Lung Center, Cantonal Hospital St.Gallen, St.Gallen, Switzerland.
Division of Endocrinology & Diabetes, Cantonal Hospital St.Gallen, St.Gallen, Switzerland.
Int J Chron Obstruct Pulmon Dis. 2024 Aug 27;19:1921-1929. doi: 10.2147/COPD.S469984. eCollection 2024.
Lung function constraints and comorbidities such as coronary heart disease, sarcopenia, and mood disorders make chronic obstructive pulmonary disease (COPD) patients avoid physical activity (PA). However, PA represents an important pillar of COPD management and is explicitly recommended by professional associations to enhance physical functioning and positively modulate disease progression.
In this monocentric, prospective, observational feasibility study, it was our primary objective to investigate the association between PA and the evolution of the COPD assessment test (CAT) and the occurrence of acute exacerbations of COPD (AECOPD), respectively. To this end, we equipped 42 COPD patients with an activity tracking wearable and telemonitored their daily PA levels over one year using a dedicated web-based interface. Patients additionally provided weekly CAT scores using the same telehealth platform and came in for 3 study visits to assess functional parameters and biochemical markers related to nutrition and inflammation.
A principal study finding was that PA was inversely associated with CAT score (drop of 0.21 points associated with an increase of 1000 daily steps, p = 0.004), and that the 50% of patients with higher PA levels showed less CAT score progression over time (0.42 points per year) than the 50% of patients with lower PA levels (3.26 points per year) (p < 0.001). In addition, higher PA levels were significantly associated with a lower likelihood of experiencing a moderate-to-severe AECOPD (31% risk reduction associated with an increase of 1000 daily steps, p = 0.0097).
Our study demonstrates the relevance of PA for key COPD outcome metrics in a real-world setting and underpins the importance of PA for COPD self-management in everyday life. Our study paves the way for future intervention trials to prospectively identify medically relevant PA thresholds and establish training recommendations for different patient subgroups.
肺功能受限以及合并症（如冠心病、肌肉减少症和情绪障碍）使得慢性阻塞性肺疾病（COPD）患者避免体力活动（PA）。然而，PA 是 COPD 管理的重要支柱，并且被专业协会明确推荐以增强身体机能并积极调节疾病进展。
在这项单中心、前瞻性、观察性可行性研究中，我们的主要目的是分别研究 PA 与 COPD 评估测试（CAT）的演变和 COPD 急性加重（AECOPD）的发生之间的关系。为此，我们为 42 名 COPD 患者配备了一个活动跟踪可穿戴设备，并使用专用的基于网络的界面在一年的时间内远程监测他们的日常 PA 水平。患者还通过相同的远程医疗平台每周提供 CAT 评分，并进行 3 次研究访问以评估与营养和炎症相关的功能参数和生化标志物。
一项主要研究发现是，PA 与 CAT 评分呈负相关（每天增加 1000 步，评分下降 0.21 分，p = 0.004），并且 PA 水平较高的 50%患者的 CAT 评分随时间的进展（每年 0.42 分）低于 PA 水平较低的 50%患者（每年 3.26 分）（p < 0.001）。此外，较高的 PA 水平与发生中重度 AECOPD 的可能性显著降低相关（每天增加 1000 步，风险降低 31%，p = 0.0097）。
我们的研究在真实环境中证明了 PA 对 COPD 关键结局指标的相关性，并强调了 PA 在日常生活中对 COPD 自我管理的重要性。我们的研究为未来的干预试验奠定了基础，可以前瞻性地确定与医学相关的 PA 阈值，并为不同的患者亚组建立培训建议。
