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. 2023 Nov-Dec:219:107424.
doi: 10.1016/j.rmed.2023.107424. Epub 2023 Oct 10.

Factors associated to physical activity in patients with COPD: An ecological approach

Astrid Blondeel  1 , Fien Hermans  2 , Sofie Breuls  1 , Marieke Wuyts  2 , Stephanie Everaerts  3 , Iwein Gyselinck  4 , Nikolaas De Maeyer  5 , Thessa Verniest  5 , Eric Derom  6 , Wim Janssens  3 , Thierry Troosters  1 , Heleen Demeyer  7
Affiliations

Factors associated to physical activity in patients with COPD: An ecological approach

Astrid Blondeel et al. Respir Med. 2023 Nov-Dec.

Abstract

Background: Physical activity (PA) is low in patients with Chronic Obstructive Pulmonary Disease (COPD). Identifying modifiable and non-modifiable correlates of PA give understanding of the individual behavior and provide future directions for PA enhancing interventions. As PA is complex and multidimensional, it should be embedded within a thorough framework.

Objective: To identify correlates of PA in a comprehensive COPD population based on a broad ecological model, including physiological, psychological, socio-demographic and environmental dimensions.

Methods: PA was objectively measured using the Dynaport Movemonitor and a comprehensive data collection of physiological, psychological, socio-demographic and environmental factors were collected. Bivariable and multivariable regression analyses (including principle component analysis) were executed.

Results: For this cross-sectional analysis, we included 148 patients with COPD and valid PA data (mean (SD) age 68 (7) years, FEV1 57 (17) % predicted, 5613 (3596) steps per day). Significant bivariable associations were found for physiological (exercise capacity, muscle force, lung function, symptoms, comorbidities), psychological (e.g. fatigue, motivation, perceived difficulty with PA), socio-demographic (dog owning, use of activity tracker) and environmental (season, daylight, temperature) factors. Based on the multivariable regression model, exercise capacity, beliefs on motivation, importance and self-confidence regarding PA and weather conditions were independent correlates of mean steps per day (R2 = 0.35). Movement intensity during walking was only independently associated with exercise capacity and age (R2 = 0.41).

Conclusion: Although a wide range of potential influence factors were evaluated, variance in PA was only partly explained, supporting that PA is a complex behavior which is difficult to predict.

Keywords: Chronic obstructive pulmonary disease; Correlates; Physical activity.

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Conflict of interest statement

Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Astrid Blondeel reports financial support was provided by Research Foundation Flanders. Heleen Demeyer reports financial support was provided by Research Foundation Flanders. Fien Hermans reports financial support was provided by Research Foundation Flanders. Marieke Wuyts reports financial support was provided by Research Foundation Flanders.