Centre for Innovative Care and Health Technology (ciTechCare), School of Health Sciences (ESSLei), Polytechnic of Leiria, Leiria, Portugal.
Lab 3R - Respiratory Research and Rehabilitation Laboratory, School of Health Sciences, University of Aveiro (ESSUA), Aveiro, Portugal.
Clin Respir J. 2021 May;15(5):530-539. doi: 10.1111/crj.13333. Epub 2021 Feb 15.
Low physical activity (PA) levels are associated with poor health-related outcomes in Chronic Obstructive Pulmonary Disease (COPD). Thus, PA should be routinely assessed in clinical practice.
This study assessed the construct validity of the Brief Physical Activity Assessment Tool (BPAAT) for clinical use in COPD and explored differences in age, sex and COPD grades.
After linguistic adaptation of the tool to Portuguese, 110 patients (66.4 ± 9.6yrs, 72.7% male, FEV = 59.3 ± 25.5%predicted) completed the BPAAT and received an accelerometer. The BPAAT includes two questions assessing the weekly frequency and duration of vigorous- and moderate-intensity PA/walking, classifying individuals as insufficiently or sufficiently active. The BPAAT was correlated with accelerometry (moderate PA, MPA = 1952-5724 counts-per-min [CPM]); vigorous PA, VPA = 5725-∞CPM; moderate-to-vigorous PA, MVPA = 1952-∞CPM; daily steps), through: Spearman's correlations (ρ) for continuous data; %agreement, Kappa, sensitivity and specificity, positive and negative predictive values (PPV, NPV) for categorical data.
The BPAAT identified 73.6% patients as "insufficiently active" and 26.4% as "sufficiently active". The BPAAT was weakly to moderately correlated with accelerometry (0.394 ≤ ρ ≤ 0.435, P < 0.05), except for VPA (P = 0.440). This was also observed in age (<65/≥65yrs), COPD grades (GOLD 1-2/3-4) and in male patients (0.363 ≤ ρ ≤ 0.518, P < 0.05 except for VPA). No significant correlations were found in female patients (P > 0.05). Agreement was fair to moderate (0.36 ≤ κ ≤ 0.43; 73.6% ≤ %agreement ≤ 74.5%; 0.50 ≤ sensitivity ≤ 0.52; 0.84 ≤ specificity ≤ 0.91, 0.55 ≤ PPV ≤ 0.79, 0.72 ≤ NPV ≤ 0.82).
The BPAAT may be useful to screen patients' PA, independently of age and COPD grade, and identify male patients who are insufficiently active. Care should be taken when using this tool to assess vigorous PA or female patients.
体力活动（PA）水平低与慢性阻塞性肺疾病（COPD）的健康相关结果不佳有关。因此，在临床实践中应常规评估 PA。
本研究评估了简短体力活动评估工具（BPAAT）在 COPD 中的临床使用的结构效度，并探讨了年龄、性别和 COPD 分级的差异。
对工具进行葡萄牙语语言适应后，110 名患者（66.4±9.6 岁，72.7%为男性，FEV = 59.3±25.5%预测值）完成了 BPAAT 并佩戴了加速度计。BPAAT 包括两个问题，评估剧烈和中等强度 PA/步行的每周频率和持续时间，将个体分类为活动不足或活动充足。BPAAT 通过以下方式与加速度计相关：连续数据的 Spearman 相关系数（ρ）；分类数据的%一致性、Kappa、敏感性和特异性、阳性和阴性预测值（PPV、NPV）。
BPAAT 将 73.6%的患者识别为“活动不足”，26.4%的患者为“活动充足”。BPAAT 与加速度计呈弱到中度相关（0.394≤ρ≤0.435，P<0.05），除了 VPA（P=0.440）。这在年龄（<65/≥65 岁）、COPD 分级（GOLD 1-2/3-4）和男性患者中也观察到（0.363≤ρ≤0.518，P<0.05，除了 VPA）。在女性患者中未发现显著相关性（P>0.05）。一致性为中等到良好（0.36≤κ≤0.43；73.6%≤%一致性≤74.5%；0.50≤敏感性≤0.52；0.84≤特异性≤0.91，0.55≤PPV≤0.79，0.72≤NPV≤0.82）。
BPAAT 可用于筛查患者的 PA，独立于年龄和 COPD 分级，并识别活动不足的男性患者。在使用该工具评估剧烈 PA 或女性患者时应谨慎。
