The association between daily exacerbation symptoms and physical activity in patients with chronic obstructive pulmonary disease
| Autor: | Milo A. Puhan, Stephan Keusch, Stephan Wieser, Anja Frei, Sarah Crook, Martin Frey, Gilbert Büsching, Alexander Turk |
|---|---|
| Přispěvatelé: | University of Zurich, Frei, Anja |
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
PRO
Male Exacerbation medicine.medical_treatment physical activity step count Pulmonary Disease Chronic Obstructive 0302 clinical medicine exacerbation Interquartile range Acute care Forced Expiratory Volume 030212 general & internal medicine Prospective Studies Original Research COPD General Medicine Middle Aged Mobile Applications Obstructive lung disease Cohort Disease Progression Female medicine.symptom Symptom Assessment management Switzerland Adult medicine.medical_specialty longitudinal 610 Medicine & health International Journal of Chronic Obstructive Pulmonary Disease 03 medical and health sciences Internal medicine medicine Humans Pulmonary rehabilitation Exercise business.industry 10060 Epidemiology Biostatistics and Prevention Institute (EBPI) 2739 Public Health Environmental and Occupational Health medicine.disease 2719 Health Policy Actigraphy 030228 respiratory system 2740 Pulmonary and Respiratory Medicine Sputum symptoms business |
| Zdroj: | International Journal of Chronic Obstructive Pulmonary Disease |
| ISSN: | 1178-2005 1176-9106 |
| Popis: | Sarah Crook,1 Gilbert Büsching,2 Stephan Keusch,3 Stephan Wieser,4 Alexander Turk,3,5 Martin Frey,2 Milo A Puhan,1 Anja Frei1 1Department of Epidemiology, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland; 2Pulmonary Rehabilitation, Klinik Barmelweid, Barmelweid, Switzerland; 3Pulmonology, Zürcher RehaZentrum Wald, Wald, Switzerland; 4Pulmonology, Stadtspital Waid, Zurich, Switzerland; 5Department of Internal Medicine, See-Spital Horgen, Horgen, Switzerland Background: Evidence from longitudinal studies on the impact of exacerbation symptoms on physical activity in chronic obstructive pulmonary disease (COPD) is lacking. The aim of this first exploratory study was to assess the association between exacerbation symptoms and physical activity, and to quantify the relative influence of specific symptoms. Methods: We recruited COPD patients at high risk for exacerbations from 2 pulmonary rehabilitation clinics and 1 acute care clinic in Switzerland. For 3 months after discharge, patients completed a daily symptom diary on a smartphone application, the EXAcerbations of Chronic pulmonary disease Tool (EXACT), and wore a pedometer to measure daily steps. We used mixed-effects models to determine the association of daily steps with exacerbation symptoms. Results: A total of 21 patients (Global Initiative for Chronic Obstructive Lung Disease grades 2–4) were enrolled for a mean of 94.4 days (standard deviation 4.2). The baseline median number of daily steps was 3,264.6 (interquartile range [IQR]: 1,851.3–4,784.1) and EXACT score was 37.0 (IQR: 30.9–41.4). A 12-point increase in EXACT score (indicating the start of an exacerbation) was statistically significantly associated with a decrease in daily steps of 653.3 (95% CI 969.7–336.9). Chest symptoms (tightness, discomfort and congestion) were more strongly associated with change in steps than breathlessness, and cough and sputum (z-value -4.5 vs -2.9 and -3.0). Conclusion: This is the first study to show that, in a small cohort of COPD patients, increases in exacerbation symptoms were associated with a statistically and clinically significant reduction in daily physical activity. These results underscore the importance for symptom control and exacerbation prevention in COPD patients. Keywords: longitudinal, management, step count, PRO, COPD, exacerbation, physical activity, symptoms |
| Databáze: | OpenAIRE |
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