Progression of physical inactivity in COPD patients: the effect of time and climate conditions – a multicenter prospective cohort study

Abstract

Afroditi K Boutou,1,2,* Yogini Raste,1,* Heleen Demeyer,3 Thierry Troosters,3 Michael I Polkey,1 Ioannis Vogiatzis,4,5 Zafeiris Louvaris,4 Roberto A Rabinovich,6 Thys van der Molen,7 Judith Garcia-Aymerich,8–10 Nicholas S Hopkinson1 On behalf of the PROactive consortium1National Institute for Health Research Respiratory Biomedical Research Unit, Royal Brompton and Harefield NHS Foundation Trust and Imperial College, London, UK; 2Department of Respiratory Medicine, “G. Papanikolaou” Hospital, Thessaloniki, Greece; 3Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences and Respiratory Division, University Hospital Leuven, Leuven, Belgium; 4First Department of Respiratory Medicine, National & Kapodistrian University of Athens, Athens, Greece; 5Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle, UK; 6ELEGI Colt Laboratory, Centre for Inflammation Research, The Queen’s Medical Research Institute, University of Edinburgh, Edinburgh, UK; 7Department of General Practice, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; 8ISGlobal, Barcelona, Spain; 9Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain; 10Universitat Pompeu Fabra (UPF), Barcelona, SpainCorrespondence: Afroditi K BoutouDepartment of Respiratory Medicine, “G. Papanikolaou” Hospital, Exohi, Thessaloniki 57010, GreeceTel [phone]Email [email protected]*These authors contributed equally to this workPurpose: Longitudinal data on the effect of time and environmental conditions on physical activity (PA) among COPD patients are currently scarce, but this is an important factor in the design of trials to test interventions that might impact on it. Thus, we aimed to assess the effect of time and climate conditions (temperature, day length and rainfall) on progression of PA in a cohort of COPD patients.Patients and methods: This is a prospective, multicenter, cohort study undertaken as part of the EU/IMI PROactive project, in which we assessed 236 COPD patients simultaneously wearing two activity monitors (Dynaport MiniMod and Actigraph GT3X). A multivariable generalized linear model analysis was conducted to describe the effect of the explanatory variables on PA measures, over three time points (baseline, 6 and 12 months).Results: At 12 months (n=157; FEV1% predicted=57.7±21.9) there was a significant reduction in all PA measures (Actigraph step count (4284±3533 vs 3533±293)), Actigraph moderate- to vigorous-intensity PA ratio (8.8 (18.8) vs 6.1 (15.7)), Actigraph vector magnitude units (374,902.4 (265,269) vs 336,240 (214,432)), MiniMod walking time (59.1 (34.9) vs 56.9 (38.7) mins) and MiniMod PA intensity (0.183 (0) vs 0.181 (0)). Time had a significant, negative effect on most PA measures in multivariable analysis, after correcting for climate factors, study center, age, FEV1% predicted, 6MWD and other disease severity measures. Rainfall was the only climate factor with a negative effect on most PA parameters.Conclusion: COPD patients demonstrate a significant decrease in PA over 1 year follow-up, which is further affected by hours of rainfall, but not by other climate considerations.Keywords: physical activity, chronic obstructive pulmonary disease, elapsed time, climate

Keywords

• physical activity
• chronic obstructive pulmonary disease
• elapsed time
• climate