School of Healthcare Sciences, University Hospital of Wales, Cardiff University, Cardiff, UK.
Rehabilitation Sciences Department, College of Applied Medical Sciences, King Saud University, P.O Box 10219, Riyadh, 11433, Kingdom of Saudi Arabia.
BMC Pulm Med. 2020 Mar 5;20(1):60. doi: 10.1186/s12890-020-1097-y.
Factors associated with reduced daily physical activity (DPA) in patients with COPD are still controversial. Physical inactivity in COPD increases risk of cardiovascular disease, frequent exacerbations, reduced health status, and increased symptoms. We hypothesised that reduced DPA in patients with COPD is independent of traditional risk factors including age and spirometry.
In this cross-sectional study, DPA (over 7 days) was assessed on 88 community stable patients with COPD and 40 controls free from cardiorespiratory disease. Spirometry, body composition, number of exacerbations, handgrip strength (HGS), modified Medical Research Council (mMRC), arterial stiffness, 6-min walking distance (6MWD) and BODE index were also determined. Frequent exacerbation was defined as ≥2 and non-frequent exacerbation < 2.
Patients with COPD had reduced DPA and exercise capacity compared with controls similar in age, BMI and gender, p < 0.001. Frequent exacerbators had less DPA than infrequent exacerbators and both less than controls, p < 0.001. Patients with higher BODE index were less active than those with lower index. Time spent on moderate activity was related to cardiovascular risk factors including arterial stiffness. The DPA in patients was independent of age, gender, spirometry, body composition and HGS, p > 0.05. The level of breathlessness was superior to lung function in predicting the level of DPA.
The level of DPA in COPD was independent of traditional risk factors. Breathlessness score is a better predictor of the DPA than lung function and handgrip strength.
与 COPD 患者日常体力活动(DPA)减少相关的因素仍存在争议。COPD 患者体力活动减少会增加心血管疾病、频繁加重、健康状况下降和症状加重的风险。我们假设 COPD 患者的 DPA 减少与包括年龄和肺功能在内的传统危险因素无关。
在这项横断面研究中,对 88 例社区稳定期 COPD 患者和 40 例无心肺疾病的对照者进行了 7 天的 DPA 评估。还测定了肺功能、身体成分、加重次数、握力(HGS)、改良的医学研究委员会(mMRC)呼吸困难量表、动脉僵硬度、6 分钟步行距离(6MWD)和 BODE 指数。频繁加重定义为≥2 次,非频繁加重<2 次。
与年龄、BMI 和性别相似的对照组相比,COPD 患者的 DPA 和运动能力均降低,p<0.001。频繁加重者的 DPA 低于非频繁加重者和对照组,p<0.001。BODE 指数较高的患者比指数较低的患者活动量更少。中等强度活动的时间与包括动脉僵硬度在内的心血管危险因素有关。患者的 DPA 独立于年龄、性别、肺功能、身体成分和握力,p>0.05。呼吸困难评分在预测 DPA 水平方面优于肺功能和握力。
COPD 患者的 DPA 水平独立于传统危险因素。呼吸困难评分是预测 DPA 水平的更好指标,优于肺功能和握力。