Socio-environmental correlates of physical activity in patients with chronic obstructive pulmonary disease (COPD)

Ane Arbillaga-Etxarri, Elena Gimeno-Santos, Anael Barberan-Garcia, Marta Benet, Eulàlia Borrell, Payam Dadvand, Maria Foraster, Alicia Marín, Mònica Monteagudo, Robert Rodriguez-Roisin, Pere Vall-Casas, Jordi Vilaró, Judith Garcia-Aymerich, Urban Training Study Group, Anna Delgado, Jaume Torrent-Pallicer, Robert Rodriguez-Roisín, Eva Balcells, Diego A Rodríguez, Pilar Ortega, Nuria Celorrio, Nuria Montellà, Laura Muñoz, Pere Toran, Pere Simonet, Carme Jané, Carlos Martín-Cantera, Ane Arbillaga-Etxarri, Elena Gimeno-Santos, Anael Barberan-Garcia, Marta Benet, Eulàlia Borrell, Payam Dadvand, Maria Foraster, Alicia Marín, Mònica Monteagudo, Robert Rodriguez-Roisin, Pere Vall-Casas, Jordi Vilaró, Judith Garcia-Aymerich, Urban Training Study Group, Anna Delgado, Jaume Torrent-Pallicer, Robert Rodriguez-Roisín, Eva Balcells, Diego A Rodríguez, Pilar Ortega, Nuria Celorrio, Nuria Montellà, Laura Muñoz, Pere Toran, Pere Simonet, Carme Jané, Carlos Martín-Cantera

Abstract

Background: Study of the causes of the reduced levels of physical activity in patients with COPD has been scarce and limited to biological factors.

Aim: To assess the relationship between novel socio-environmental factors, namely dog walking, grandparenting, neighbourhood deprivation, residential surrounding greenness and residential proximity to green or blue spaces, and amount and intensity of physical activity in COPD patients.

Methods: This cross-sectional study recruited 410 COPD patients from five Catalan municipalities. Dog walking and grandparenting were assessed by questionnaire. Neighbourhood deprivation was assessed using the census Urban Vulnerability Index, residential surrounding greenness by the satellite-derived Normalized Difference Vegetation Index, and residential proximity to green or blue spaces as living within 300 m of such a space. Physical activity was measured during 1 week by accelerometer to assess time spent on moderate-to-vigorous physical activity (MVPA) and vector magnitude units (VMU) per minute.

Findings: Patients were 85% male, had a mean (SD) age of 69 (9) years, and post-bronchodilator FEV1 of 56 (17) %pred. After adjusting for age, sex, socio-economic status, dyspnoea, exercise capacity and anxiety in a linear regression model, both dog walking and grandparenting were significantly associated with an increase both in time in MVPA (18 min/day (p<0.01) and 9 min/day (p<0.05), respectively) and in physical activity intensity (76 VMU/min (p=0.05) and 59 VMUs/min (p<0.05), respectively). Neighbourhood deprivation, surrounding greenness and proximity to green or blue spaces were not associated with physical activity.

Conclusions: Dog walking and grandparenting are associated with a higher amount and intensity of physical activity in COPD patients.

Trial registration number: Pre-results, NCT01897298.

Keywords: COPD epidemiology; Exercise.

Conflict of interest statement

Competing interests: RRR reports receipt of grants/research support from Almirall (not related to this study), lectured for Almirall, AstraZeneca, Boehringer Ingelheim, Ferrer, Menarini, Novartis, Takeda and TEVA, and consulted with AstraZeneca, Boehringer Ingelheim, Pearl, Takeda and TEVA. AAE, EGS, ABG, MB, LB, MF, PD, AM, MM, PVC, JV and JGA have nothing to disclose. There are no patents, products in development or marketed products to declare.

Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Figures

Figure 1
Figure 1
Distribution of amount (time in moderate-to-vigorous activity) and intensity (VMU/min) of physical activity according to socio-environmental characteristics in COPD patients. NDVI, Normalized Difference Vegetation Index; UVI, Urban Vulnerability Index; VMU, vector magnitude units. Bars represent mean and SE.

References

    1. Vorrink SNW, Kort HSM, Troosters T, et al. . Level of daily physical activity in individuals with COPD compared with healthy controls. Respir Res 2011;12:33
    1. Vestbo J, Hurd SS, Agustí AG, et al. . Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. Am J Respir Crit Care Med 2013;187:347–65.
    1. Gimeno-Santos E, Frei A, Steurer-Stey C, et al. . Determinants and outcomes of physical activity in patients with COPD: a systematic review. Thorax 2014;69:731–9.
    1. Watz H, Krippner F, Kirsten A, et al. . Indacaterol improves lung hyperinflation and physical activity in patients with moderate chronic obstructive pulmonary disease--a randomized, multicenter, double-blind, placebo-controlled study. BMC Pulm Med 2014;14:158
    1. Spruit MA, Pitta F, McAuley E, et al. . Pulmonary rehabilitation and physical activity in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2015;192:924–33.
    1. Leidy NK, Kimel M, Ajagbe L, et al. . Designing trials of behavioral interventions to increase physical activity in patients with COPD: insights from the chronic disease literature. Respir Med 2014;108:472–81.
    1. Altenburg WA, ten Hacken NH, Bossenbroek L, et al. . Short- and long-term effects of a physical activity counselling programme in COPD: a randomized controlled trial. Respir Med 2015;109:112–21.
    1. Garcia-Aymerich J. Research needs on physical activity and COPD: bridging the gap between knowledge and behaviour. BRN Rev 2015;1:92–104.
    1. Bauman AE, Reis RS, Sallis JF, et al. . Correlates of physical activity: why are some people physically active and others not? Lancet 2012;380:258–71.
    1. McNeill LH, Kreuter MW, Subramanian SV. Social environment and physical activity: a review of concepts and evidence. Soc Sci Med 2006;63:1011–22.
    1. Sallis JF, Cerin E, Conway TL, et al. . Physical activity in relation to urban environments in 14 cities worldwide: a cross-sectional study. Lancet 2016;387:2207–17.
    1. Arbillaga-Etxarri A, Torrent-Pallicer J, Gimeno-Santos E, et al. . Validation of walking trails for the Urban Training™ of chronic obstructive pulmonary disease patients. PLoS ONE 2016;11:e0146705
    1. Celli BR, MacNee W, Agusti A, et al. . Standards for the diagnosis and treatment of patients with COPD: a summary of the ATS/ERS position paper. Eur Respir J 2004;23:932–46.
    1. Atlas de la Vulnerabilidad Urbana. Ministerio de Fomeno. Gobierno de España. (accessed 13 May 2013).
    1. Weier J, Herring D.. 2011. Measuring Vegetation (NDVI & EVI). (accessed 13 May 2013).
    1. Annerstedt M, Ostergren PO, Björk J, et al. . Green qualities in the neighbourhood and mental health—results from a longitudinal cohort study in Southern Sweden. BMC Public Health 2012;12:337
    1. European Commission, Expert Group on the Urban Environment. Towards a Local Sustainability Profile—European Common Indicators. Luxembourg: Office for Official Publications of the European Communities, 2001.
    1. Rabinovich RA, Louvaris Z, Raste Y, et al. . Validity of physical activity monitors during daily life in patients with COPD. Eur Respir J 2013;42:1205–15.
    1. Demeyer H, Burtin C, Van Remoortel H, et al. . Standardizing the analysis of physical activity in patients with COPD following a pulmonary rehabilitation program. Chest 2014;146:318–27.
    1. Westgarth C, Christley RM, Christian HE. How might we increase physical activity through dog walking?: a comprehensive review of dog walking correlates. Int J Behav Nutr Phys Act 2014;11:83
    1. Peel E, Douglas M, Parry O, et al. . Type 2 diabetes and dog walking: patients’ longitudinal perspectives about implementing and sustaining physical activity. Br J Gen Pract 2010;60:570–7.
    1. Curl AL, Bibbo J, Johnson RA. Dog walking, the human-animal bond and older adults’ physical health. Gerontologist. Published Online First: 21 Mar 2016
    1. Christian HE, Westgarth C, Bauman A, et al. . Dog ownership and physical activity: a review of the evidence. J Phys Act Health 2013;10:750–9.
    1. Di Gessa G, Glaser K, Tinker A. The impact of caring for grandchildren on the health of grandparents in Europe: a lifecourse approach. Soc Sci Med 2016;152:166–75.
    1. Tsai F-J, Motamed S, Rougemont A. The protective effect of taking care of grandchildren on elders’ mental health? Associations between changing patterns of intergenerational exchanges and the reduction of elders’ loneliness and depression between 1993 and 2007 in Taiwan. BMC Public Health 2013;13:567
    1. Grundy EM, Albala C, Allen E, et al. . Grandparenting and psychosocial health among older Chileans: a longitudinal analysis. Aging Ment Health 2012;16:1047–57.
    1. Harris D, Hayter M, Allender S. Improving the uptake of pulmonary rehabilitation in patients with COPD: qualitative study of experiences and attitudes. Br J Gen Pract 2008;58:703–10.
    1. Van Holle V, Deforche B, Van Cauwenberg J, et al. . Relationship between the physical environment and different domains of physical activity in European adults: a systematic review. BMC Public Health 2012;12:807
    1. Dadvand P, Bartoll X, Basagaña X, et al. . Green spaces and general health: roles of mental health status, social support, and physical activity. Environ Int 2016;91:161–7.
    1. Kaczynski AT, Besenyi GM, Stanis SAW, et al. . Are park proximity and park features related to park use and park-based physical activity among adults? Variations by multiple socio-demographic characteristics. Int J Behav Nutr Phys Act 2014;11:146
    1. Van Cauwenberg J, Cerin E, Timperio A, et al. . Park proximity, quality and recreational physical activity among mid-older aged adults: moderating effects of individual factors and area of residence. Int J Behav Nutr Phys Act 2015;12:1–8.
    1. Barnett A, Cerin E, Zhang CJP, et al. . Associations between the neighbourhood environment characteristics and physical activity in older adults with specific types of chronic conditions: the ALECS cross-sectional study. Int J Behav Nutr Phys Act 2016;13:53
    1. Pla territorial metropolità de Barcelona. Departament de Territori i Sostenibilitat. (accessed 13 May 2013).
    1. Kruis AL, Ställberg B, Jones RC, et al. . Primary care COPD patients compared with large pharmaceutically-sponsored COPD studies: an UNLOCK validation study. PLoS ONE 2014;9:e90145

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