Abstract
In health and disease, the benefits of regular participation in moderate to vigorous intensity physical activity are well documented. However, individuals with chronic conditions, such as those with chronic obstructive pulmonary disease (COPD), typically do very little activity at a moderate or vigorous intensity. Much of their day is instead spent in sedentary behaviour, such as sitting or reclining, which requires very little energy expenditure. This high level of time spent in sedentary behaviour can have serious health consequences, including increased risk of diabetes, cardiovascular disease and premature mortality. There is emerging evidence to suggest that participation in light intensity physical activities (e.g. standing or slow walking) may have benefits for cardio-metabolic health. Given the low aerobic capacity of individuals with moderate to severe COPD, increasing light intensity activity (through reducing sedentary time) may be a feasible additional strategy to improve health in this population, alongside traditional recommendations to increase the time spent in moderate to vigorous intensity physical activity. This review provides an overview of physical activity and sedentary behaviour, with a particular emphasis on these behaviours for people with COPD. It provides suggestions for the measurement of these behaviours within the clinical setting, as well as for interventions that may be effective at increasing physical activity and reducing sedentary behaviour in this population.
Highlights
The widespread benefits of regular participation in moderate to vigorous intensity physical activity are well established.[1]
This review provides an overview of the health benefits of physical activity across the spectrum, from light intensity through to moderate and vigorous intensity, as well as the adverse health effects of too much time spent in sedentary behaviour
There is preliminary evidence to suggest that there are cardio-metabolic benefits for those who have a positive light-sedentary balance, even if recommended levels of moderate to vigorous intensity physical activity are not achieved.[29]. Though it is ideal if adults have both low sedentary time, and high moderate to vigorous intensity physical activity time,[29] these findings collectively suggest that there may be benefit from shifting sedentary time to light intensity activities; a potentially more feasible and acceptable target for change especially for those with chronic conditions such as chronic obstructive pulmonary disease (COPD)
Summary
The widespread benefits of regular participation in moderate to vigorous intensity physical activity are well established.[1]. Pulmonary rehabilitation, which has a focus on exercise training, has strong evidence for reducing symptoms, improving exercise tolerance and quality of life,[6] and reducing healthcare utilisation[7] in this patient population, there is limited evidence that pulmonary rehabilitation increases daily levels of physical activity and reduces sedentary time. This review provides an overview of the health benefits of physical activity across the spectrum, from light intensity through to moderate and vigorous intensity, as well as the adverse health effects of too much time spent in sedentary behaviour. It includes a summary of the methods used to measure physical activity and sedentary behaviour in research and clinical settings. Physical activity may be classified as activities undertaken as part of daily living, such as domestic and occupational tasks, or as exercise, which is a form of physical activity that is planned, structured and undertaken regularly with the goal of improving or maintaining fitness.[1]
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