ISGlobal, Barcelona, SPAIN.
Universitat Pompeu Fabra (UPF), Barcelona, SPAIN.
Med Sci Sports Exerc. 2019 May;51(5):833-840. doi: 10.1249/MSS.0000000000001859.
Chronic obstructive pulmonary disease (COPD) progression is variable and affects several disease domains, including decline in lung function, exercise capacity, muscle strength, and health status as well as changes in body composition. We aimed to assess the longitudinal association of physical activity (PA) with these a priori selected components of disease progression.
We studied 114 COPD patients from the PAC-COPD cohort (94% male, mean [SD], 70 yr [8 yr] of age, 54 [16] forced expiratory volume in 1 s % predicted) at baseline and 2.6 yr (0.6 yr) later. Baseline PA was assessed by accelerometry. Multivariable general linear models were built to assess the association between PA and changes in lung function, functional exercise capacity, muscle strength, health status, and body composition. All models were adjusted for confounders and the respective baseline value of each measure.
Per each 1000 steps higher baseline PA, forced expiratory volume in 1 s declined 7 mL less (P < 0.01), forced vital capacity 9 mL less (P = 0.03) and carbon monoxide diffusing capacity 0.10 mL·min·mm Hg less (P = 0.04), while the St George's Respiratory Questionnaire symptom domain deteriorated 0.4 points less (P = 0.03), per year follow-up. Physical activity was not associated with changes in functional exercise capacity, muscle strength, other domains of health status or body composition.
Higher PA is associated with attenuated decline in lung function and reduced health status (symptoms domain) deterioration in moderate-to-very severe COPD patients.
慢性阻塞性肺疾病（COPD）的进展是多变的，影响多个疾病领域，包括肺功能下降、运动能力、肌肉力量和健康状况，以及身体成分的变化。我们旨在评估体力活动（PA）与这些预先选定的疾病进展组成部分的纵向关联。
我们研究了 PAC-COPD 队列中的 114 名 COPD 患者（94%为男性，平均[标准差]年龄为 70 岁[8 岁]，54[16]预计 1 秒用力呼气量），基线和 2.6 年（0.6 年）后。基线 PA 通过加速度计进行评估。建立多变量一般线性模型，以评估 PA 与肺功能、功能运动能力、肌肉力量、健康状况和身体成分变化之间的关系。所有模型均经过混杂因素和每个测量值的基线值的调整。
与基线 PA 每增加 1000 步相比，用力呼气量第 1 秒下降更少 7 毫升（P < 0.01），用力肺活量少 9 毫升（P = 0.03），一氧化碳弥散量少 0.10 毫升·分钟·毫米汞柱（P = 0.04），而乔治呼吸问卷症状域恶化每年减少 0.4 分（P = 0.03）。PA 与功能运动能力、肌肉力量、健康状况的其他领域或身体成分的变化无关。
在中重度 COPD 患者中，较高的 PA 与肺功能下降和健康状况恶化（症状域）的减少有关。
