Faculty of Kinesiology and Rehabilitation Sciences, Department of Rehabilitation Sciences, KU Leuven, , Leuven, Belgium.
Thorax. 2013 Oct;68(10):962-3. doi: 10.1136/thoraxjnl-2013-203534. Epub 2013 Apr 20.
Information about daily physical activity levels (PAL) in subjects with undiagnosed chronic obstructive pulmonary disease (COPD) is scarce. This study aims to assess PA and to investigate the associations between PA and clinical characteristics in subjects with newly diagnosed COPD.
Fifty-nine subjects with a new spirometry-based diagnosis of mild (n=38) and moderate (n=21) COPD (63±6 years, 68% male) were matched with 65 smoking controls (62±7 years, 75% male). PA (daily steps, time spent in moderate-to-vigorous intense physical activities (MVPA) and PAL) was measured by accelerometry. Dyspnoea, complete pulmonary function tests, peripheral muscle strength and exercise capacity served as clinical characteristics.
PA was significantly lower in COPD versus smoking controls (7986±2648 vs 9765±3078 steps, 64 (27-120) vs 110 (55-164) min of MVPA, 1.49±0.21 vs 1.62±0.24 PAL respectively, all p<0.05). Subjects with COPD with either mild symptoms of dyspnoea (mMRC 1), those with lower diffusion capacity (T(L),co), low 6 min walking distance (6MWD) or low maximal oxygen uptake (VO(2) peak) had significantly lower PA. Multiple regression analysis identified 6 MWD and T(L),co as independent predictors of PA in COPD.
The reduction in PA starts early in the disease, even when subjects are not yet diagnosed with COPD. Inactivity is more pronounced in subjects with mild symptoms of dyspnoea, lower levels of diffusion capacity and exercise capacity.
关于未经诊断的慢性阻塞性肺疾病(COPD)患者的日常体力活动水平(PAL)的信息很少。本研究旨在评估 PA,并研究 PA 与新诊断的 COPD 患者的临床特征之间的关系。
59 名新诊断为轻度(n=38)和中度(n=21)COPD(63±6 岁,68%男性)的患者根据肺量计进行诊断,与 65 名吸烟对照者(62±7 岁,75%男性)相匹配。通过加速度计测量 PA(每日步数、中高强度体力活动(MVPA)时间和 PAL)。呼吸困难、完整的肺功能测试、周围肌肉力量和运动能力作为临床特征。
COPD 患者的 PA 明显低于吸烟对照组(7986±2648 与 9765±3078 步,64(27-120)与 110(55-164)min MVPA,1.49±0.21 与 1.62±0.24 PAL,均 p<0.05)。呼吸困难症状较轻的 COPD 患者(mMRC 1)、弥散能力(T(L),CO)较低、6 分钟步行距离(6MWD)较短或最大摄氧量(VO(2)峰值)较低的患者,PA 明显较低。多元回归分析确定 6MWD 和 T(L),CO 是 COPD 患者 PA 的独立预测因子。
PA 的减少在疾病早期就开始了,即使患者尚未被诊断为 COPD。呼吸困难症状较轻、弥散能力和运动能力较低的患者,活动量减少更为明显。