Impact of Previous Physical Activity Levels on Symptomatology, Functionality, and Strength during an Acute Exacerbation in COPD Patients

Laura López-López,Marie Valenza,María Granados-Santiago,Janet Rodríguez-Torres,Irene Torres-Sánchez,Ramón Romero-Fernández

doi:10.3390/healthcare6040139

Laura López-López, Marie Valenza + Show 4 more

Open Access

https://doi.org/10.3390/healthcare6040139

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Journal: Healthcare	Publication Date: Nov 29, 2018
Citations: 6	License type: CC BY 4.0

Affiliation: University of Granada

Abstract

The main objective of this study is to determine the relationship between physical activity (PA) level prior to hospitalization and the pulmonary symptomatology, functionality, exercise capacity, and strength of acute exacerbated chronic obstructive pulmonary disease (COPD) patients. In this observational study, all data were taken during the patient’s first day in hospital. Patients were divided into two groups (a PA group, and a physical inactivity (PI) group), according to the PA level evaluated by the Baecke questionnaire. Cough status was evaluated by the Leicester Cough Questionnaire (LCQ), and dyspnea was assessed using the modified Medical Research Council dyspnea scale (mMRC). Functionality was measured by the Functional Independence Measure (FIM) and the London Chest Activity of Daily Living scale (LCADL). Exercise capacity was evaluated by the two-minute step-in-place (2MSP) test, and strength assessed by dynamometry. A total of 151 patients were included in this observational study. Patients in the PI group obtained worse results compared to the PA group, and significant differences (p < 0.05) were found in all of the variables. Those COPD patients who regularly perform PA have less dyspnea and cough, as well as better functionality, exercise capacity and strength during an exacerbation, without relationship to the severity of the pathology.

Highlights

Chronic obstructive pulmonary disease (COPD) is an excessive inflammatory response in the airway, which generates a persistent airflow limitation in response to chronic exposure to harmful particles or gases
The objective of this study is to determine whether physical activity (PA) level in COPD patients prior to hospitalization is related to the pulmonary symptomatology, functionality, exercise capacity, and strength during exacerbation
The objective of this study was to determine whether the PA level in COPD patients prior to hospitalization is related to the pulmonary symptomatology, functionality, exercise capacity, and strength during an exacerbation

Summary

Introduction

Chronic obstructive pulmonary disease (COPD) is an excessive inflammatory response in the airway, which generates a persistent airflow limitation in response to chronic exposure to harmful particles or gases. The three main symptoms in these patients are cough, dyspnea, and sputum production [1]. The development of COPD is interspersed by exacerbations: Acute events, associated with an accelerated decline in lung function and health status [2], a reduction in quality of life, and an increase in morbidity and mortality [3]. Acute exacerbations of COPD are the main reason for hospitalization in these patients [4]. Despite the effect of COPD on the lungs, it has been characterized as a systemic disease due to the significant extrapulmonary manifestations that patients present [5]. Extrapulmonary symptoms include weakness of the skeletal musculature and emaciation, and have been associated with intolerance to exercise and deterioration in the state of health [6]

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