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. 2019 Feb 15:14:431-437.
doi: 10.2147/COPD.S188710. eCollection 2019.

No impact of exacerbation frequency and severity on the physical activity decline in COPD: a long-term observation

Noriane A Sievi  1 , Malcolm Kohler  1 , Robert Thurnheer  2 , Joerg D Leuppi  3 , Sarosh Irani  4 , Martin Frey  5 , Martin Brutsche  6 , Thomas Brack  7 , Christian F Clarenbach  1
Affiliations

No impact of exacerbation frequency and severity on the physical activity decline in COPD: a long-term observation

Noriane A Sievi et al. Int J Chron Obstruct Pulmon Dis. .

Abstract

Introduction: COPD exacerbations are associated with a concomitant profound reduction in daily physical activity (PA). Thereby, exacerbation frequency and severity may have an amplifying effect. Whether the reduced level of PA returns to the level prior to exacerbation or has a sustained negative impact on activity behavior over time is unclear.

Methods: The number of steps per day over 1 week, as a measure of daily PA, was assessed annually in a cohort of patients with COPD. Exacerbation frequency and severity were documented. Uni- and multivariate mixed effect models were used to investigate associations between change in number of steps per day (dependent variable) and exacerbations. Stratification by possible confounders was performed.

Results: One hundred and eighty one COPD patients (median [quartile] age 64 [59/69] years, 65% male, median [quartiles] FEV1 % pred. 46 [33/65]) suffered a total of 273 exacerbations during the observation period (median [quartiles] follow-up time of 2.1 [1.6/3.1] years). Neither the frequency nor the severity of exacerbations was significantly related to the overall decline in PA over time. Stratification by different possible confounders such as age, sex and disease severity did not yield a subgroup in which exacerbations enhance the decrease in PA over time.

Conclusion: The drop in PA during the phase of an acute exacerbation seems not to be a lasting phenomenon leading to a fundamental change in activity behavior.

Trial registration: www.ClinicalTrials.gov, NCT01527773.

Keywords: COPD; daily physical activity; exacerbation.

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Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Study flow. Abbreviation: FU, follow up.
Figure 2
Figure 2
Exacerbation categories and change in number of steps per day over time. Notes: The adjusted for baseline change in number of steps per day over time of exacerbation categories (no exacerbation/moderate exacerbation/severe exacerbation) is illustrated. It reveals a nonsignificant but slightly greater decline in daily PA over time in patients with at least one severe exacerbation. Abbreviation: PA, physical activity.
See this image and copyright information in PMC

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