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. 2022 Sep 9;22(1):340.
doi: 10.1186/s12890-022-02134-4.

Predictors and changes of physical activity in idiopathic pulmonary fibrosis

Diana Badenes-Bonet  1   2   3 , Anna Rodó-Pin  1 , Diego Castillo-Villegas  4 , Vanesa Vicens-Zygmunt  5 , Guadalupe Bermudo  5 , Fernanda Hernández-González  6 , Karina Portillo  7 , Juana Martínez-Llorens  1   2   8   3 , Roberto Chalela  1   2   3 , Oswaldo Caguana  1 , Jacobo Sellarés  6 , Maria Molina-Molina  8   5 , Xavier Duran  9 , Joaquim Gea  1   2   8   3 , Diego Agustín Rodríguez-Chiaradia  1   2   8   3 , Eva Balcells  10   11   12   13
Affiliations

Predictors and changes of physical activity in idiopathic pulmonary fibrosis

Diana Badenes-Bonet et al. BMC Pulm Med. .

Abstract

Background: Different clinical predictors of physical activity (PA) have been described in idiopathic pulmonary fibrosis (IPF), but studies are lacking evaluating the potential role of muscle strength and anxiety and depression symptoms in PA limitation. Moreover, little is known about the impact of changes in PA in the course of the disease. The aim of the present study was to investigate the relationship between baseline PA and a wide range of variables in IPF, to assess its longitudinal changes at 12 months and its impact on progression free-survival.

Methods: PA was assessed by accelerometer and physiological, clinical, psychological factors and health-related quality of life were evaluated in subjects with IPF at baseline and at 12 month follow-up. Predictors of PA were determined at baseline, evolution of PA parameters was described and the prognostic role of PA evolution was also established.

Results: Forty participants with IPF were included and 22 completed the follow-up. At baseline, subjects performed 5765 (3442) daily steps and spent 64 (44) minutes/day in moderate to vigorous PA. Multivariate regression models showed that at baseline, a lower six-minute walked distance, lower quadriceps strength (QMVC), and a higher depression score in the Hospital Anxiety and Depression scale were associated to lower daily step number. In addition, being in (Gender-Age-Physiology) GAP III stage, having a BMI ≥ 25 kg/m2 and lower QMVC or maximum inspiratory pressure were factors associated with sedentary behaviour. Adjusted for age, gender and forced vital capacity (FVC) (%pred.) a lower progression-free survival was evidenced in those subjects that decreased PA compared to those that maintained, or even increased it, at 12 months [HR 12.1 (95% CI, 1.9-78.8); p = 0.009].

Conclusion: Among a wide range of variables, muscle strength and depression symptoms have a predominant role in PA in IPF patients. Daily PA behaviour and its evolution should be considered in IPF clinical assessment and as a potential complementary indicator of disease prognosis.

Keywords: Depression; Idiopathic pulmonary fibrosis; Muscle strength; Physical activity; Predictors; Prognosis.

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Conflict of interest statement

The authors declare that they have no competing interests related to the manuscript.

Figures

Fig. 1
Fig. 1
Study flowchart. mMRC Modified medical research council; SGRQ St. George respiratory questionnaire; HADS Hospital anxiety and depression scale; PFTs Pulmonary function tests; 6MWT Six-minute walking test
Fig. 2
Fig. 2
Physical activity parameters at baseline and 12 month follow-up (n = 22). Bars graph show the mean and standard deviation. PA Physical activity; MVPA Moderate to vigorous physical activity
Fig. 3
Fig. 3
Kaplan–Meier progression-free survival curves at 24 months in IPF patients who decline ≥ 895 steps/day and those who do not decline (n = 22). IPF idiopathic pulmonary fibrosis
See this image and copyright information in PMC

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