Minakata Yoshiaki, Sasaki Seigo
Department of Respiratory Medicine, National Hospital Organization Wakayama Hospital, Wakayama 644-0044, Japan.
J Clin Med. 2020 Oct 29;9(11):3497. doi: 10.3390/jcm9113497.
Increasing physical activity (PA) in patients with chronic obstructive pulmonary disease (COPD) is an important issue, however, the effect of bronchodilators on PA is still controversial. The indicators of PA, as measured by an accelerometer, can easily fluctuate based on several factors, which might cause inconsistent results. In this review, we listed the indicators of PA and the factors influencing the reproducibility of indicators of PA, and reviewed reports in which the effects of bronchodilators on PA were evaluated by an accelerometer. Then, we investigated the association between the processing of influencing factors and the effectiveness of bronchodilators for improving the PA of COPD patients. Fifteen reports were extracted using the PubMed database. In all seven reports in which adjustment was performed for at least two of four influencing factors (non-wear time, data from days with special behavior, environmental factors, and number of valid days required to obtain reproducible data), bronchodilators showed beneficial effects on PA. No adjustment was made for any of these factors in any of the four bronchodilator-ineffective reports. This suggests that the processing of influencing factors to secure reproducibility might affect the results regarding the effectiveness of bronchodilators for improving PA in COPD patients.
增加慢性阻塞性肺疾病（COPD）患者的体力活动（PA）是一个重要问题，然而，支气管扩张剂对PA的影响仍存在争议。通过加速度计测量的PA指标，可能会因多种因素而容易波动，这可能导致结果不一致。在本综述中，我们列出了PA指标以及影响PA指标可重复性的因素，并回顾了通过加速度计评估支气管扩张剂对PA影响的报告。然后，我们研究了影响因素的处理与支气管扩张剂改善COPD患者PA有效性之间的关联。使用PubMed数据库提取了15篇报告。在所有七篇对四个影响因素（非佩戴时间、特殊行为日的数据、环境因素以及获得可重复数据所需的有效天数）中的至少两个进行了调整的报告中，支气管扩张剂对PA显示出有益效果。在四篇支气管扩张剂无效的报告中，对这些因素均未进行任何调整。这表明为确保可重复性而对影响因素进行的处理可能会影响关于支气管扩张剂改善COPD患者PA有效性的结果。
