Prevalence and prognostic importance of exercise limitation and physical inactivity in COPD
Anouk W. Vaes,
Chris Burtin,
Richard Casaburi,
Bartolome R. Celli,
Rachael A. Evans,
Suzanne C. Lareau,
Linda Nici,
Carolyn L. Rochester,
Thierry Troosters
Affiliations
Anouk W. Vaes
Department of Research and Development, Ciro, Horn, The Netherlands
Chris Burtin
REVAL - Rehabilitation Research Center, BIOMED - Biomedical Research Institute, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium
Richard Casaburi
Rehabilitation Clinical Trials Center, Lundquist Institute for Biomedical Innovation at Harbor-University of California, Los Angeles (UCLA) Medical Center, Torrance, CA, USA
Bartolome R. Celli
Pulmonary and Critical Care Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
Rachael A. Evans
Department of Respiratory Science, University of Leicester, Leicester, UK
Suzanne C. Lareau
University of Colorado College of Nursing, Anschutz Medical Campus, Aurora, CO, USA
Linda Nici
Providence Veterans Affairs Medical Center, Providence, RI, USA
Carolyn L. Rochester
Yale University School of Medicine, New Haven, CT, USA
Thierry Troosters
Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
Exercise limitation and physical inactivity are separate, but related constructs. Both are commonly present in individuals with COPD, contribute to disease burden over and above the respiratory impairments, and are independently predictive of adverse outcomes. Because of this, clinicians should consider assessing these variables in their patients with COPD. Field tests of exercise performance such as the 6-min walk test and the incremental and endurance shuttle walk tests require limited additional resources, and results correlate with negative outcomes. Laboratory measures of exercise performance using a treadmill or cycle ergometer assess exercise capacity, provide prognostic information and have the advantage of explaining physiological mechanisms (and their interactions) underpinning exercise limitation. Limitations in exercise capacity (i.e. “cannot do”) and physical inactivity (i.e. “do not do”) are both associated with mortality; exercise limitation appears to be the more important driver of this outcome.
