scholarly journals Increasing physical activity in people with COPD

2020 ◽  
Vol 31 (11) ◽  
pp. 461-466
Author(s):  
Matthew Armstrong
Keyword(s):  
Physical Activity ◽  
Pulmonary Rehabilitation ◽  
Physical Inactivity ◽  
Interdisciplinary Approach ◽  
Complex Nature ◽  
Chronic Obstructive ◽  
Activity Levels ◽  
Obstructive Pulmonary Disease ◽  
Behavioural Interventions ◽  
Extra Pulmonary

Levels of physical activity tend to be reduced in people with COPD. Matthew Armstrong discusses the benefits of improving activity levels in this group of patients It is well acknowledged that levels of physical activity in patients with chronic obstructive pulmonary disease (COPD) are considerably lower than healthy-age matched individuals, with physical inactivity recognised as a key predictor of hospitalisation and mortality. Pulmonary rehabilitation (PR) has become a major tool for managing symptoms of COPD and the associated extra-pulmonary effects. However, inconsistencies surrounding its effectiveness in terms of improving physical activity remain due to the complex nature of physical activity. To overcome these inconsistencies, both pharmacological and behavioural interventions have been documented to aid improvements in physical activity, with behavioural interventions alongside PR found to be the most effective tool to promote levels of physical activity. Health professionals must therefore look to incorporate an interdisciplinary approach in order to best achieve improvements in physical activity levels in patients with COPD.

scholarly journals Severe physical inactivity in chronic obstructive pulmonary disease: changes in systemic inflammation after pulmonary rehabilitation – a pilot study

2020 ◽  
Author(s):  
Mimi Thyregod ◽  
Anders Løkke ◽  
Søren T. Skou ◽  
Jacob Larsen ◽  
Uffe Bodtger
Keyword(s):  
Physical Activity ◽  
Systemic Inflammation ◽  
Pulmonary Rehabilitation ◽  
Physical Inactivity ◽  
Chronic Obstructive ◽  
Activity Levels ◽  
True Negative ◽  
Obstructive Pulmonary Disease ◽  
Negative Finding ◽  
Rehabilitation Centers

Abstract Background The purpose was to investigate whether severe physical inactivity (SPI) is associated with altered levels of common inflammatory markers as compared to higher Physical activity levels (PALs), and whether pulmonary rehabilitation would reduce the levels of systemic inflammation in SPI in patients with COPD. Methods This prospective, cohort study was conducted in four rehabilitation centers in Region Zealand, Denmark. We included patients with COPD referred for 7-12 weeks of pulmonary rehabilitation (2-hours of exercise therapy and education twice weekly). We measured b-eosinophils, p-fibrinogen, p-CRP, s-IL-6, s-CD 163, nasal lavage-IL-8, and daily physical activity, using a validated activity monitor, SenseWear®, at baseline and after rehabilitation. SPI was defined as PAL <1.4.Results In total, 31 of 57 patients were SPI at baseline, and seven (23%) of these patients improved to non-SPI after pulmonary rehabilitation. We observed no significant differences in the primary endpoint i.e. change in systemic inflammation between patients who remained SPI at both time pints vs. patients who improved PAL from SPI at baseline to non-SPI at follow-up. At baseline, SPI was associated with significantly higher p-fibrinogen levels (p=0.04) than non-SPI, but no other differences were observed between SPI and non-SPI Conclusion In a cohort of patients with COPD attending pulmonary rehabilitation, we could not demonstrate any differences or changes in systemic inflammation or PAL following rehabilitation between patients with SPI and non-SPI. This might be a true negative finding or due to a high pro-inflammatory drive in all patients regardless of SPI status or study limitations such as suboptimal levels of rehabilitation intensity and SPI cut-off level. The study was registered at ClinicalTrials.gov (NCT01700296), https://register.clinicaltrials.gov. Registered in November 2012.

scholarly journals Impact of Previous Physical Activity Levels on Symptomatology, Functionality, and Strength during an Acute Exacerbation in COPD Patients

Healthcare ◽  
2018 ◽  
Vol 6 (4) ◽  
pp. 139 ◽  
Author(s):  
Laura López-López ◽  
Irene Torres-Sánchez ◽  
Ramón Romero-Fernández ◽  
María Granados-Santiago ◽  
Janet Rodríguez-Torres ◽  
...  
Keyword(s):  
Physical Activity ◽  
Observational Study ◽  
Exercise Capacity ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Chronic Obstructive ◽  
Activity Levels ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Hospital Patients

The main objective of this study is to determine the relationship between physical activity (PA) level prior to hospitalization and the pulmonary symptomatology, functionality, exercise capacity, and strength of acute exacerbated chronic obstructive pulmonary disease (COPD) patients. In this observational study, all data were taken during the patient’s first day in hospital. Patients were divided into two groups (a PA group, and a physical inactivity (PI) group), according to the PA level evaluated by the Baecke questionnaire. Cough status was evaluated by the Leicester Cough Questionnaire (LCQ), and dyspnea was assessed using the modified Medical Research Council dyspnea scale (mMRC). Functionality was measured by the Functional Independence Measure (FIM) and the London Chest Activity of Daily Living scale (LCADL). Exercise capacity was evaluated by the two-minute step-in-place (2MSP) test, and strength assessed by dynamometry. A total of 151 patients were included in this observational study. Patients in the PI group obtained worse results compared to the PA group, and significant differences (p < 0.05) were found in all of the variables. Those COPD patients who regularly perform PA have less dyspnea and cough, as well as better functionality, exercise capacity and strength during an exacerbation, without relationship to the severity of the pathology.

scholarly journals Impact of feedback on physical activity levels of individuals with chronic obstructive pulmonary disease during pulmonary rehabilitation

2014 ◽  
Vol 11 (4) ◽  
pp. 191-198 ◽  
Author(s):  
Joana Cruz ◽  
Dina Brooks ◽  
Alda Marques
Keyword(s):  
Physical Activity ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Pulmonary Rehabilitation ◽  
Forced Expiratory Volume ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Activity Monitors ◽  
Standing Time ◽  
The Impact

This study aimed at investigating whether providing feedback on physical activity (PA) levels to patients with chronic obstructive pulmonary disease (COPD) is feasible and enhances daily PA during pulmonary rehabilitation (PR). Patients with COPD participated in a 12-week PR program. Daily PA was measured using activity monitors on weeks 1, 7, and 12, and feedback was given in the following weeks on the number of steps, time spent in sedentary, light, and moderate-to-vigorous intensity activities, and time spent standing, sitting, and lying. Compliance with PA monitoring was collected. Two focus groups were conducted to obtain patients’ perspectives on the use of activity monitors and on the feedback given. Differences in PA data were also assessed. Sixteen patients (65.63 ± 10.57 years; forced expiratory volume in one second (FEV1) 70.31 ± 22.74% predicted) completed the study. From those, only eleven participants used the activity monitors during all monitoring days. Participants identified several problems regarding the use of activity monitors and monitoring duration. Daily steps (  p = 0.026) and standing time (  p = 0.030) were improved from week 1 to week 7; however, the former declined from week 7 to week 12. Findings suggest that using feedback to improve PA during PR is feasible and results in improved daily steps and standing time on week 7. The subsequent decline suggests that additional strategies may be needed to stimulate/maintain PA improvements. Further research with more robust designs is needed to investigate the impact of feedback on patients’ daily PA.

scholarly journals A Comparison of Physical Activity Between Home-Based and Centre-Based Pulmonary Rehabilitation: A Randomised Controlled Secondary Analysis

2021 ◽  
Vol 2 ◽  
Author(s):  
Elizabeth J. Horton ◽  
Justina Ruksenaite ◽  
Katy Mitchell ◽  
Louise Sewell ◽  
Christopher Newby ◽  
...  
Keyword(s):  
Physical Activity ◽  
Pulmonary Rehabilitation ◽  
Secondary Analysis ◽  
Mean Difference ◽  
Step Count ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Physical Activity Monitoring ◽  
Home Based ◽  
Randomised Controlled

Background: Pulmonary rehabilitation (PR) is a highly effective intervention for individuals with chronic obstructive pulmonary disease (COPD). Physical activity (PA) has been shown to increase after a centre-based programme, yet it is not clear if a home-based programme can offer the same benefit. This study aimed to evaluate the effect of home-based PR compared with the centre-based PR on the PA levels post 7 weeks of PR and 6 months follow-up.Method: In this study, 51 participants with COPD, of them, 36 (71%) men completed physical activity monitoring with a SenseWear Armband, at three time points (baseline, 7 weeks, and 6 months). The participants were randomly assigned to either centre-based supervised PR (n = 25; 69 ± 6 years; FEV1 55 ± 20% predicted) or home-based PR (n = 26; 68 ± 7 years; FEV1 42 ± 19% predicted) programmes lasting 7 weeks. The home-based programme includes one hospital visit, a self-management manual, and two telephone calls. The PA was measured as step count, time in moderate PA (3–6 metabolic equivalent of tasks [METs]) in bouts of more than 10 min and sedentary time (&lt;2 METs).Results: Home-based PR increased step count significantly more than the centre-based PR after 7 weeks (mean difference 1,463 steps: 95% CI 280–2,645, p = 0.02). There was no difference in time spent in moderate PA was observed (mean difference 62 min: 95% CI −56 to 248, p = 0.24). Sedentary behaviour was also significantly different between the centre and home-based groups. The home group spent 52 min less time sedentary compared with the centre-based (CI −106 to 2, p = 0.039). However, after 6 months, the step count and time spent in moderate PA returned to baseline in both the groups.Conclusion: This study provides an important insight into the role of home-based PR which has the potential to be offered as an alternative to the centre-based PR. Understanding who may best respond from the centre or home-based PR warrants further exploration and how to maintain these initial benefits for the long-term.Trial Registry: ISRCTN: No.: ISRCTN81189044; URL: isrctn.com.

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