Department of Respiratory Medicine, National Hospital Organization Wakayama Hospital, Wakayama, Japan.
Int J Chron Obstruct Pulmon Dis. 2021 Nov 9;16:3041-3053. doi: 10.2147/COPD.S336670. eCollection 2021.
To improve physical activity (PA) in patients with chronic obstructive pulmonary disease (COPD), providing a target PA value based on the individual patient's condition may be a useful interventional strategy. However, to determine the target value, a predictive PA value for each patient is required.
What is the reference equation consisting of PA-related factors to determine the predictive PA value for each patient with COPD?
In this prospective cross-sectional observational study, we measured the PA with a triaxial accelerometer and several other factors including demographic factors, pulmonary function, dyspnea, exercise capacity, muscle strength, nutrition, and indicators of several comorbidities in stable Japanese outpatients with COPD aged ≥40 years old and detected PA-related factors by a multiple regression analysis and stepwise method. We created reference equations for four indices of PA using multiple linear regression equations.
Two hundred and twenty-seven patients were registered. The equations of duration at ≥2.0 metabolic equivalents (METs) and step count consisted of 4 factors: 6-minute walk distance, modified Medical Research Council dyspnea scale, anxiety score of the Hospital Anxiety and Depression Scale, and the forced expiratory volume in 1 second % of predicted value. Those of duration at ≥3.0 METs and total activity at ≥3.0 METs consisted of 5 factors: the above 4 factors and age or brain natriuretic peptide. There was no fixed bias or proportional bias between the measured and predictive values in patients with non-high measured PA values.
We determined reference equations for four indicators of PA using PA-related factors in Japanese patients with COPD. The predictive values calculated using the equations could be useful for deciding target PA values for each patient.
UMIN-CTR; No.: UMIN000025459; URL: https://www.umin.ac.jp/ctr/index.htm.
为提高慢性阻塞性肺疾病（COPD）患者的体力活动（PA）水平，提供基于患者个体状况的目标 PA 值可能是一种有用的干预策略。然而，为了确定目标值，需要为每个患者预测 PA 值。
包含 PA 相关因素的参考方程是什么，可用于确定每个 COPD 患者的预测 PA 值？
在这项前瞻性的横断面观察性研究中，我们使用三轴加速度计测量 PA，并测量了其他一些因素，包括人口统计学因素、肺功能、呼吸困难、运动能力、肌肉力量、营养状况以及几种合并症的指标，研究对象为年龄≥40 岁的稳定期日本 COPD 门诊患者。我们通过多元回归分析和逐步法来检测 PA 相关因素。我们使用多元线性回归方程为 4 项 PA 指标创建参考方程。
共登记了 227 名患者。持续时间≥2.0 代谢当量（METs）和步数的方程由 4 个因素组成：6 分钟步行距离、改良医学研究理事会呼吸困难量表、医院焦虑和抑郁量表的焦虑评分和预测值的 1 秒用力呼气量百分比。持续时间≥3.0 METs 和总活动≥3.0 METs 的方程由 5 个因素组成：上述 4 个因素以及年龄或脑利钠肽。在非高测量 PA 值的患者中，测量值和预测值之间没有固定偏差或比例偏差。
我们使用日本 COPD 患者的 PA 相关因素确定了 4 项 PA 指标的参考方程。使用这些方程计算的预测值可用于为每个患者确定目标 PA 值。
UMIN-CTR；编号：UMIN000025459；网址：https://www.umin.ac.jp/ctr/index.htm。
