Factors associated with a low level of physical activity in patients with chronic obstructive pulmonary disease

Abstract

Background: Physical activity such as walking is strongly recommended for patients with chronic obstructive pulmonary disease (COPD).

Methods: We undertook a multicenter observational study on COPD patients, collecting the daily walking time, COPD severity score (COPDSS), functional status [London Chest Activity of Daily Living (LCADL) questionnaire], health-related quality of life (QoL) rating [five-item EuroQL (EQ-5D) and Airways Questionnaire 20 (AQ20)], and anxiety and depression rating (Hospital Anxiety and Depression Scale). Multivariate logistic regression modeling was performed to identify the independent predictors of a low walking time (<30 min/day).

Results: We included 4,574 patients with a mean (±standard deviation) age of 67.1 ± 10.0 years, with a mean FEV1 (%) of 54.0 ± 23.7. The mean daily walking time was 73.6 ± 67.1 min (58.9 % at ≥60 min and 13.7 % at <30 min). A strong direct relationship was observed between daily walking time and better QoL (EQ-5D and AQ20) and functional status (LCADL; p < 0.001 in all cases). The independent predictors of a low walking time were a worse score in EQ-5D [odds ratio (OR) (95 % confidence interval per one-point increase of 0.23 (0.15-0.35)], a higher COPDSS [OR per one-point increase of 1.04 (1.02-1.07)], and the presence of depression [OR 1.58 (1.25-2.01)].

Conclusions: After adjustment for age and severity of symptoms, poor health status, severity of COPD, and depression are the main factors associated with a low walking time in COPD patients.