Barriers associated with reduced physical activity in COPD patients

Abstract

Objective: To evaluate the ability of COPD patients to perform activities of daily living (ADL); to identify barriers that prevent these individuals from performing ADL; and to correlate those barriers with dyspnea severity, six-minute walk test (6MWT), and an ADL limitation score.

Methods: In COPD patients and healthy, age-matched controls, the number of steps, the distance walked, and walking time were recorded with a triaxial accelerometer, for seven consecutive days. A questionnaire regarding perceived barriers and the London Chest Activity of Daily Living (LCADL) scale were used in order to identify the factors that prevent the performance of ADL. The severity of dyspnea was assessed with two scales, whereas submaximal exercise capacity was determined on the basis of the 6MWT.

Results: We evaluated 40 COPD patients and 40 controls. In comparison with the control values, the mean walk time was significantly shorter for COPD patients (68.5 ± 25.8 min/day vs. 105.2 ± 49.4 min/day; p < 0.001), as was the distance walked (3.9 ± 1.9 km/day vs. 6.4 ± 3.2 km/day; p < 0.001). The COPD patients also walked fewer steps/day. The most common self-reported barriers to performing ADL were lack of infrastructure, social influences, and lack of willpower. The 6MWT distance correlated with the results obtained with the accelerometer but not with the LCADL scale results.

Conclusions: Patients with COPD are less active than are healthy adults of a comparable age. Physical inactivity and the barriers to performing ADL have immediate implications for clinical practice, calling for early intervention measures.

Figure 1. Questionnaire regarding perceived barriers to physical activity: proportion of participants with scores = 5 on each domain in the COPD and control groups.

Figure 2. Correlation of the six-minute walk distance (6MWD) with the distance walked, the time spent walking, and the number of steps as measured by the accelerometer.

Figura 1. Questionário de barreiras: proporção de participantes com valores = 5 pontos por domínio nos grupos estudados.

Figura 2. Correlação da distância percorrida no teste de caminhada de seis minutos (DTC6) com a distância percorrida, tempo de caminhada e número de passos mensurados pelo acelerômetro.