Department of Clinical Physiology, University Montpellier I, Montpellier, France.
Arch Phys Med Rehabil. 2011 Oct;92(10):1611-1617.e2. doi: 10.1016/j.apmr.2011.05.012. Epub 2011 Sep 8.
To compare the lifetime pattern of physical activity (PA) in chronic obstructive pulmonary disease (COPD) patients and sedentary healthy subjects (SHS) using a PA questionnaire with a lifetime period of recall (Quantification de l'Activité Physique [QUANTAP] system), and to compare the pattern of PA reduction in COPD patients with the onset of breathlessness and other relevant clinical events in this disease (diagnosis, first rehabilitation, onset of smoking).
Cross-sectional comparative study.
Outpatient university hospital and inpatient pulmonary rehabilitation center.
COPD patients (n=129; mean age ± SD, 61±10y; forced expiratory volume in 1s, 57±23%) and SHS (n=29; mean age ± SD, 61±5y; <150min·wk(-1) of moderate-vigorous PA).
Not applicable.
Lifetime PA was compared in COPD patients and SHS using the QUANTAP system. The patients with COPD and SHS underwent pulmonary function, exercise, and quadriceps endurance testing. The current PA level was assessed with a triaxial accelerometer and the Voorrips questionnaire. The age at the onset of breathlessness was also recorded.
Accelerometry showed no significant difference between patients and SHS (in vector magnitude units, 136±56 vs 135±47; P=.95). Within the past 15 years, the cumulated PA level was not different for each 5-year period. Then, from the period of 16 to 40 years ago, it was systematically higher in patients compared with SHS (in metabolic equivalent/y(-1); median [interquartile range], 6973 [5400-12,207] vs 4248 [3545-5919]; P<.05). The COPD patients reduced their PA earlier than the SHS (45y vs 55y; P<.01), and the PA was dropped before the onset of breathlessness (45y vs 49y; P<.001).
The observation of an early PA reduction, preceding the onset of breathlessness, suggests the implication of prior pathologic mechanisms in the PA reduction of COPD patients.
使用具有终生回忆期的体力活动（PA）问卷（Quantification de l'Activité Physique [QUANTAP] 系统）比较慢性阻塞性肺疾病（COPD）患者和久坐的健康受试者（SHS）的终生 PA 模式，并比较 COPD 患者的 PA 减少模式与该疾病的呼吸困难发作和其他相关临床事件（诊断、首次康复、吸烟开始）的关系。
横断面比较研究。
大学门诊医院和住院肺康复中心。
COPD 患者（n=129；平均年龄±标准差，61±10 岁；1 秒用力呼气量，57±23%）和 SHS（n=29；平均年龄±标准差，61±5 岁；<150 分钟·周（-1）的中-剧烈 PA）。
不适用。
使用 QUANTAP 系统比较 COPD 患者和 SHS 的终生 PA。COPD 患者和 SHS 接受肺功能、运动和股四头肌耐力测试。目前的 PA 水平通过三轴加速度计和 Voorrips 问卷进行评估。还记录了呼吸困难发作的年龄。
加速度计未显示患者和 SHS 之间存在显著差异（在矢量幅度单位中，136±56 与 135±47；P=0.95）。在过去的 15 年中，每个 5 年期间的累积 PA 水平没有差异。然后，从 16 到 40 年前，患者的 PA 水平系统地高于 SHS（以代谢当量/年（-1）计；中位数[四分位数范围]，6973[5400-12207]与 4248[3545-5919]；P<.05）。COPD 患者比 SHS 更早地减少了他们的 PA（45 岁比 55 岁；P<.01），并且 PA 在呼吸困难发作之前就下降了（45 岁比 49 岁；P<.001）。
观察到 PA 减少发生在呼吸困难发作之前，这表明先前的病理机制在 COPD 患者 PA 减少中起作用。
