Abstract
Background: Physical capacity (PC) and physical activity (PA) represent associated but separate domains of physical function. It remains unknown whether this framework may support a better understanding of the impaired physical function in patients with chronic obstructive pulmonary disease (COPD). The current study had two aims: (1) to determine the distribution of patients with COPD over the PC-PA quadrants, and (2) to explore whether differences exist in clinical characteristics between these quadrants. Methods: In this retrospective study, PC was measured using the six-minute walk distance (6MWD), and PA was assessed with an accelerometer. Moreover, patients’ clinical characteristics were obtained. Patients were divided into the following quadrants: (I) low PC (6MWD <70% predicted), low PA, using a step-defined inactivity index (<5000 steps/day, ”can’t do, don’t do” quadrant); (II) preserved PC, low PA (“can do, don’t do” quadrant); (III) low PC, preserved PA (“can’t do, do do” quadrant); and (IV) preserved PC, preserved PA (“can do, do do” quadrant). Results: The distribution of the 662 COPD patients over the quadrants was as follows: “can’t do, don’t do”: 34%; “can do, don’t do”: 14%; “can’t do, do do”: 21%; and “can do, do do”: 31%. Statistically significant differences between quadrants were found for all clinical characteristics, except for educational levels. Conclusions: This study proves the applicability of the PC-PA quadrant concept in COPD. This concept serves as a pragmatic clinical tool, that may be useful in the understanding of the impaired physical functioning in COPD patients and therefore, may improve the selection of appropriate interventions to improve physical function.
Highlights
Impaired physical capacity (PC) and low-level daily physical activity (PA) are common features in people with chronic obstructive pulmonary disease (COPD) [1]
An increasing number of studies have shown the clinical relevance of low-level daily PA in COPD patients, as it is associated with poor health status, increased healthcare utilization, and higher mortality risk
53% of the COPD patients had a high ssymptom burden based on a CCCCQ ssccoorree ooff ≥≥11..99 poiinnttss andd 50% based on a CATT ssccoorree ooff≥≥18 points [35]
Summary
Impaired physical capacity (PC) and low-level daily physical activity (PA) are common features in people with chronic obstructive pulmonary disease (COPD) [1]. PA may be defined as any bodily movement produced by skeletal muscles that results in energy expenditure beyond that of the resting state [3] These days, the measurement of PA is performed with activity monitors rather than with questionnaires [4]. An increasing number of studies have shown the clinical relevance of low-level daily PA in COPD patients, as it is associated with poor health status, increased healthcare utilization, and higher mortality risk. These associations are independent of the degree of airway obstruction [1]. This concept serves as a pragmatic clinical tool, that may be useful in the understanding of the impaired physical functioning in COPD patients and may improve the selection of appropriate interventions to improve physical function
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