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Physical activity and fatigue in chronic obstructive pulmonary disease: A population based study
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
Luleå University of Technology.
Umeå University.
Umeå University.
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(English)Manuscript (preprint) (Other academic)
Abstract [en]

Introduction

Dyspnea with exertion and fatigue are the cardinal symptoms of chronic obstructive pulmonary disease (COPD); impaired muscle function and reduced exercise capacity are also frequently associated with COPD. We aimed to assess the physical activity levels, in a population based sample study, of subjects with and without COPD. We also aimed to investigate the factors associated with low physical activity in these groups.

Methods

In this study, 470 subjects with COPD (FEV1/FVC< 0.70) and 569 subjects without COPD (Non-COPD) were analyzed. Physical activity was assessed with the International Physical Activity Questionnaire (IPAQ). Fatigue was investigated with the Functional Assessment of Chronic Illness Therapy - Fatigue scale (FACIT-F). An interview questionnaire was used to record the sample characteristics and history of heart disease. Binary logistic regression was used to investigate the factors associated with low physical activity.

Results

Low physical activity was significantly more prevalent in GOLD grade ≥II COPD subjects, and this prevalence was higher than that for Non-COPD subjects (22.4 vs. 14.6%, p = 0.016). The strongest factors associated with low physical activity in COPD subjects were a history of heart disease, OR (CI 95%) 2.11 (1.10 - 4.08), and clinically significant fatigue, OR 2.33 (1.31 - 4.13); obesity was the only significant factor in Non-COPD subjects, OR 2.26 (1.17 – 4.35).

Conclusion

Physical activity levels are reduced for COPD grade II and higher, and the factors associated with lower levels of physical activity are different for the COPD group compared to the Non-COPD group. We propose that measurements of fatigue and a history of heart disease are useful tools to include when screening subjects for pulmonary rehabilitation.

Keyword [en]
COPD, physical activity, fatigue, questionnaire, IPAQ, FACIT-F
National Category
Medical and Health Sciences
Research subject
Medical Science
Identifiers
URN: urn:nbn:se:uu:diva-220600OAI: oai:DiVA.org:uu-220600DiVA: diva2:705747
Available from: 2014-03-17 Created: 2014-03-17 Last updated: 2014-04-29
In thesis
1. Assessing Physical Activity and Physical Capacity in Subjects with Chronic Obstructive Pulmonary Disease
Open this publication in new window or tab >>Assessing Physical Activity and Physical Capacity in Subjects with Chronic Obstructive Pulmonary Disease
2014 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The overall aim of this thesis was to assess measurement properties of methods suitable for screening or monitoring of physical capacity and physical activity in subjects with chronic obstructive pulmonary disease (COPD), and to explore factors associated with physical activity levels.

Methods: Four observational studies were conducted. Participants in studies I-III (sample sizes) (n=49, n=15, n=73) were recruited from specialist clinics, and in study IV from a population-based cohort (COPD n=470 and Non-COPD n=659). Psychometric properties of methods assessing physical capacity (study I) and physical activity (study II) were investigated in laboratory settings. Daily physical activity and clinical characteristics were assessed with objective methods (study III) and with subjective methods (study IV).

Results: Physical capacity as measured by walking speed during a 30-metre walk test displayed high test-retest correlations (ICC>0.87) and small measurement error. The accuracy for step count and body positions differed between activity monitors and direct observations. In study III 92% of subjects had an activity level below what is recommended in guidelines. Forty five percent of subjects’ activity could be accounted for by clinical characteristics with lung function (22.5%), walking speed (10.1%), quadriceps strength (7.0%) and fat-free mass index (3.0%) being significant predictors. In study IV, low physical activity was significantly more prevalent in COPD subjects from GOLD grade ≥II than among Non-COPD subjects (22.4 vs. 14.6%, p = 0.016). The strongest factors associated with low activity in COPD subjects were a history of heart disease, OR (CI 95%) 2.11 (1.10-4.08) and fatigue, OR 2.33 (1.31-4.13) while obesity was the only significant factor in Non-COPD subjects, OR 2.26 (1.17-4.35).

Conclusion: The 30 meter walk test and activity monitors are useful when assessing physical capacity and physical activity, respectively in patients with COPD. Impaired physical activity in severe COPD is related to low lung function, low walking speed, low muscle strength and altered body composition, whereas comorbidities and fatigue are linked to insufficient physical activity in patients with moderately severe COPD.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2014. 64 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 982
Keyword
COPD, chronic obstructive pulmonary disease, physical activity, measurement properties, reliability, accuracy, validity, sedentary behavior, activity monitor, questionnaire, anthropometrics, comorbidity, fatigue
National Category
Physiotherapy
Research subject
Medical Science
Identifiers
urn:nbn:se:uu:diva-220602 (URN)978-91-554-8905-2 (ISBN)
Public defence
2014-05-09, Gunnesalen, Akademiska sjukhuset, ingång 10, Uppsala, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2014-04-16 Created: 2014-03-17 Last updated: 2014-04-29

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