Driver C Noelle, Novotny Paul J, Benzo Roberto P
Graduate School of Biomedical Sciences, School of Graduate Medical Education, Mayo Clinic, Rochester, Minnesota, United States.
Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, United States.
Chronic Obstr Pulm Dis. 2022 Jan 27;9(1):34-44. doi: 10.15326/jcopdf.2021.0230.
There is a knowledge gap about how much physical activity is recommended to patients with chronic obstructive pulmonary disease (COPD). We asked, what is the average difference in sedentary time and physical activity associated with clinically meaningful differences in symptoms in a large, well-characterized cohort of patients with advanced COPD?
We conducted a cross-sectional analysis of daily activity data in 292 patients with stable COPD. Activity measure coefficients from multivariable linear models were used to predict the average difference in activity between patients with twice the minimal clinically important difference in reported symptoms.
Symptoms were assessed with the Chronic Respiratory Disease Questionnaire subdomains - dyspnea, fatigue, mastery, and emotions. Daily steps, minutes in light physical activity, and sedentary time were measured by triaxial accelerometers. Average sedentary time, light physical activity, and steps were 767.6 minutes, 177.7 minutes, and 2960 steps, respectively. Individuals with 1-point better dyspnea scores averaged 24.5 (8.4-40.5) minutes less sedentary time per day. Individuals with 1-point better dyspnea and fatigue scores averaged 21.5 (10.9-32.3) minutes or 12.5 (2.0-23.2) minutes more light physical activity per day, respectively. Individuals with 1-point better dyspnea, fatigue, mastery, and emotions scores averaged 762 (546-984), 579 (351-814), 418 (207-636), and 392 (157-634) more steps per day, respectively.
We provide guidance to clinicians counseling patients with severe COPD in activity-related goal setting on sedentary time, light physical activity, and steps associated with better symptoms.
对于慢性阻塞性肺疾病(COPD)患者推荐进行多少体力活动,目前存在知识空白。我们提出的问题是,在一个特征明确的晚期COPD患者大样本队列中,久坐时间和体力活动的平均差异与具有临床意义的症状差异有何关联?
我们对292例稳定期COPD患者的日常活动数据进行了横断面分析。多变量线性模型的活动测量系数用于预测报告症状具有两倍最小临床重要差异的患者之间活动的平均差异。
使用慢性呼吸系统疾病问卷子领域(呼吸困难、疲劳、掌控感和情绪)评估症状。通过三轴加速度计测量每日步数、轻度体力活动分钟数和久坐时间。平均久坐时间、轻度体力活动时间和步数分别为767.6分钟、177.7分钟和2960步。呼吸困难评分每改善1分的个体,平均每天久坐时间减少24.5(8.4 - 40.5)分钟。呼吸困难和疲劳评分各改善1分的个体,平均每天轻度体力活动分别增加21.5(10.9 - 32.3)分钟或12.5(2.0 - 23.2)分钟。呼吸困难、疲劳、掌控感和情绪评分各改善1分的个体,平均每天分别多走762(546 - 984)步、579(351 - 814)步、418(207 - 636)步和392(157 - 634)步。
我们为临床医生在为重度COPD患者进行与活动相关的目标设定时提供指导,内容涉及久坐时间、轻度体力活动以及与更好症状相关的步数。