Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho, São Paulo, Brazil.
Pulmonary Division, Heart Institute, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Brazil.
Respir Care. 2018 Dec;63(12):1498-1505. doi: 10.4187/respcare.05771. Epub 2018 Sep 25.
Bronchiectasis leads to reduced functional capacity, which might have implications for physical activity. The impact of dyspnea and long-term oxygen therapy on physical activity has never been investigated in subjects with bronchiectasis. Based on these findings, specific strategies could be applied to allow individuals to be more active in their daily life. In this study we aimed to evaluate physical activity, the impact of dyspnea and long-term oxygen therapy on physical activity, and the determinants of physical activity in subjects with bronchiectasis.
We performed a cross-sectional study in 139 subjects with bronchiectasis (age 45 ± 13 y, FVC 70 ± 22% of predicted, FEV 54 ± 25% of predicted) and 49 healthy subjects as controls. Physical activity was assessed using steps per day (measured with a pedometer), spirometry, incremental shuttle walking test (ISWT), and dyspnea.
Reduced physical activity was observed in subjects with bronchiectasis, who recorded a median (interquartile range) of 8,007 (5,131-10,432) steps/d compared with controls, who recorded 10,994 (8,551-14,078) steps/d ( < .001). Significant correlations were observed between physical activity and FVC (r = 0.43), FEV (r = 0.36), ISWT (r = 0.37), and dyspnea (r = -0.48). Determinants for reduced physical activity included pulmonary function (R = 0.150), dyspnea (R = 0.075), ISWT (R = 0.044), and long-term oxygen therapy (R = 0.038); these factors explained 32% of the physical activity.
Subjects with bronchiectasis exhibited reduced physical activity compared with healthy peers. Dyspnea has a negative impact on physical activity. Independent factors associated with physical activity included pulmonary function, dyspnea, functional capacity, and long-term oxygen therapy. These findings will guide strategies to enhance daily physical activity and to encourage subjects with bronchiectasis to be more active.
支气管扩张症导致功能能力下降,这可能对体力活动产生影响。呼吸困难和长期氧疗对支气管扩张症患者体力活动的影响从未被研究过。基于这些发现,可以应用特定策略,使个人在日常生活中更加活跃。本研究旨在评估支气管扩张症患者的体力活动、呼吸困难和长期氧疗对体力活动的影响,以及体力活动的决定因素。
我们对 139 名支气管扩张症患者(年龄 45 ± 13 岁,FVC 为预计值的 70 ± 22%,FEV 为预计值的 54 ± 25%)和 49 名健康对照者进行了横断面研究。使用每天的步数(用计步器测量)、肺活量测定、递增穿梭步行试验(ISWT)和呼吸困难来评估体力活动。
与记录 10,994(8,551-14,078)步/d 的健康对照组相比,支气管扩张症患者的体力活动减少,中位数(四分位距)为 8,007(5,131-10,432)步/d(<0.001)。体力活动与 FVC(r = 0.43)、FEV(r = 0.36)、ISWT(r = 0.37)和呼吸困难(r = -0.48)呈显著相关性。体力活动减少的决定因素包括肺功能(R = 0.150)、呼吸困难(R = 0.075)、ISWT(R = 0.044)和长期氧疗(R = 0.038);这些因素解释了 32%的体力活动。
与健康同龄人相比,支气管扩张症患者的体力活动减少。呼吸困难对体力活动有负面影响。与体力活动相关的独立因素包括肺功能、呼吸困难、功能能力和长期氧疗。这些发现将指导增强日常体力活动和鼓励支气管扩张症患者更加活跃的策略。