Physical Activity and Sedentary Behaviour Patterns in 326 Persons with COPD before Starting a Pulmonary Rehabilitation: A Cluster Analysis.

Geidl Geidl,Cassar Cassar,Schultz Schultz,Lehbert Lehbert,Wittmann Wittmann,Pfeifer Pfeifer,Mino Mino,Carl Carl,Wagner Wagner

doi:10.3390/jcm8091346

Abstract

This study applies a cluster analysis to identify typical physical activity (PA) and sedentary behaviour (SB) patterns in people with chronic obstructive pulmonary disease (COPD) before starting pulmonary rehabilitation (PR). We implemented an observational design which assessed baseline data of objectively measured PA and SB from the STAR (Stay Active after Rehabilitation) study. A total of 355 persons wore an accelerometer (Actigraph wGT3X) for seven days before the start of their PR. Sociodemographic and disease-related parameters were assessed at the start of PR. We applied cluster analysis and compared clusters applying univariate variance analyses. Data was available for 326 persons (31.6% women; age ø = 58 years). Cluster analysis revealed four movement clusters with distinct PA and SB patterns: Sedentary non-movers (28.5%), sedentary occasional movers (41.7%), sedentary movers (19.6%), and sedentary exercisers (10.1%). The four clusters displayed varying levels of moderate PA before rehabilitation (Ø daily min: 9; 28; 38; 70). Notably, all four clusters displayed considerably long average sedentary time per day (Ø daily minutes: 644; 561; 490; 446). The clusters differed significantly in disease-related parameters of GOLD severity, FEV1, CAT, and 6-Min-Walk-Test. In addition to PA promotion, PR programs should consider the reduction of sedentary behaviour as a valuable goal.

Highlights

Regular physical activity (PA) is proven to help treat noncommunicable diseases (NCDs) [1]
A key contribution of this study is the detailed reporting of health-related movement behaviours in individuals with chronic obstructive pulmonary disease (COPD) including sedentary behaviour (SB) and PA in very light, light and moderate intensity areas as well as patterns of activity bouts
The present study concludes that patients with COPD perform varied levels of PA in free-living conditions

Summary

Introduction

Regular physical activity (PA) is proven to help treat noncommunicable diseases (NCDs) [1]. For people with chronic obstructive pulmonary disease (COPD) engaging in the recommended moderate-to-vigorous physical activities (MVPA) results in improved muscle function, increases in exercise capacity, decreased mood disturbance, reduced symptom burden, and improved cardiovascular function [3]. It includes MVPA but a wide variety of PA in different intensities spanning from running, walking or standing, as well as sedentary behaviour (SB) [4]. PA levels, including PA in light, moderate and vigorous intensities positively influence various health outcomes, including reduced risks of COPD exacerbations, reduced risk of mortality, and improved quality of life [5]. After adjusting for MVPA levels, sedentary time is a strong predictor of mortality in the general population [7] and in people with COPD [8]. For people with COPD, high sedentary time is associated with poor overall and mental health, unhealthy aging, and overnight hospital stays [9]

Methods

Results

Discussion

Conclusion