Physical inactivity in COPD and increased patient perception of dyspnea

Milla Katajisto, Henna Kupiainen, Piritta Rantanen, Ari Lindqvist, Maritta Kilpeläinen, Heikki Tikkanen, Tarja Laitinen, Milla Katajisto, Henna Kupiainen, Piritta Rantanen, Ari Lindqvist, Maritta Kilpeläinen, Heikki Tikkanen, Tarja Laitinen

Abstract

Objective: To study patients' levels of exercise activity and the clinical characteristics that relate to physical activity and inactivity among patients with chronic obstructive pulmonary disease (COPD).

Methods: A postal questionnaire was administered to 719 patients with COPD in 2010; patients were recruited from the Helsinki and Turku University Central Hospitals in Finland and have been followed since 2005. The questionnaire asked participants about their exercise routines and other daily activities, potential restrictions to exercise, health-related quality of life, and subjective sensations of dyspnea upon exertion.

Results: A total of 50% of the participants reported exercising>2 times a week throughout the year. The proportion of the exercise inactive patients increased in parallel with disease progression, but the participants exhibited great variation in the degree of activity as well as in sport choices. Year-round activity was better maintained among patients who exercised both indoors and outdoors. Training activity was significantly correlated with patients' reported subjective dyspnea (r=0.32, P<0.001), health-related quality of life (r=0.25, P<0.001), mobility score (r=0.37, P<0.001), and bronchial obstruction (r=0.18, P<0.001). Active patients did not differ from inactive patients in terms of sex, age, smoking status, somatic comorbidities, or body mass index. Irrespective of the level of severity of patients' COPD, the most significant barrier to exercising was the subjective sensation of dyspnea.

Conclusion: When a patient with COPD suffers from dyspnea and does not have regular exercise routines, the patient will most likely benefit from an exercise program tailored to his or her physical capabilities.

Keywords: COPD; exercise training; physical activity; physical fitness; pulmonary rehabilitation.

Figures

Figure 1
Figure 1
Seasonal changes in estimated exercise time (minutes/week) of patients with different FEV1 % values. Notes: Dark bars represent spring, summer, and autumn; light bars represent winter. Significant P-values of the difference between winter and other seasons within the FEV1 % groups are given above the bars. Abbreviation: FEV1, forced expiratory volume in 1 second.
Figure 2
Figure 2
Daily life activities (minutes/week) and mobility score in different FEV1 % classes. Notes: Dark bars represent active patients; light bars represent inactive patients; Mobility score 1 = rests inside most of the day, and cannot get out without help; 2 = stays up inside most of the day; 3 = moves in and out, doing light household chores when needed. Abbreviation: FEV1, forced expiratory volume in 1 second.
Figure 3
Figure 3
MRC dyspnea scale in different FEV1 % classes among active and inactive patients as represented in the dark and light bars, respectively. Abbreviations: MRC, British Medical Research Council; FEV1, forced expiratory volume in 1 second.

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Source: PubMed

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