Level Of Activity In Daily Life Research Articles

Changing Your Tune: Lessons for Using Music to Encourage Physical Activity

Our research investigated whether music can communicate physical activity levels in daily life. Past studies have shown that simple musical tunes can provide wellness information, but no study has examined whether musical feedback can affect daily behavior or lead to healthier habits. We conducted a within-subject study with 62 participants over a period of 76 days, providing either musical or text-based feedback on their daily physical activity. The music was built and personalized based on participants' step counts and baseline wellness perceptions. Results showed that participants were marginally more active during the music feedback compared to their baseline period, and significantly more active compared to the text-based feedback (p = 0.000). We also find that the participant's average activity may influence the musical features they find most inspiration within a song. Finally, context influenced how musical feedback was interpreted, and specific musical features correlated with higher activity levels regardless of baseline perceptions. We discuss lessons learned for designing music-based feedback systems for health communication.

Physical Activity Pattern of Adults With Metabolic Syndrome Risk Factors: Time-Series Cluster Analysis.

Physical activity plays a crucial role in maintaining a healthy lifestyle, and wrist-worn wearables, such as smartwatches and smart bands, have become popular tools for measuring activity levels in daily life. However, studies on physical activity using wearable devices have limitations; for example, these studies often rely on a single device model or use improper clustering methods to analyze the wearable data that are extracted from wearable devices. This study aimed to identify methods suitable for analyzing wearable data and determining daily physical activity patterns. This study also explored the association between these physical activity patterns and health risk factors. People aged >30 years who had metabolic syndrome risk factors and were using their own wrist-worn devices were included in this study. We collected personal health data through a web-based survey and measured physical activity levels using wrist-worn wearables over the course of 1 week. The Time-Series Anytime Density Peak (TADPole) clustering method, which is a novel time-series method proposed recently, was used to identify the physical activity patterns of study participants. Additionally, we defined physical activity pattern groups based on the similarity of physical activity patterns between weekdays and weekends. We used the χ2 or Fisher exact test for categorical variables and the 2-tailed t test for numerical variables to find significant differences between physical activity pattern groups. Logistic regression models were used to analyze the relationship between activity patterns and health risk factors. A total of 47 participants were included in the analysis, generating a total of 329 person-days of data. We identified 2 different types of physical activity patterns (early bird pattern and night owl pattern) for weekdays and weekends. The physical activity levels of early birds were less than that of night owls on both weekdays and weekends. Additionally, participants were categorized into stable and shifting groups based on the similarity of physical activity patterns between weekdays and weekends. The physical activity pattern groups showed significant differences depending on age (P=.004) and daily energy expenditure (P<.001 for weekdays; P=.003 for weekends). Logistic regression analysis revealed a significant association between older age (≥40 y) and shifting physical activity patterns (odds ratio 8.68, 95% CI 1.95-48.85; P=.007). This study overcomes the limitations of previous studies by using various models of wrist-worn wearables and a novel time-series clustering method. Our findings suggested that age significantly influenced physical activity patterns. It also suggests a potential role of the TADPole clustering method in the analysis of large and multidimensional data, such as wearable data.

#6447 ASSOCIATION BETWEEN PHYSICAL ACTIVITY LEVEL AND A HISTORY OF FALLS IN PATIENTS ON HEMODIALYSIS

Abstract Background and Aims Patients with end-stage renal disease on hemodialysis have a lower physical activity level in daily life and a higher prevalence of sedentary lifestyle. Moreover, these patients have clinical, musculoskeletal, and physical function complications that contribute to a higher risk of falling. Therefore, the aim of this study was to evaluate the association between physical activity level and a history of falls in a retrospective 12-month interval in patients on hemodialysis. Method A retrospective study was conducted with patients aged ≥18 years who were undergoing regular hemodialysis treatment for at least three months. Patients were excluded if presented severe and unstable comorbidities, psychiatric or cognitive disorders, uncorrected visual impairments, and hospitalization in the past three months. The retrospective history of falls was assessed for the last 12 months, and a fall was defined as an “unexpected event in which the individual comes to rest on the ground, floor or lower level”. The daily step counts were recorded in the ActiGraph accelerometer (wGT3X-BT) during seven days, and analyzed by excluding the first and last day of recording and calculating the mean among the valid days (≥ 8 hours of wear time). Normality of data was analyzed using the Shapiro-Wilk test. The Student's t-test and the Mann-Whitney U test were used for between-group comparisons (patients with and without a history of falls). The univariate and multivariate linear regression models investigated the association between daily step counts and a history of falls. A p value &amp;lt;0.05 was considered as statistically significant. Results This study included 103 patients (59.2 ± 12.6 years, 59.2% male). Of these patients, 49.5% had a history of falls. Patients with a history of falls showed lower prevalence of workers (9.8% vs. 26.9%, p = 0.025) and daily step counts [2989 (2595) vs. 4550 (2966) steps, p = 0.018], and higher educational level [9 (7) vs. 5 (5) years, p = 0.033] compared to patients without a history of falls. The univariate linear regression model showed that daily step counts was significantly associated with a history of falls (p = 0.017). After adjusting for age, gender, educational level, work status, hemoglobin, and diabetes mellitus, this association remained significant in multiple linear regression model with a coefficient of determination of 0.21 and an adjusted coefficient of determination of 0.16 (p = 0.001). Conclusion Physical activity level was associated with a history of falls in a retrospective 12-month interval in patients on hemodialysis.

Design and analysis of a continuous optoelectronic pulse wave velocity blood pressure sensor with multiple-subject controlled experiments

The main purpose of this study is to perform the pulse wave velocity (PWV) measurements with a new noninvasive optoelectronic continuous-time wearable sensor design and to analyze the quantitative relation between the reference blood pressure (BP) measurement. PWV was measured at baseline 32 normotensive volunteers, including 15 females and 17 males aged between 23 and 41 years old. The day before the measurements, the volunteers were not allowed to drink alcohol, stay up late or use any medicine that would affect BP. Repeated BP measurements were performed with an average follow-up system at certain times of the day. Results: Equivalent constituents were established after questioning age, height, weight, physical activity levels in daily life, genetic predisposition for blood pressure and diabetic from all volunteers participating in the measurements. Systolic BP (SBP), diastolic BP (DBP), heart rate (HR), pulse pressure (PP), mean arterial pressure (MAP), distance between brachial to radial artery (D), pulse transit time between brachial to radial artery (brPTT) and PWV measurements were all collected to correlate results with the introduced sensor’s readings. Following the experimental results, a linear link was found between SBP and PWV when the two groups separated by gender related were examined and the correlation coefficients between them were r: 0.9915 in females and r: 0.9845 in males Measurements taken with the new non-invasive low-power continuous-time sensor design show that the PWV may in the near future be used as a screening tool to identify continuous SBP values in clinical practice. The new non-invasive design suggests that SBP has the strongest correlation with PWV among a variety of BP parameters. • Non-invasive continuous monitoring of blood pressure may improve the quality of life for patients. • Pulse wave velocity measurement (PWV) is one of the promising methods to measure blood pressure. • A simple wearable sensor has proven a distinguishable correlation between PWV readings and corresponding blood pressure. • A multi-subject human experiments from a variety of groups have suggested that PWV can be a candidate for blood pressure sensors.

Occupational Therapy Practice Guidelines for People With Parkinson's Disease.

Occupational therapy practitioners address the occupational performance and participation needs of people with Parkinson's disease (PD) and their care partners. This Practice Guideline is informed by systematic reviews on the use of occupational therapy interventions to promote participation in occupations for people with PD and to facilitate their caregivers' participation in the caregiver role. This guideline is meant to support practitioners' clinical decision making when working with people with PD and their care partners. We examined and synthesized the results of four systematic reviews and integrated those results into clinical recommendations for practice. Thirty-three articles from the systematic reviews served as the basis for the clinical recommendations in this Practice Guideline. Clinical recommendations are provided for interventions that have strong or moderate supporting evidence. Multidisciplinary, tailored, goal-oriented intervention is recommended for people with PD. Various forms of exercise can be used to improve activities of daily living and instrumental activities of daily living performance and social participation, and interventions should incorporate health behavior change techniques to support adequate physical activity levels in daily life. Mindfulness meditation and exercise can be used to support sleep, and task-oriented training can be used to improve performance of specific tasks. Occupational therapy practitioners should incorporate self-management, coaching, compensatory, cognitive-behavioral, and other approaches into multicomponent treatment plans depending on the client's needs and goals. Additional potentially appropriate intervention approaches or areas to address are discussed on the basis of existing or emerging evidence and expert opinion. What This Article Adds: This Practice Guideline provides a summary and applications of the current evidence supporting occupational therapy intervention for people with PD. It includes case examples and suggested decision-making algorithms to support practitioners in addressing client goals.

B-PO05-039 MET SCORE IN PATIENTS WITH AND WITHOUT ATRIAL FIBRILLATION

Patients (pts) with paroxysmal atrial fibrillation (PAF) often report markedly reduced activity levels in daily life, which is associated with adverse outcome. Activity is a modifiable risk factor for AF progression. Accelerometer data can be used to objectively assess the daily metabolic equivalent of task (MET) score. We aimed to investigate the association between MET score during sinus rhythm (SR) in PAF pts, using a 30 day mobile cardiac telemetry device with integrated accelerometer data. Pts 50-85 years old who recorded an ambulatory ECG with sufficient quality using the PocketECG device (MediLynx) in the US during 2019, to assess, ICD10 codes I48.xx or R00.2, were included. Subjects with PAF-burden ≥ 20% were excluded. MET score during SR was compared in pts with and without PAF with a duration ≥30s. All PAF episodes were algorithmically detected and manually verified. The population consisted of 1,096 men and 1,591 women (mean age 70.1 and 69.7 years, respectively, A), of whom 14.4% (n=386) pts were diagnosed with PAF (13.8% of women and 15.2% of men, p = 0.31). Pts with PAF had a significantly lower MET score during SR (B), compared to pts without PAF (1.24 vs. 1.32; 95% CI of the difference: [-0.11; -0.06]), as did women compared to men (1.29 vs. 1.34; 95% CI of the difference: [-0.07; -0.02]). Interaction of sex and presence of PAF was not significant (95% CI: [-0.04; 0.08]). Patients with PAF are less active during sinus rhythm than patients without AF. Future studies are needed to determine whether MET measurement could identify subjects at risk of progression or recurrence post-ablation, who may benefit from targeted interventions.

Nonleisure-Time Physical Activity Guidance Following Minor Ischemic Stroke: A Randomized Clinical Trial.

The purpose of this single-masked randomized clinical trial was to examine whether nonleisure-time physical activity guidance (NLTPAG) improves physical activity levels in patients after minor ischemic stroke. Patients who had been hospitalized for minor ischemic stroke in an acute care hospital (National Health Institute Stroke Scale ≤ 5) were randomized to either an NLTPAG group (n = 17) or a leisure-time physical activity guidance group (n = 16). NLTPAG focused on reducing sedentary behavior and increasing the frequency of walking for shopping and household activities to improve physical activity levels in daily life. Physical activity levels significantly improved only in participants in the NLTPAG group (initial assessment: metabolic equivalents of task = 12.6; final assessment: metabolic equivalents of task = 14.8; p = .035, r = .51). These results suggest that NLTPAG may be effective for improving physical activity levels in patients after minor ischemic stroke.

P011 Physical Activity Levels in Daily Life of Patients with Moderate-to-Severe Crohn's Disease Before and After Infliximab-Induced Remission.

BACKGROUND: Although the role of physical activity (PA) in inflammatory bowel disease (IBD) patients is not well defined, several studies about its effect on disease’s etiology and activity have addressed this issue. In addition, Crohn’s disease (CD) patients seem to have a lower level of PA and this behavior is associated with disease activity. This study evaluated a cohort of patients with moderately-to-severely active CD submitted to anti-TNF therapy in order to compare the exercise capacity and physical activity in daily life before and after anti-TNF-therapy induced remission. It is hypothesized that CD patients who achieved anti-TNF-therapy-induced remission present significant improvement in the previous levels of exercise capacity and PA in daily life. METHODS: In this prospective longitudinal study conducted between March 2015 and June 2018, 44 adult outpatients with active CD were evaluated at two different moments: before infliximab (IFX) administration and 24 weeks after infliximab therapy. We included patients with CD, aged ≥ 18 years and under 65 years, with a 3-month history of active disease, defined as a Harvey-Bradshaw index (HBI) score of 8 or higher and a serum level of C-reactive protein of more than 5.0 mg per liter, with indication for anti-tumor necrosis factor alpha therapy, i.e. refractory disease unresponsive to conventional therapies or steroid-dependent and those presenting with aggressive disease or features of poor prognosis prediction, such as extensive bowel disease, complex fistulizing disease, or severe endoscopic lesion as defined by the presence of deep and extensive ulcers. Eligible patients received induction therapy consisting of intravenous injections of 5 mg/Kg of IFX at weeks 0, 2, and 6 followed by maintenance infusion (5 mg/Kg) at weeks 14 and 22. Participants were followed until week 24. Patients were evaluated for PA in daily life using accelerometer, exercise capacity, peripheral muscle strength, anthropometry, and body composition. The primary endpoint was an increase in the total number of steps/day in daily life at week 24 in CD patients achieving IFX-induced remission. Secondary endpoints included improvement in the shuttle walking test (SWT), the handgrip strength (HS), active time, and inactive time. RESULTS: Thirty-eight (86.4%) patients achieved infliximab-induced remission at the end of 24 weeks and presented a significant increment from baseline in number of steps taken of 1092 (7440 ± 2980 vs. 6348 ± 3177, respectively; P = 0.006). The inactive time was significantly reduced when compared to baseline period (454.2 ± 106.3 vs. 427.9 ± 97.8, respectively; P = 0.033). There was no difference in the distance walked before and after IFX therapy. CONCLUSION: Infliximab-induced remission followed by maintenance therapy has shown to be effective for increasing PA levels in daily life as shows by increase in the number of steps taken per day as well as by reduced inactive time on patients with moderately-to-severely active CD. Given the important role of PA for patients with CD, anti-TNF therapy may be useful therapeutic strategy along with targeted PA recommendations for increasing PA levels. Furthermore, strategies of treatment associated with an exercise program must be considered for this population.

Preoperative physical activity has a protective effect against postoperative pulmonary complications after abdominal surgery

Physical activity level and fitness condition seem to be related with pulmonary surgical risk in thoracic and cardiac surgeries; however, in abdominal surgery this relation is not clear. Objective: To compare the physical activity level in daily life and during hospitalization before surgery between patients who developed and did not develop postoperative pulmonary complications (PPC) after abdominal surgery and to relate to this outcome. Methods: This prospective cohort enrolled 191 hospitalized candidates (52 ± 14yrs; BMI = 29 ± 11 kg/m2) for upper abdominal surgery. Two different tools related to two distinct moments were used to assess preoperatively the physical activity level. First, to assess life physical activity level, the questionnaire Human Activity Profile (HAP) was administered for all patients. During hospitalization, the accelerometry was performed during 4 consecutive days to assess the time in activity. In addition, lung function, muscle strength and resting energy expenditure were assessed. PPC (pneumonia, atelectasis or severe hypoxemia) were checked until discharge. Multivariate analyses were used. Results: 92% of patients were classified as moderately to physically active in daily life. During hospitalization, patients were inactive during 90% ± 5% of time. There was no association with HAP score and acelerometry. 10.5% of patients developed PPC. Being physically active in daily life and during hospitalization have a protective effect against PPC. Our results show that the physical activity behavior in hospital do not reflect the daily life even in patients not restricted to bed and on preoperative period, patients physically actives on daily life and during hospitalization present less chance to develop PPC after abdominal surgery.Keywords: surgery, physical activity, postoperative complication, pneumonia, accelerometry, hospitalization.

Impact of A Six Week Training Program on Ventilatory Efficiency, Red Blood Cell Rheological Parameters and Red Blood Cell Nitric Oxide Signaling in Young Sickle Cell Anemia Patients: A Pilot Study

Patients with sickle cell anemia (SCA) show impaired ventilatory efficiency, altered blood rheology, high levels of oxidative/nitrosative stress and enhanced hemolysis with large amounts of circulating free hemoglobin, which reduces nitric oxide (NO) bioavailability. The aim of the study was to investigate whether physical exercise could improve these physiological and biological markers described to contribute to SCA pathophysiology. Twelve SCA patients participated in a controlled six weeks training program with moderate volume (two sessions per week with 15–30 min duration per session) and intensity (70% of the first ventilatory threshold). Parameters were compared before (T0) and after (T1) training. Daily activities were examined by a questionnaire at T0 and one year after the end of T1. Results revealed improved ventilatory efficiency, reduced nitrosative stress, reduced plasma free hemoglobin concentration, increased plasma nitrite levels and altered rheology at T1 while no effect was observed for exercise performance parameters or hematological profile. Red blood cell (RBC) NO parameters indicate increased NO bioavailability which did not affect RBC deformability. Participants increased their daily life activity level. The data from this pilot study concludes that even low intensity activities are feasible and could be beneficial for the health of SCA patients.

Effect of counselling during pulmonary rehabilitation on self-determined motivation towards physical activity in people with chronic obstructive pulmonary disease \u2013 protocol of a mixed methods study

BackgroundPhysical activity promotion in people with Chronic Obstructive Pulmonary Disease (COPD) is focus of research and public health. Patient-centred interventions like counselling are promising approaches to help patients reducing sedentary behaviour. Aim of the present study is to investigate if a physical activity counselling program during pulmonary rehabilitation increases physical activity level in daily life in people with COPD.MethodsA two-armed, single blind randomised controlled trial including 56 people with COPD will be conducted in an outpatient pulmonary rehabilitation. Patients will participate in a 12-week-rehabilitation program; individuals randomized to the interventional group will additionally participate in five counselling sessions with a physiotherapist, based on the principles of motivational interviewing. The participants’ physical activity level will be measured using an accelerometer (SenseWear Pro®) before, directly and 3 months after pulmonary rehabilitation. Semi-structured interviews will be conducted to learn more about barriers and facilitators regarding daily physical activity.DiscussionIf the strategy successfully improves the physical activity level in people with COPD, counselling might be implemented in pulmonary rehabilitation.Trial registrationClinical Trials.gov NCT02455206 (05/21/2015), Swiss National Trails Portal SNCTP000001426 (05/21/2015).

Arm Activity During Daily Life in Individuals With Chronic Obstructive Pulmonary Disease.

To determine whether individuals with chronic obstructive pulmonary disease (COPD) have decreased arm activity during daily life compared with healthy controls and explore the relationships between arm activity during daily life and arm functional measures in individuals with COPD. This was a prospective cross-sectional study that included 30 people with COPD and 14 healthy controls. Subjects attended a single assessment session in which measurements of arm exercise capacity, arm functional performance, self-perception of performance during activities of daily living (ADL), shoulder and elbow flexion force and biceps and triceps thickness were performed. On completion of this session, participants were issued a wrist actigraph and asked to wear the device on the dominant arm for 24 hours for 7 consecutive days. Compared with healthy controls, patients with COPD presented decreased total activity level in daily life (P = .001). When corrected for walking, the level of arm activity did not differ between individuals with COPD and healthy controls (P = .62). No correlations were found between arm activity and arm exercise capacity, arm functional performance, upper limb muscle strength, and self-perception of performance during ADL (r =-0.20 to 0.14; all P ≥ .10). Arm activity intensity in individuals with COPD did not differ from that of healthy controls when measured by a wrist actigraph. Moreover, arm activity was not associated with other clinical outcomes of arm function. Disability during ADL is multifactorial, and only limited inferences of function can be made from accelerometer data.

Activity among long-term stroke survivors. A study based on an ICF-oriented analysis of two established ADL and social activity instruments

Purpose: To describe activity in different aspects of daily life among long-term stroke survivors, and conceptualise the content of the Barthel Index (BI) and the Swedish extended and modified Frenchay Activities Index (mFAI) using the ICF framework.Method: Assessments were performed by means of the BI and the mFAI at a 10-year follow-up of 145 consecutive stroke survivors from Lund Stroke Register, Sweden. After linking the two instruments to the ICF core set for stroke, data were analysed and presented in terms of activity-specific domain-scores for the total sample and sub-groups according to gender and age.Results: Together the two instruments covered 69% of the Activities and participation component of the ICF core set for stroke. Two activity-specific domains were identified within the BI and six within the mFAI. Most participants reported a high overall activity level. Inactivity was most common among those ≥80 years. Men and women participated in different types of activities and used different modes of transport.Conclusions: Long-term stroke survivors have a high activity level in daily life, though individual variation is considerable. The structure provided by linking instruments to the ICF core set for stroke can be used for more fine-tuned descriptions of activity.Implications for RehabilitationSince most long-term stroke survivors are independent in ADL but may have limitations in other activity domains such as social and leisure activities, these aspects should be considered in the rehabilitation process.Older stroke survivors deserve special attention due to their higher risk of long-term inactivity.The Barthel Index and the Swedish extended and modified Frenchay Activities Index are complementary for assessments of ADL and social activity after stroke and cover over two thirds of the Activities and participation component in the ICF core set for stroke.

Association of Fitness Level With Cardiovascular Risk and Vascular Function in Older Nonexercising Individuals.

It is currently unknown whether differences in physical fitness in older, nonexercising individuals affect cardiovascular risk profile and vascular function. To examine this, 40 healthy older individuals (age 69 ± 4 years) who were classified as nonexercising for the past 5-10 years were allocated to a lower physical fitness (LF; VO2max 20.7 ± 2.4 mlO2/min/kg) or higher physical fitness group (HF; VO2max 29.1 ± 2.8 mlO2/ min/kg, p < .001). Cardiovascular risk profile was calculated using the Lifetime Risk Score (LRS). Vascular function was examined using the gold standard venous occlusion plethysmography to assess blood flow changes in response to intra-arterial infusion of acetylcholine, sodium nitroprusside, and L-NNMA. Daily life activity level of the HF group was higher compared with the LF group (p = .04). LRS was higher (p < .001) and blood flow ratio response to acetylcholine was lower (p = .04) in the LF group. This study shows that a higher physical fitness level is associated with better cardiovascular health and vascular function in nonexercising older individuals.

High-sensitivity C-reactive protein and exercise-induced changes in subjects suspected of coronary artery disease

BackgroundInflammation plays a major role in the development of atherosclerosis. We wanted to investigate the effects of exercise on high-sensitivity (hs) C-reactive protein (CRP) in subjects who were suspected of having coronary artery disease (CAD).MethodsBlood samples were obtained before, 5 minutes after, and 20 hours after an exercise test in 155 subjects who were suspected of CAD. Coronary anatomy was evaluated by computed tomography coronary angiography and/or coronary angiography.ResultsMedian baseline hs-CRP was higher in subjects with ≥50% coronary artery lumen diameter stenosis (n=41), compared with non-CAD-subjects (n=114), 2.93 mg/L (interquartile range 1.03–5.06 mg/L) and 1.30 mg/L (interquartile range 0.76–2.74 mg/L), respectively, P=0.007. In multivariate analyses testing conventional risk factors, hs-CRP proved borderline significant, odds ratio =2.32, P=0.065. Adding baseline hs-CRP to the results of the exercise test did not improve the diagnostic evaluation. Baseline natural logarithm (Ln) hs-CRP was positively associated with body mass index and baseline Ln-transformed hs troponin T levels, and negatively associated with the daily life activity level. An increase in hs-CRP of 0.13 mg/L (interquartile range 0.05–0.24 mg/L) from baseline to 5 minutes after peak exercise was found (P<0.0001), but the increase was not associated with presence of CAD. From baseline to 20 hours after exercise, no increase in hs-CRP was found.ConclusionIn conclusion, hs-CRP was not independently associated with CAD. Hs-CRP increased immediately as a response to the exercise, and the increase was modest and not associated with CAD. The results indicate that exercise has potential to cause unwanted variations in hs-CRP and that exercise prior to hs-CRP measurements in subjects included in epidemiological studies, therefore, should be avoided.

Preserved function and reduced angiogenesis potential of the quadriceps in patients with mild COPD

BackgroundLittle is known about limb muscle abnormalities in mild COPD. Inactivity and systemic inflammation could play a role in the development of limb muscle dysfunction in COPD. The objective of the present study was to characterize quadriceps function, enzymatic activities and morphometry, levels of plasma inflammatory markers and physical activity levels in daily life (PAdl) in patients with mild COPD (GOLD 1).MethodsMid-thigh muscle cross-sectional area (MTCSA), quadriceps strength, endurance, fiber-type distribution, capillarity, pro-angiogenesis factors (VEGF-A, angiopoietin I and II) and muscle oxidative capacity were assessed in 37 patients with mild COPD and 19 controls. Systemic inflammatory markers (CRP, IL-6, TNF-α, Fibrinogen, SP-D) and PAdl were assessed.ResultsMTCSA, quadriceps strength and endurance were not different between COPD and controls. Capillarity and muscle oxidative capacity were all preserved in mild COPD. Reduced pro-angiogenesis factor mRNA expression was seen in COPD. The level of moderately active intensity (>3 METs) was significantly lower in mild COPD and, in multiple regression analyses, the level of physical activity was a determinant of muscle oxidative capacity and capillarization. No between-group differences were found regarding muscle oxidative stress while circulating IL-6 levels were elevated in mild COPD.ConclusionsThe quadriceps muscle function was preserved in mild COPD although a reduced potential for angiogenesis was found. The reduced level of daily activities and evidence of systemic inflammation in these individuals suggest that these factors precede the development of overt limb muscle dysfunction in COPD.

Assessment of Physical Activity by Movement Registration Systems in Chronic Pain

Physical activity assessments in chronic pain research have mostly been based on self-report. However, earlier research indicated that chronic pain patients have difficulties in estimating their own daily life activity level. Movement registration systems have been introduced to overcome the limitations of self-reported measures. However, no uniform guidelines for researchers on how to analyze and interpret movement registration data in chronic pain exist. The aim of the study was to provide recommendations for physical activity assessment based on movement registration in patients with chronic pain. First, a systematic review of the procedures and data processing techniques used in movement registration for chronic pain patients will be performed. Second, it will be discussed whether the recommendations for physical activity assessment in healthy individuals are applied in chronic pain research. Last, recommendations regarding assessment procedure and data processing for using movement registration systems in future research in patients with chronic pain will be given. In chronic pain literature, 27 articles on movement registration were identified. According to the recommendations for activity assessment in healthy individuals, the various descriptions of the assessment procedures in these articles were mostly limited. Especially, information regarding the minimal requirements for the assessment period and the method used for calculation of the final outcome variable were often lacking. It is recommended that studies in chronic pain research explicitly apply and report the criteria that have been used to define an assessment day, the total assessment time, and the method for calculating the final test outcome.

Do depression and pain intensity interfere with physical activity in daily life in patients with Chronic Low Back Pain?

Patients with chronic pain may have difficulties estimating their own physical activity level in daily life. Pain-related factors such as depression and pain intensity may affect a patients’ ability to estimate their own daily life activity level. This study evaluates whether patients with Chronic Low Back Pain (CLBP) who are more depressed and/or report more pain indeed have a lower objectively assessed daily life activity level or whether they only perceive their activity level as lower. Patients with CLBP were included in a cross-sectional study. During 14 days physical activity in daily life was measured, with both an electronic diary and an accelerometer. Multilevel analyses were performed to evaluate whether a higher level of depression and/or pain intensity was associated with a lower objectively assessed activity level or the discrepancy between the self-reported and objectively assessed daily life activity levels. Results, based on 66 patients with CLBP (mean RDQ score 11.8), showed that the objectively assessed daily life activity level is not associated with depression or pain intensity. There was a moderate association between the self-reported and objectively assessed activity levels ( β = 0.39, p < 0.01). The discrepancy between the two was significantly and negatively related to depression ( β = −0.19, p = 0.01), indicating that patients who had higher levels of depression judged their own activity level to be relatively low compared to their objectively assessed activity level. Pain intensity was not associated with the perception of a patient’s activity level ( β = 0.12, ns).

Comparison of daily physical activity between COPD patients from Central Europe and South America

In healthy elderly and adults, lower physical activity level in daily life has been associated with lower socio-economic level and non-Caucasian race. The objective of this study was to determine if this is also applicable in chronic obstructive pulmonary disease (COPD) by comparing physical activity levels in daily life in stable patients from two countries (Austria and Brazil) with different socio-economic and ethnic characteristics. Physical activity in daily life was objectively assessed in 40 Austrian and 40 Brazilian COPD patients. Groups were matched for age, gender, body mass index, disease severity, smoking history, presence of concomitant heart disease, lung function, dyspnea and functional exercise capacity. In addition, climatic conditions were similar during the period of data collection in the two groups. In comparison to Brazilian patients, Austrian patients had a significantly lower walking time (p=0.04), higher sitting time (p=0.02) and lower movement intensity (p=0.0001). The proportion of patients who did not reach an average of 30min of walking per day was 48% in the Austrian group and 23% in the Brazilian group. Austrian patients with COPD showed a significantly lower daily physical activity level in comparison to matched Brazilian patients. Socio-economic and ethnic factors appear to influence stable COPD patients differently than described in previous studies including healthy subjects.

Heart Rate Variability and Disease Characteristics in Patients with COPD

Heart rate variability (HRV) is reduced in patients with chronic obstructive pulmonary disease (COPD). However, the relationships among HRV and characteristics of COPD are unknown. The aim of this study was to characterize HRV in patients with COPD and to verify the correlation of HRV measured during rest with disease severity and pulmonary, muscular, and functional impairment. Thirty-one patients with COPD (16 male; 66 +/- 8 years; BMI = 24 +/- 6 kg/m(2); FEV(1) = 46 +/- 16% predicted) without severe cardiac dysfunction were included. HRV assessment was performed by the head-up tilt test (HUTT), and the main variables used for analysis were SDNN index, LF/HF ratio, and R-R intervals. Other tests included spirometry, bioelectrical impedance, cardiopulmonary exercise test, 6-minute walk test, respiratory and peripheral muscle force, health-related quality of life and functional status questionnaires, and objective quantification of physical activity level in daily life with the DynaPort and SenseWear armband activity monitors, besides calculation of the BODE index. There was a statistical difference in all variables of HRV between the HUTT positions (lying and standing). There was no correlation of HRV with BODE index or FEV(1). Out of the BODE index, just the BMI was correlated with SDNN and R-R intervals (r = 0.44; p < 0.05 and r = 0.37; p < 0.05, respectively). There was correlation between HRV reduction and a lower level of physical activity in daily life, besides worse health-related quality of life, functional status, and respiratory and peripheral muscle force. Cardiac autonomic function of patients with COPD is not related to disease severity but mainly to the level of physical activity in daily life.