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Daily activity during stability and exacerbation of chronic obstructive pulmonary disease

Title: Daily activity during stability and exacerbation of chronic obstructive pulmonary disease
Authors: Alahmari, AD
Patel, AR
Kowlessar, BS
Mackay, AJ
Singh, R
Wedzicha, JA
Donaldson, GC
Item Type: Journal Article
Abstract: BACKGROUND: During most COPD exacerbations, patients continue to live in the community but there is little information on changes in activity during exacerbations due to the difficulties of obtaining recent, prospective baseline data. METHODS: Patients recorded on daily diary cards any worsening in respiratory symptoms, peak expiratory flow (PEF) and the number of steps taken per day measured with a Yamax Digi-walker pedometer. Exacerbations were defined by increased respiratory symptoms and the number of exacerbations experienced in the 12 months preceding the recording of daily step count used to divide patients into frequent (> = 2/year) or infrequent exacerbators. RESULTS: The 73 COPD patients (88% male) had a mean (+/-SD) age 71(+/-8) years and FEV1 53(+/-16)% predicted. They recorded pedometer data on a median 198 days (IQR 134-353). At exacerbation onset, symptom count rose by 1.9(+/-1.3) and PEF fell by 7(+/-13) l/min. Mean daily step count fell from 4154(+/-2586) steps/day during a preceding baseline week to 3673(+/-2258) step/day during the initial 7 days of exacerbation (p = 0.045). Patients with larger falls in activity at exacerbation took longer to recover to stable level (rho = -0.56; p < 0.001). Recovery in daily step count was faster (median 3.5 days) than for exacerbation symptoms (median 11 days; p < 0.001). Recovery in step count was also faster in untreated compared to treated exacerbation (p = 0.030).Daily step count fell faster over time in the 40 frequent exacerbators, by 708 steps/year, compared to 338 steps/year in 33 infrequent exacerbators (p = 0.002). CONCLUSIONS: COPD exacerbations reduced physical activity and frequent exacerbations accelerate decline in activity over time.
Issue Date: 2-Jun-2014
Date of Acceptance: 21-May-2014
URI: http://hdl.handle.net/10044/1/53987
DOI: https://dx.doi.org/10.1186/1471-2466-14-98
ISSN: 1471-2466
Publisher: BioMed Central
Start Page: 98
End Page: 98
Journal / Book Title: BMC Pulmonary Medicine
Volume: 14
Copyright Statement: © 2014 Alahmari et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Keywords: Science & Technology
Life Sciences & Biomedicine
Respiratory System
RESPIRATORY SYSTEM
COPD
Exacerbation
Daily step-count
Physical activity
Daily monitoring
HEALTH-CARE UTILIZATION
PHYSICAL-ACTIVITY
COPD EXACERBATIONS
MEASURING STEPS
LUNG-FUNCTION
REHABILITATION
DEPRESSION
ACCURACY
COHORT
HOSPITALIZATION
Activities of Daily Living
Aged
Aged, 80 and over
Cohort Studies
Disease Progression
Female
Follow-Up Studies
Humans
Male
Monitoring, Physiologic
Physical Fitness
Pulmonary Disease, Chronic Obstructive
Severity of Illness Index
Time Factors
Walking
1102 Cardiovascular Medicine And Haematology
Notes: Alahmari, Ayedh D Patel, Anant Rc Kowlessar, Beverly S Mackay, Alex J Singh, Richa Wedzicha, Jadwiga A Donaldson, Gavin C England BMC Pulm Med. 2014 Jun 2;14(1):98. doi: 10.1186/1471-2466-14-98. BACKGROUND: During most COPD exacerbations, patients continue to live in the community but there is little information on changes in activity during exacerbations due to the difficulties of obtaining recent, prospective baseline data. METHODS: Patients recorded on daily diary cards any worsening in respiratory symptoms, peak expiratory flow (PEF) and the number of steps taken per day measured with a Yamax Digi-walker pedometer. Exacerbations were defined by increased respiratory symptoms and the number of exacerbations experienced in the 12 months preceding the recording of daily step count used to divide patients into frequent (> = 2/year) or infrequent exacerbators. RESULTS: The 73 COPD patients (88% male) had a mean (+/-SD) age 71(+/-8) years and FEV1 53(+/-16)% predicted. They recorded pedometer data on a median 198 days (IQR 134-353). At exacerbation onset, symptom count rose by 1.9(+/-1.3) and PEF fell by 7(+/-13) l/min. Mean daily step count fell from 4154(+/-2586) steps/day during a preceding baseline week to 3673(+/-2258) step/day during the initial 7 days of exacerbation (p = 0.045). Patients with larger falls in activity at exacerbation took longer to recover to stable level (rho = -0.56; p < 0.001). Recovery in daily step count was faster (median 3.5 days) than for exacerbation symptoms (median 11 days; p < 0.001). Recovery in step count was also faster in untreated compared to treated exacerbation (p = 0.030).Daily step count fell faster over time in the 40 frequent exacerbators, by 708 steps/year, compared to 338 steps/year in 33 infrequent exacerbators (p = 0.002). CONCLUSIONS: COPD exacerbations reduced physical activity and frequent exacerbations accelerate decline in activity over time.
Publication Status: Published
Appears in Collections:National Heart and Lung Institute