Improvement of physical activity after endobronchial valve treatment in emphysema patients

Abstract

Rationale: Bronchoscopic lung volume reduction using endobronchial valves is a promising treatment for severe emphysema patients without collateral ventilation. Physical activity is an important contributing factor for the autonomy, morbidity and mortality of these patients.

Objective: We investigated the impact of endobronchial valve treatment on physical activity in severe emphysema patients.

Methods: Physical activity was measured for 7 days by a triaxial accelerometer at baseline and 6 months follow-up after EBV treatment, and compared with standard medical care in a randomized controlled trial.

Results: Forty-three patients (77%female, age 59 ± 9years, FEV1 30 ± 7%pred, steps 3563 ± 2213per/day) wore the accelerometer and were included in the analysis. Nineteen patients received EBV treatment and 24 standard medical care. At baseline, physical activity level was comparable between groups. After 6 months, the endobronchial valve group significantly improved compared to the controls in steps/day (+1252vs-148) and locomotion time (+17vs-2 min/day). Change in sit duration (0vs + 27 min/day) did not significantly differ.

Conclusions: Physical activity significantly improved after endobronchial valve treatment in severe emphysema patients. This improvement was without any specific encouragement on physical activity.

Clinical trial number: Dutch trial register: NTR2876.

Keywords: Bronchoscopy; COPD; Lung volume reduction; Physical activity.