Determinants and outcomes of physical activity in patients with COPD: a systematic review
Elena Gimeno-Santos, Anja Frei, Claudia Steurer-Stey, Jordi de Batlle, Roberto A Rabinovich, Yogini Raste, Nicholas S Hopkinson, Michael I Polkey, Hans van Remoortel, Thierry Troosters, Karoly Kulich, Niklas Karlsson, Milo A Puhan, Judith Garcia-Aymerich, PROactive consortium, Caterina Brindicci, Tim Higenbottam, Thierry Trooster, Fabienne Dobbels, Margaret X Tabberer, Roberto Rabinovich, Bill McNee, Ioannis Vogiatzis, Michael Polkey, Nick Hopkinson, Judith Garcia-Aymerich, Milo Puhan, Anja Frei, Thys van der Molen, Corina De Jong, Pim de Boer, Ian Jarrod, Paul McBride, Nadia Kamel, Katja Rudell, Frederick J Wilson, Nathalie Ivanoff, Karoly Kulich, Alistair Glendenning, Niklas X Karlsson, Solange Corriol-Rohou, Enkeleida Nikai, Boehringer Ingelheim, Damijen Erzen, Elena Gimeno-Santos, Anja Frei, Claudia Steurer-Stey, Jordi de Batlle, Roberto A Rabinovich, Yogini Raste, Nicholas S Hopkinson, Michael I Polkey, Hans van Remoortel, Thierry Troosters, Karoly Kulich, Niklas Karlsson, Milo A Puhan, Judith Garcia-Aymerich, PROactive consortium, Caterina Brindicci, Tim Higenbottam, Thierry Trooster, Fabienne Dobbels, Margaret X Tabberer, Roberto Rabinovich, Bill McNee, Ioannis Vogiatzis, Michael Polkey, Nick Hopkinson, Judith Garcia-Aymerich, Milo Puhan, Anja Frei, Thys van der Molen, Corina De Jong, Pim de Boer, Ian Jarrod, Paul McBride, Nadia Kamel, Katja Rudell, Frederick J Wilson, Nathalie Ivanoff, Karoly Kulich, Alistair Glendenning, Niklas X Karlsson, Solange Corriol-Rohou, Enkeleida Nikai, Boehringer Ingelheim, Damijen Erzen
Abstract
Background: The relationship between physical activity, disease severity, health status and prognosis in patients with COPD has not been systematically assessed. Our aim was to identify and summarise studies assessing associations between physical activity and its determinants and/or outcomes in patients with COPD and to develop a conceptual model for physical activity in COPD.
Methods: We conducted a systematic search of four databases (Medline, Embase, CINAHL and Psychinfo) prior to November 2012. Teams of two reviewers independently selected articles, extracted data and used the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) to assess quality of evidence.
Results: 86 studies were included: 59 were focused on determinants, 23 on outcomes and 4 on both. Hyperinflation, exercise capacity, dyspnoea, previous exacerbations, gas exchange, systemic inflammation, quality of life and self-efficacy were consistently related to physical activity, but often based on cross-sectional studies and low-quality evidence. Results from studies of pharmacological and non-pharmacological treatments were inconsistent and the quality of evidence was low to very low. As outcomes, COPD exacerbations and mortality were consistently associated with low levels of physical activity based on moderate quality evidence. Physical activity was associated with other outcomes such as dyspnoea, health-related quality of life, exercise capacity and FEV1 but based on cross-sectional studies and low to very low quality evidence.
Conclusions: Physical activity level in COPD is consistently associated with mortality and exacerbations, but there is poor evidence about determinants of physical activity, including the impact of treatment.
Keywords: COPD Exacerbations; COPD epidemiology; Exercise.
Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
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Source: PubMed