our intervention reduced pain, although pain did not affect the impact of the intervention on PA.

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Influence of Physical Activity and Socio-Economic Status on Depression and Anxiety Symptoms in Patients after Stroke

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18158058 ◽

2021 ◽

Vol 18 (15) ◽

pp. 8058

Author(s):

Małgorzata Paprocka-Borowicz ◽

Mona Wiatr ◽

Maria Ciałowicz ◽

Wojciech Borowicz ◽

Agnieszka Kaczmarek ◽

...

Keyword(s):

Physical Activity ◽

Physical Therapy ◽

Economic Status ◽

Depression Scale ◽

Post Stroke ◽

Positive Effects ◽

Socio Economic Status ◽

Treatment Of Depression ◽

Post Stroke Depression ◽

The Impact

Stroke is a high-risk factor for depression. Neurological rehabilitation is greatly difficult and often does not include treatment of depression. The post-stroke depression plays an important role in the progress of treatment, health, and the life of the patient. The appropriate treatment of depression could improve the quality of life of the patient and their family. The study aimed to evaluate the impact of physical activity and socio-economic status of the patient on the effectiveness of recovery from depression and the severity of the symptoms of depression. The study was conducted with 40 patients after stroke aged 42–82 years, and included 10 women and 30 men who were hospitalized for two weeks. The severity of depression/anxiety (D/A) symptoms were evaluated two times; at admission and after two weeks of physical therapy. The hospital anxiety and depression scale (HADS) questionnaire was used for this purpose. Socio-economic status was evaluated by several simple questions. It was revealed that physical therapy has a positive influence on mental state. The severity of D/A symptoms after stroke is related to the financial status of the patients (2 = 11.198, p = 0.024). The state of health (2 = 20.57, p = 0.022) and physical fitness (2 = 12.95, p = 0.044) changed the severity of symptoms of anxiety and depressive disorders. The kinesiotherapy in the group of patients with post-stroke depression had positive effects; however, economic and health conditions may influence the prognosis of the disease.

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FRI0300 ARE COPING STRATEGIES, ANXIETY AND DEPRESSION ASSOCIATED WITH DAILY PHYSICAL ACTIVITY IN PATIENTS WITH AXIAL SPONDYLOARTHRITIS?

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.2724 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 739-739

Author(s):

M. Carbo ◽

L. Overbeeke ◽

S. Arends ◽

Y. Kamsma ◽

F. Wink ◽

...

Keyword(s):

Physical Activity ◽

Coping Strategies ◽

Coping Strategy ◽

Axial Spondyloarthritis ◽

Depression Scale ◽

Daily Physical Activity ◽

Anxiety And Depression ◽

Research Support ◽

Related Factors

Background:Patients with axial spondyloarthritis (axSpA) who are more physically active experience less pain and better physical functioning.1Psychological factors such as anxiety and depression are associated with physical functioning and reduction of Quality of Life (QoL).2Furthermore, evasive coping strategies are commonly used in health-related coping.3However, as far as we know, no data is available regarding the influence of coping strategies, anxiety and depression on daily physical activity in axSpA.Objectives:To determine if coping strategies, anxiety and depression are associated with daily physical activity in patients with axSpA.Methods:Consecutive outpatients from the Groningen Leeuwarden AxSpA cohort (GLAS) participated in this study. Additionally to the standardized follow-up assessments, patients filled out the axSpA-Short Questionnaire to assess health-enhancing physical activity (axSpA-SQUASH), the Coping with Rheumatic Stressors (CORS) and the Hospital Anxiety and Depression Scale (HADS). Univariable and multivariable linear regression analyses were performed to explore associations of copings strategies, anxiety and depression, and patient- and disease related factors with daily physical activity. Additionally, patients were stratified into three tertiles of physical activity: low, intermediate and high. To identify group differences, Kruskal-Wallis test or Chi-Square test were used with post-hoc testing.Results:In total 85 patients were included; 59% were male, mean age was 49±14, median symptom duration 19.5 years (IQR 12.0-31.0), 71% were HLA-B27 positive and mean ASDAS was 2.1±1.0. Median axSpA-SQUASH total physical activity score was 9406.3 (IQR 5538.8–12081.3). Median scores of HADS-Anxiety (scale 7-28) and HADS-Depression (scale 7-28) were scores of 12 (IQR 10.0-14.0) and 10(IQR 9.0-12.5). The mostly frequently used coping strategie was comforting cognitions (for pain, range 9-36); median of 25.5 (IQR 22.0-28.0).Univariable analysis showed that lower daily physical activity was significantly associated with gender (female), higher disease activity (BASDAI), worse physical function (BASFI), worse quality of life (ASQoL), coping strategies ‘decreasing activities’ and ‘pacing’, higher depression score (HADS) and higher perceived influence of axSpA on general well-being. In multivariable analysis, only the coping strategy “decreasing activity” was independently associated with physical activity (β: -419.3, R2: 0.155, P<0.001). Additionally, patients in the highest physical activity tertile were significantly more often male, had higher working status, lower BASDAI and ASDAS, better BASFI and ASQoL and scored lower on the coping strategy “decreasing activities”.Conclusion:In this cross-sectional study in axSpA patients with established disease, multiple patient and disease related factors were associated with daily physical activity. The evasive coping strategy ‘decreasing activities’ was the only independently associated factor. These findings suggest that to improve daily physical activity in axSpA patients attention should be paid not only on targeting disease activity, but also to other patient and disease related aspects, especially coping strategies used.References:[1]Regel A et al.RMD Open. 2017;3(1):e000397.[2]Kilic G et al.Med (United States). 2014;93(29):e337.[3]Peláez-Ballestas I et al.Med (United States). 2015;94(10):e600.Acknowledgments:The authors would like to thank all patients who participated in the GLAS cohort.Disclosure of Interests:Marlies Carbo: None declared, Laura Overbeeke: None declared, Suzanne Arends Grant/research support from: Grant/research support from Pfizer, Yvo Kamsma: None declared, Freke Wink Consultant of: Abbvie, Janssen, Davy Paap: None declared, Anneke Spoorenberg: None declared

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Abstract P176: Moderate Physical Activity and Sleep Duration as Predictors of Cognitive Function in Older Adults With Hypertension: NHANES 2011-2014

Circulation ◽

10.1161/circ.137.suppl_1.p176 ◽

2018 ◽

Vol 137 (suppl_1) ◽

Author(s):

Nicole Hoffmann ◽

Megan E Petrov

Keyword(s):

Physical Activity ◽

Cognitive Function ◽

Sleep Duration ◽

Cognitive Outcomes ◽

Moderate Physical Activity ◽

Digit Symbol Substitution Test ◽

Lifestyle Behaviors ◽

Hypertension Status ◽

Increased Risk ◽

Symbol Substitution

Introduction: Hypertension is associated with increased risk for cognitive decline. Lifestyle behaviors such as moderate physical activity (MPA) and adequate sleep duration may mitigate this decline, though limited research exists. The aim of the study was to examine the joint association of MPA and sleep duration on cognitive function by hypertension status. Methods: Adults (n=2976, ≥60yrs) from the 2011-2014 National Health and Nutrition Examination Survey (NHANES) were assessed for their habitual sleep duration (<7, 7-8.9, ≥9hr) , self-reported participation in regular MPA (yes/no), reported physician-diagnosed hypertension (yes/no), and cognitive function (Digit Symbol Substitution Test [DSST]; Animal Fluency test). Weighted linear regression analyses were conducted to assess joint association of sleep duration and MPA on cognitive function, and test the modifying effect of hypertension status (alpha level set at 0.1) after adjustment for demographics. Results: See Table. There were significant main effects for combined MPA and sleep duration on DSST (Wald F (5,28)=5.33, p =.001) and Animal Fluency (Wald F (5,28)=2.58, p =.05). Participants who did not engage in MPA regardless of sleep duration had significantly worse cognitive function compared to participants who engaged in MPA and obtained 7-8.9hr sleep. There was a significant interaction between MPA-sleep duration groups and hypertension status on DSST (Wald F (5,28)=2.42, p =.06), but not on Animal Fluency. Stratified analyses indicated among individuals with hypertension the buffering effect of MPA regardless of sleep duration was maintained, but not for individuals without hypertension. Conclusions: In a sample of adults, regular MPA predicted better cognitive outcomes regardless of sleep duration. Among individuals with hypertension regular MPA regardless of sleep duration was significantly associated with better executive function, but no such association was found among individuals without hypertension.

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451 THE BEST MARKER FOR COGNITION—RELATIVE HANDGRIP STRENGTH, ASYMMETRY OR WEAKNESS?

Age and Ageing ◽

10.1093/ageing/afab118.02 ◽

2021 ◽

Vol 50 (Supplement_2) ◽

pp. ii5-ii7

Author(s):

V Ho ◽

C Chen ◽

R A Merchant

Keyword(s):

Physical Activity ◽

Cognitive Function ◽

Cognitive Decline ◽

Handgrip Strength ◽

Demographic Characteristics ◽

Hand Dominance ◽

Perceived Health Status ◽

Cognitive Limitations ◽

Strength Asymmetry ◽

The Impact

Abstract Introduction Handgrip strength (HGS) is increasingly used to estimate overall muscle strength. Association between low HGS and cognitive decline has been well documented. Recently, McGrath’s team elucidated a new dimension of HGS asymmetry with important implications on physical and cognitive limitations. It is unclear if these effects can be generalised. The Asian working group for sarcopenia (AWGS) has called for ‘special considerations’ due to ‘anthropometric and cultural or lifestyle-related differences’6. Hence, we aim to investigate if HGS asymmetry is associated with cognition in Asians. Methodology We defined sarcopenia by AWGS consensus: HGS <28 kg for men; <18 kg for women. Asymmetry was HGS >10% stronger on either hand; relative HGS was HGS adjusted for BMI. Low cognitive function was defined as MMSE<26. We compared weakness alone, any HGS asymmetry or relative HGS alone and combination of weakness and HGS asymmetry or relative HGS asymmetry. Each model was adjusted for demographic characteristics, hand dominance, obesity, frailty, physical activity, depression and perceived health status. Results 738 Asian subjects participated. Mean age 70.8 ± 0.2 years, 45.1% males, 82.5% Chinese. More than 50% have multimorbidity. 5.4% were frail. Mean BMI 24.4 ± 0.1 kg/m2. Mean HGS 22.6 ± 0.3. 93 (12.7%) had symmetrical HGS and not weak, 59 (7.8%) asymmetrical and not weak, 321 (43.6%) symmetrical and weak, 265 (35.9%) asymmetrical and weak. Mean MMSE scores for weakness alone, asymmetry alone and combined weakness and asymmetry are 26.6 ± 0.1, 26.8 ± 0.2 and 26.5 ± 0.2 respectively. HGS asymmetry alone was not associated with better cognitive function OR 0.66 (95%CI: 0.30–1.44). Combined asymmetry and weakness was non-significantly linked to worse cognition OR 2.14 (95%CI: 0.79–5.82). We found relative HGS to be protective for cognitive decline, OR 0.31 (95%CI: 0.12–0.78, p = 0.012). Conclusion Our study highlights the impact of ethnicity in sarcopenia research. Our population shows association of relative HGS with cognition. Further longitudinal studies are needed.

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