Daily Physical Activity In Patients Research Articles

Effect of Behavior-change Interventions on Daily Physical Activity in Patients with Intermittent Claudication: The OPTIMA Systematic Review with Meta-Analysis.

The study aimed to synthesize evidence of daily physical activity (PA) following Behavior-change technique (BCT)-based interventions compared to any control in individuals with peripheral arterial disease/intermittent claudication (PAD/IC); and examine the relationship between BCTs and daily PA. Systematic search of 11 databases from inception to 30/11/2022 was conducted, plus weekly email alerts of new literature until 31/8/2023. Studies comparing BCT-based interventions with any control were included. Primary analysis involved a pairwise random-effects meta-analysis. Risk of bias was assessed using the Cochrane-RoB-2 and ROBINS-I tools. Certainty of evidence was evaluated with the GRADE system. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guideline was followed. Outcome measures were short-term (<6 months) change in daily PA, and maintenance of the daily PA (6 months or longer) reported as standardized mean differences (SMDs) with 95% confidence intervals (95%CIs). Forty-one studies (4,339 patients; 26 RCTs/3,357 patients; 15 non-RCTs/982 patients; study mean age 60.3 to 73.8, 29.5% female) were included. Eleven RCTs (15 comparisons, 952 participants) suggested that BCT-based interventions increased daily PA in the short term compared to non-SET [increase of 0.20 SMD (95%CI: 0.07 to 0.33), ∼473 steps/day] with high certainty. Evidence of maintenance of daily PA (≥6 months) is unclear [increase of 0.12 SMD (95%CI: -0.04 to 0.29); ∼288 steps/day; 6RCTs, 8 comparisons, 899 participants], with moderate certainty. For daily PA, compared to SET it was inconclusive both for < 6months change [-0.13 SMD, 95%CI: -0.43 to 0.16); 3RCTs, 269 participants; low certainty] and ≥6months [-0.04 SMD, 95%CI: -0.55 to 0.47); 1 RCT, 89 participants; very low certainty]. It was unclear whether the number of BCTs or any BCT domain were independently related to an increase in PA. BCT-based interventions improve short-term daily PA in people with PAD/IC compared to non-SET controls. Evidence for maintenance of the improved PA at 6 months or longer and comparison with SET is uncertain. BCT-based interventions are effective choices for enhancing daily PA in PAD/IC.

Correlation of fatigue with disability and accelerometer-measured daily physical activity in patients with relapsing-remitting MS.

Fatigue is one of the most common symptoms in patients with multiple sclerosis (MS). Furthermore, measuring its effects on patients in daily life is challenging. This study aimed to discover the association between relapsing-remitting MS (RRMS) patients' disability, fatigue, and accelerometer-measured physical activity. A total of 41 patients with RRMS with an Expanded Disability Status Scale (EDSS) level of 0-5.5 and 20 healthy controls completed the Modified Fatigue Impact Scale (MFIS) and the Fatigue Severity Scale (FSS) questionnaires. The EDSS was evaluated for all patients with RRMS, and all participants performed the MS Functional Composite (MSFC) test and six-min walk test and wore an accelerometer for seven days. Patients with an EDSS level of 0-2.5 were found to have higher fatigue levels (p < 0.001) than healthy controls but lower levels than patients with an EDSS level of 3-5.5 (p < 0.001). A significant correlation was found to exist between fatigue and disability level measured by the EDSS (EDSS/FSS, r=0.750/p=0.001; EDSS/MFIS, r=0.661/p=0.001) and with the MSFC test in the patient group (MSFC/FSS, r=-0.350 p=0.025; MSFC/MFIS, r=-0.423/p=0.007). Total daily activity correlated with fatigue as measured by the FSS (MVPS/FSS r=-0.357/p=0.028, step count/FSS r=-0.463/p=0.003), but no correlation was found between the EDSS or the MSFC. A lower disability rate, better physical condition, and higher daily-living activity were found to predict lower fatigue levels.

The Impact of Nordic Pole Walk Advice Alone or in Combination with Exercise Strategies on Daily Physical Activity in Patients with Intermittent Claudication. A Randomized Clinical Trial.

The impact of exercise interventions on physical activity remains undetermined in intermittent claudication, which is why it is important to include objectively measured physical activity as an additional endpoint. The aim of this pre-specified secondary analysis of a randomized clinical trial was to investigate the impact of unsupervised Nordic pole walk advice (WA) alone or in combination with hospital-based supervised exercise (SEP) or home-based structured exercise (HSEP) on physical activity inpatients with intermittent claudication. In total, 166 patients with intermittent claudication (mean age = 72 [SD = 7.4] y; 41% women) were randomized to 3 intermittent claudication-treatment strategies: WA, WA + SEP, or WA + HSEP. All patients received Nordic poles and standardized WA (≥30min, 3 times weekly). Patients randomized to HSEP and SEP accepted participation in an additional 6-months exercise program. Physical activity was measured with an accelerometer-based activPAL3 monitor for 7days at baseline and 3, 6, and 12months. Physical activity outcomes were steps per day, time spent within a stepping cadence ≥100 steps per minute, time spent upright, number of body transitions from sitting to standing, and number of sitting bouts of >30minutes and > 60minutes. At 1year, no intergroup differences were observed in any of the physical activity variables, whereas significant intergroup differences were observed at 3months regarding time spent within a stepping time cadence ≥100 steps per minute. The mean change for HSEP (2.47 [SD = 10.85] min) was significantly different from the mean change for WA (-3.20 [SD = 6.24] min). At 6months, the number of sitting bouts (>60min) for SEP was significantly different from WA (mean change = 0.24 [SD = 0.69] versus -0.23 [SD = 0.81]). This study indicates that the addition of 6months of HSEP or SEP does not improve physical activity at 1year, as compared to unsupervised WA alone. Factors of importance for increasing physical activity in patients with intermittent claudication require further investigation. At the 1-year follow-up, the addition of intermittent claudication-tailored additional exercise strategies did not improve daily physical activity in patients with intermittent claudication compared with unsupervised Nordic pole walk advice alone. Future studies may explore the role of behavior change techniques to increase physical activity in this patient group.

Interactional effects of depressive symptoms and physical function on daily physical activity in ambulatory patients receiving hemodialysis

BackgroundClarification of the factors associated with decreased physical activity is crucial for effective disease management in patients undergoing hemodialysis. Although evidence suggests that physical activity may be associated with physical function or depressive symptoms, limited studies have demonstrated these factors to be independently associated with the former in patients undergoing hemodialysis. This study aimed to examine whether physical function and depressive symptoms were independently or interactively associated with daily physical activity in patients undergoing hemodialysis.MethodsThis cross-sectional study analyzed 157 clinically stable outpatients (median age: 68 years) receiving hemodialysis. Physical activity (steps/day) was measured using an accelerometer for four consecutive non-dialysis days. Physical function was evaluated by calculating usual walking speed along a 10-m walkway. The 10-item version of the Center for Epidemiologic Studies for Depression Scale was used to assess depressive symptoms.ResultsThe hierarchical multiple regression model (Model 2), constructed by adding physical function to Model 1 (clinical characteristics), showed a significant increase in coefficient of determination (R2), compared to Model 1 (ΔR2 = 0.15, P < 0.01). There was no significant increase in R2 between Models 2 and 3, where depressive symptoms were added to Model 2. The interaction term of physical function with depressive symptoms in Model 4 indicated an increase in R2 (ΔR2 = 0.01, P = 0.03), compared with Model 3. The simple slope analysis demonstrated that the difference in physical activity between patients with or without depressive symptoms at higher levels of physical function was greater than that at its lower levels.ConclusionsPhysical function was a strong and independent factor associated with physical activity, but no independent relationship between depressive symptoms and the physical activity was observed in patients undergoing hemodialysis. In contrast, physical function and depressive symptoms were interactively associated with daily physical activity in patients undergoing hemodialysis who were capable of walking independently. Our findings suggested that a two-step screening, primarily based on physical function and then depressive symptoms, can be useful to identify factors associated with physical inactivity in hemodialysis patients.

Observational prospective study of physical activity in patients with cancer to define an objective performance status (OPS).

1506 Background: Clinical trials in patients with advanced cancer rely on a good selection of candidates based on their functional status. The Eastern Cooperative Oncology Group (ECOG) Performance Status is the most frequently used in adult patients and is based on the subjective impression of the clinician during the interview with the patient. The current use of wearable devices will allow clinicians to assess the functional status of candidates for a clinical trial in a more objective way. We aim to define an “Objective Performance Status” (OPS) by measuring the daily physical activity of patients with metastatic cancer and correlating it with the classical prognostic variables. Methods: We prospectively measured daily physical activity with a wearable device in 111 patients with metastatic cancer during the screening period for a phase 1 clinical trial to avoid treatment interference with the functional status. Daily steps/distance and sleeping hours were measured and correlated with overall survival (OS) to define the OPS. Results: Full data was available for 70 patients. Median survival was gradually shorter as physical activity decreases (HR 5.76 (95% CI 2.98-11.1) P &lt; 0001). The cut off selected to define the OPS was determined by univariate survival analysis and showed that patients who walk less than 1200 meters per day have 5 times the risk of mortality (poor OPS). Median OS was 3.2 months (95% CI 2.5-5.8) P &lt; 0001) for patients with poor OPS and 11.2 months for patients with good OPS (95% CI 7.2-31.3 P &lt; 0001). Conclusions: The objective assessment of performance status (OPS) using a wearable device to monitor the physical activity in patients with cancer is an independent prognostic factor for survival and is an objective predictor of mortality.[Table: see text]

Impact of increased physical activity in patients after pulmonary vein isolation - BE-ACTION trial

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Medical School Brandenburg and Local Government Concil Brandenburg Background Pulmonary vein isolation (PVI) is one of the key therapies for patients with atrial fibrillation (AF), however, there are numerous recurrences after ablation. Improving cardiorespiratory fitness (CF) may result in fewer recurrences of AF. The aim of the present study (Brandenburg Enhance ACTIvity ONset after pulmonary vein isolation - BE-ACTION) was to evaluate the impact of increased physical activity in patients after PVI on the recurrence of AF. Methods From January 2018 to April 2021, 200 patients with scheduled PVI were randomized at 4 different centres and fitted with an activity tracker for 24-hour activity monitoring via mobile phone. Patients aged between 50 and 77 years with a BMI between 23 and 35 kg/m2 were included. Patients with orthopaedic limitations were excluded. Patients in the ACTION group (n=99) were contacted regularly by telephone by a physical therapist and intensively motivated if the steps fell below 6,000 steps per day. Patients in the No-ACTION group (n=101) received standard of care. A loop recorder was implanted in 74 patients; those who refused loop recorder implantation underwent 7-day Holter monitoring at 6 and 12 months after PVI. Recurrence was defined as any atrial arrhythmia &amp;gt;30 sec, cardioversion or need of redo ablation after blanking period (3 month) up to 12 month. Results The number of steps per day increased in all pts from 7,918 (5,725-10,989) at week 2 after PVI to 9,511 (7,230-12,800) at 6 months and to 9,788 (6,962-12,152) at 12 months (p&amp;lt;0.001; Friedman), figure 1. In the ACTION group, the number of steps per day continued to increase between 6 and 12 months, whereas it decreased in the No-ACTION group. In total, recurrence of arrhythmia was found in 58 patients (29.9%: 31 patients with loop recorder, 14 with Holter monitoring and 13 with ECG). Recurrence occurred in 24 patients (25%) in the ACTION group and 34 patients (35%) in the No-ACTION group (p=0.140), table 1. Conclusion The level of daily physical activity was unexpectedly high in this study. The use of an activity tracker led to an increased daily physical activity in patients with AF after PVI. A further increase of activity did not reduce the recurrence of atrial arrhythmia in the ACTION group.

Improving Daily Physical Activity in Patients Undergoing Hemodialysis Using Plantar Electrical Nerve Stimulation: A Randomized Double-Blinded Controlled Trial

Improving Daily Physical Activity in Patients Undergoing Hemodialysis Using Plantar Electrical Nerve Stimulation: A Randomized Double-Blinded Controlled Trial

Three weeks of rehabilitation improves walking capacity but not daily physical activity in patients with multiple sclerosis with moderate to severe walking disability.

Patients with multiple sclerosis have low levels of physical activity. This is of concern because low activity levels are related to cardiovascular disease, poor walking ability, and reduced quality of life. The aim of this study was to evaluate the impact of rehabilitation on daily physical activity and walking capacity in patients with multiple sclerosis who have moderate to severe walking disability. This exploratory, observational study of 24 patients with multiple sclerosis examined daily physical activity, walking capacity and fatigue before and after 3 weeks of inpatient rehabilitation. Inpatient rehabilitation included physiotherapy (30-60 min, 5 times/week), strength and endurance training (30-45 min, 3-5 times/week), occupational therapy (30 min, 2-3 times/week), and neuropsychological training (30 min, 2 times/week). There were no specific interventions to target daily levels of physical activity. Daily physical activity did not change after rehabilitation (physical activity: effect size = -0.23, 95% confidence interval (95% CI) 0.02‒0.62). There were significant improvements in walking capacity (Two-Minute Walk Test: effect size = 0.74, 95% CI 0.31‒1.16, +17 m, 20.2%) and mobility (Timed Up and Go Test: effect size = 0.65, 95% CI 0.22‒1.07, ‒2.1 s, 14.9%). Motor and cognitive fatigue (Fatigue Scale for Motor: effect size = 0.56, 95% CI 0.14‒0.99 and Cognitive Functions: effect size = 0.44, 95% CI 0.01‒0.86) improved significantly after rehabilitation. Three weeks of rehabilitation improved walking capacity, but not daily physical activity, in patients with multiple sclerosis with moderate to severe walking disability. To increase physical activity, it may be necessary to add specific behavioural interventions to the rehabilitation programme. The intervention plan should include strategies to overcome personal and environmental barriers.

The impact of walk advice and exercise strategies on daily physical activity in patients with intermittent claudication - a randomized controlled trial

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): The Research and Development Council for Southern Gothenburg and Bohuslän and the Healthcare Board, Region Västra Götaland, Sweden. The Swedish state under the agreement between the Swedish government and the county councils, the ALF agreement. Introduction Exercise is a first-line treatment in intermittent claudication (IC). However, as the real impact of exercise interventions on daily physical activity (PA) behaviour remains largely undetermined, it is important to include objectively measured PA as an additional endpoint in clinical trials. Purpose The aim of this study was to investigate the impact of unsupervised Nordic pole walk advice (WA) alone or in combination with hospital-based supervised exercise (SEP) or home-based structured exercise (HSEP) with 1year follow up, on daily PA in patients with IC. Methods In this pre-specified analysis from an RCT, a total of 166 patients with IC (mean age 72 (7.4), 41% women) were randomized to three IC-treatment strategies: WA, WA+SEP or WA+HSEP. All patients received Nordic poles and the advice to walk for 30 min, 3 times weekly (WA strategy). Patients allocated to HSEP, and SEP were offered to participate in an additional 6 month exercise program with muscle resistance and aerobic walking exercises. During the following 7-12 months, patients continued with the exercise program at home, with no further feedback. PA was measured through wearable accelerometer recordings for 7-days consecutive periods at baseline, 3, 6, and 12 months. Studied PA outcomes were steps/day, time spent within a stepping cadence ≥100 steps/min, time spent in upright position (standing still and stepping), number of sit to stand transitions, number of sitting bouts of &amp;gt;30 min and &amp;gt;60 min. Intergroup comparisons were performed with one-way analysis of variances ANOVA and intragroup comparisons by paired sample t-test. Results No statistically significant intergroup differences were observed in steps/day over time. HSEP and SEP numerically improved in steps/day at 3 months (HSEP: +472 steps, 95% CI: -146 to 1090; SEP: +241 steps, 95% CI: -282 to 764) but again declined at 6 and 12 months, while WA improved in steps/day at 1year (+89 steps, 95% CI: -568 to 747). At 3 months, a significant improvement were observed in favour of HSEP vs. WA in time spent within a stepping cadence ≥100 steps/min (P=.01) and at 6 months, a significant decrease in favour of SEP vs. WA in number of sitting bouts (&amp;gt;60 min; P=.01). Conclusion Compared to WA alone, receiving additional exercise strategies resulted in a trend toward increased steps/day and time spent within a stepping cadence ≥100 steps/min at 3 months. The opposite pattern occurred at 1year follow-up with a trend for WA to increase in steps/day, while the exercise strategies declined. No firm conclusions can be drawn on the impact of HSEP, SEP and WA strategies on daily PA, and future studies should focus on elaborating on factors that increase daily PA levels in patients with IC. Such studies also need to attach a high priority to develop exercise interventions that translate to more sustainable improvements in daily PA levels in this target population.

PO-706-05 DECREASE IN ACTIVITY OF DAILY LIVING DURING THE COVID-19 PANDEMIC CORRELATES WITH A DECREASE IN BIOMETRIC VARIABLES

The COVID-19 pandemic caused home quarantine of majority of US population including patients with CIED. Outpatient remote monitoring can be used to record and analyze basic biometric variables during the months of the pandemic. To compare the biometric variables as heart rate and heart rate variability with daily physical activity before and during COVID-19 pandemic in patients with CIED. We retrospectively analyzed CareLinkTM data transmissions across a large healthcare system prior and during the COVID-19 pandemic. The cohort included 345,459 transmissions from 4141 patients between March and May in 2019 and 464,003 transmissions from 5371 patients in 2020. When comparing the period of March to May of 2019 to March to May of 2020 there was a significant decrease in daily physical activity (244±153 min vs. 204±143 min; p< 0.0001), decrease in day-time average HR (75.3± 9 bpm vs. 74.4±9 bpm; p< 0.0001), decrease in night-time average HR (69.0±8.8 bpm vs. 68.2±8.7 bpm; p< 0.0001) and decrease HR variability (81.5±30.4 ms vs. 80.2±34.2 ms ; p< 0.0001). During March and May of 2020 there was a significant correlation between the daily physical activity and HR variability (r2=0.24; p < 0.0001), day-time HR (r2=0.32; p < 0.0001) and night-time HR (r2=0.02; p < 0.0001). During the COVID-19 pandemic there was a significant decrease in the daily physical activity in patients with CIED likely from home quarantine that correlated with a decrease in HR variability, day-time HR and night-time HR. The changes in these parameters may adversely affect overall cardiovascular health and outcomes of patients with CIED.

The mSQUASH; a valid, reliable and responsive questionnaire for daily physical activity in patients with axial spondyloarthritis

AimAdaptation of the Short QUestionnaire to Assess Health-enhancing physical activity (SQUASH) in order to improve measurement properties in axSpA patients. MethodsThe original SQUASH was adapted using a qualitative stepwise approach with in-depth interviews including healthcare professionals and patients. Content validity was explored by comparing modified-SQUASH (mSQUASH) and original SQUASH. Next, mSQUASH was validated according to the OMERACT filter. International Physical Activity Questionnaire (IPAQ) was used as comparator and tri-axial accelerometer as gold standard for criterion validity and classification accuracy of intensity. Construct validity was assessed using Spearman correlations with clinical outcome assessments. For test-retest reliability, intra-class correlation coefficients (ICCs) were calculated. Responsiveness was assessed using standardized response mean (SRM), stratified by Anchor method. ResultsThe mSQUASH measured a systematically higher activity count and had less missing values (8% vs. 16%) then SQUASH. mSQUASH correlated better with accelerometer compared to IPAQ (ρ = 0.60 vs. ρ = 0.34). Accelerometer measured most activity in light intensity, whereas mSQUASH and IPAQ predominately measured moderate intensity. Correlations with ASDAS, BASDAI, BASFI and ASQoL were better for mSQUASH then IPAQ. Test-retest reliability was good in both questionnaires. In contrast to IPAQ, responsiveness was in correspondence with self-reported changes in physical activity for mSQUASH (SRM -0.84 for improvement and 0.88 for decrease). The average completion time of the mSQUASH was 7 minutes. ConclusionsThe development of the mSQUASH resulted in an easy applicable, valid, reliable and responsive questionnaire for the assessment of daily physical activity in axSpA patients, which can be used in research and daily clinical practice.

Association of daily physical activity with psychosocial aspects and functional capacity in patients with pulmonary arterial hypertension: a cross-sectional study.

Pulmonary arterial hypertension impairs exercise tolerance and daily physical activity. Aside from the hemodynamic limitations, physical, cognitive, and emotional factors may play a relevant and as yet unexplored role. We investigated whether there is an association between the physical activity level and psychological disorders, health-related quality of life, and daily activities. We also searched for an association of the physical activity level with clinical factors and functional capacity. This was an analytical, cross-sectional, observational study conducted in a Brazilian University Hospital. Twenty stable pulmonary arterial hypertension subjects wore an accelerometer for a week and completed an activity diary. They answered the quality of life questionnaire (SF-36), as well as the Hospital Anxiety and Depression scale, and the Manchester Respiratory Activities of Daily Living questionnaire. Transthoracic echocardiography, the six-minute walk test, the one-minute sit-to-stand test, and spirometry were performed. For statistical analysis, we used Chi-square tests or Fisher’s test as appropriate and the Mann–Whitney test to compare numerical values between two groups. The relationship between the parameters was assessed using the Spearman correlation test. The mean age was 44.3 years, 80% were women, 80% had idiopathic pulmonary arterial hypertension, and 20% had connective tissue disease. The mean daily step count was 4280 ± 2351, and the mean activity time was 41.6 ± 19.3 min. The distance covered (six-minute walk test) was 451.5 m, and the number of movements (one-minute sit-to-stand test) was 23.8. Thirty percent scored positive for anxiety, and 15% for depression (Hospital Anxiety and Depression scale). There was a significant correlation between accelerometer data and walking distance (six-minute walk test), number of movements (one-minute sit-to-stand test), level of daily physical activity (Manchester Respiratory Activities of Daily Living questionnaire), and depression symptoms. Our findings support the hypothesis that other aspects beyond physical and hemodynamic ones might impact the daily physical activity of patients with pulmonary arterial hypertension.

OUTSTEP-HF: randomised controlled trial comparing short-term effects of sacubitril/valsartan versus enalapril on daily physical activity in patients with chronic heart failure with reduced ejection fraction.

OUTSTEP-HF compared the effect of sacubitril/valsartan vs. enalapril on 6-min walk test (6MWT) distance, non-sedentary daytime physical activity and heart failure (HF) symptoms in patients with HF with reduced ejection fraction (HFrEF). Ambulatory patients (n=621) with stable symptomatic HFrEF were randomised 1:1 to sacubitril/valsartan (n=310) or enalapril (n=311). Changes in physical activity and mean daily non-sedentary daytime activity from baseline to Week 12 were measured using 6MWT and a wrist-worn accelerometer device, respectively. After 12 weeks, 6MWT improved by 35.09 m with sacubitril/valsartan [97.5% confidence interval (CI) 27.85, 42.32] and by 26.11 m with enalapril (97.5% CI 18.78, 33.43); however, there was no significant difference between groups [least squares means treatment difference: 8.98 m (97.5% CI -1.31, 19.27); P=0.0503]. Mean daily non-sedentary daytime activity decreased by 27 min with sacubitril/valsartan and by 21 min with enalapril [least squares means treatment difference: -6min (97.5% CI -25.7, 13.4), P=0.4769] after 12 weeks. 6MWT improved by ≥30 m in 51% of patients in the sacubitril/valsartan group vs. 44% of patients treated with enalapril (odds ratio 1.251, 95% CI 0.895, 1.748). At Week 4, non-sedentary daytime activity increased by ≥10% in 58% of patients treated with sacubitril/valsartan vs. 64% with enalapril; 58% of patients treated with sacubitril/valsartan reported improved HF symptoms as assessed by patient global assessment vs. 43% with enalapril. However, these differences did not persist at Week 12. After 12 weeks of treatment, there was no significant benefit of sacubitril/valsartan on either 6MWT or daytime physical activity measured by actigraphy compared with enalapril.

Daily physical activity in patients on chronic haemodialysis and its relation with fatigue and depressive symptoms.

Fatigue and depressed mood are considered main impediments to physical activity in haemodialysis (HD) patients. A better understanding of their interrelationships is crucial to develop effective therapies. Moreover, measurement of daily physical activity (DPA) in HD patients is tricky, as it is usually assessed by subjective self-report questionnaires. Therefore, we aimed to objectively measure sponteanous DPA with motion sensors and to explore its relation with fatigue and depressive symptoms. DPA was assessed for seven consecutive days in 37 HD patients based on their daily step count measured with the SenseWear™ Armband. The Fatigue Severity Scale (FSS) and Beck Depression Inventory-II (BDI-II) were administered to evaluate fatigue and depressed mood. Median DPA was 2424 steps/day, (IQR:892-4545). In 81% of subjects, DPA felt within a sedentary lifestyle classification, as they made < 5.000 steps/day. DPA did not correlate with fatigue (rs = 0.04, p = 0.832), and did not significantly differ between patients categorized as clinically fatigued (n = 23, FSS ≥ 4) or not (n = 14, FSS < 4) (p = 0.654, d = 0.20). Although low-depressed subjects (n = 19, BDI-II ≤ 13) made on average 1.7 times more steps/day than high-depressed subjects (n = 18, BDI-II > 13) (p = 0.111, d = 0.60), depressive mood did also not correlate significantly with DPA (rs = -0.23, p = 0.175). Objective assessment of DPA with motion sensors is feasible in HD patients and allows identifying a sedentary lifestyle. Our results suggest that spontanous DPA is determined by age rather than by fatigue or mood.

Daily physical activity and related risk factors in COPD

BackgroundFactors associated with reduced daily physical activity (DPA) in patients with COPD are still controversial. Physical inactivity in COPD increases risk of cardiovascular disease, frequent exacerbations, reduced health status, and increased symptoms. We hypothesised that reduced DPA in patients with COPD is independent of traditional risk factors including age and spirometry.MethodsIn this cross-sectional study, DPA (over 7 days) was assessed on 88 community stable patients with COPD and 40 controls free from cardiorespiratory disease. Spirometry, body composition, number of exacerbations, handgrip strength (HGS), modified Medical Research Council (mMRC), arterial stiffness, 6-min walking distance (6MWD) and BODE index were also determined. Frequent exacerbation was defined as ≥2 and non-frequent exacerbation < 2.ResultsPatients with COPD had reduced DPA and exercise capacity compared with controls similar in age, BMI and gender, p < 0.001. Frequent exacerbators had less DPA than infrequent exacerbators and both less than controls, p < 0.001. Patients with higher BODE index were less active than those with lower index. Time spent on moderate activity was related to cardiovascular risk factors including arterial stiffness. The DPA in patients was independent of age, gender, spirometry, body composition and HGS, p > 0.05. The level of breathlessness was superior to lung function in predicting the level of DPA.ConclusionThe level of DPA in COPD was independent of traditional risk factors. Breathlessness score is a better predictor of the DPA than lung function and handgrip strength.

Physical activity in patients with cancer: self-report versus accelerometer assessments

PurposeThe level of daily physical activity in patients with cancer is frequently assessed by questionnaires, such as the Physical Activity Scale for the Elderly (PASE). Objective assessments, with for example accelerometers, may be a good alternative. The aim of this study was to investigate the agreement between the PASE questionnaire and accelerometer-assessed physical activity in a large group of patients with different types of cancer.MethodsBaseline accelerometer and PASE questionnaire data of 403 participants from the REACT (Resistance and Endurance Exercise After Chemotherapy, n = 227), the EXIST (Exercise Intervention After Stem-Cell Transplantation, n = 74), and NET-QUBIC (NEtherlands QUality of Life And Biomedical Cohort Studies In Cancer, n = 102) studies were available for the current analyses. Physical activity was assessed by the PASE questionnaire (total score) and accelerometers (total minutes per day > 100 counts). Linear mixed models regression analysis was used to assess the agreement between the PASE questionnaire and accelerometer-assessed physical activity.ResultsThe mean (SD) PASE score was 95.9 (75.1) points and mean (SD) time in physical activity measured with the accelerometer was 256.6 (78.8) min per day. The agreement between the PASE score and the accelerometer data was significant, but poor (standardized regression coefficient (B) = 0.36, 95%CI = 0.27; 0.44, p < 0.01).ConclusionAgreement between the PASE questionnaire and accelerometer-assessed physical activity was poor. The poor agreement indicates that they measure different physical activity constructs and cannot be used interchangeably to assess the level of daily physical activity in patients with cancer.

Daily Physical Activity in Patients With COPD After Hospital Discharge in a Minority Population.

Low physical activity in patients with chronic obstructive pulmonary disease (COPD) is associated with increased morbidity and mortality. To inform the design of a home-based physical activity promotion program for patients with COPD recently discharged from a minority-serving hospital, we conducted a cohort study to evaluate objectively measured daily physical activity and patient-reported outcomes. This was a 12-week prospective cohort study of patients with a physician diagnosis of COPD recently hospitalized (≤ 12 weeks) for respiratory symptoms. Daily physical activity was recorded using wrist-based and "clip-on" pedometers, and analyzed as mean daily step counts averaged over 7 days. Twenty-two patients were enrolled a median (interquartile range, [IQR]) of 14 (7 to 29) days after hospital discharge. The median daily step count (IQR) in the first week after enrollment (week 1) was 3710 (1565 to 5129) steps. The median within-person change in daily step count (IQR) from week 1 to week 12 was 314 (-30 to 858) steps (p=0.28). Within-person correlation of week-to-week daily step counts was high (r ≥ 0.75). Time from hospital discharge to enrollment was not correlated with mean daily step counts on week 1 (r= -0.13) and only weakly correlated with change in mean daily step counts from week 1 to week 12 (r=0.37). Daily physical activity was variable in this cohort of recently hospitalized patients with COPD, but with little within-person change over a 12-week period. These observations highlight the need for flexible physical activity promotion programs addressing the needs of a heterogeneous patient population.

Minimal Important Difference for Physical Activity and Validity of the International Physical Activity Questionnaire in Interstitial Lung Disease.

The optimal method of physical activity measurement has not been determined in patients with fibrotic interstitial lung disease (ILD). To assess the validity, internal consistency, and responsiveness of the International Physical Activity Questionnaire long form (IPAQ-LF) and to estimate the minimal important difference (MID) for moderate to vigorous physical activity (MVPA) in patients with fibrotic ILD. This two-center prospective cohort study included a convenience sample of 111 outpatients with fibrotic ILD who wore waist and wrist ActiGraph accelerometers for 7 consecutive days, followed by self-administration of the IPAQ-LF. Both measurements were performed at baseline and 6-month follow-up. Spearman rank correlations were used to evaluate the IPAQ-LF validity in comparison to activity monitor data, lung function, step count, and quality of life. The internal consistency of the IPAQ-LF was determined using Cronbach's α. Self-reported changes in IPAQ-LF parameters were compared among tertiles of change measured by the waist activity monitor to assess the responsiveness of the IPAQ-LF after 6 months. Anchor- and distribution-based methods were used to estimate the MID for MVPA. Self-reported MVPA minutes, activity-related energy expenditure, sedentary time, and inactive time of the IPAQ-LF generally showed moderate to strong correlations with corresponding waist activity monitor data, step count, lung function, and quality of life. The Cronbach's α of the IPAQ-LF was 0.78. The IPAQ-LF was responsive at detecting increases in weekly MVPA and energy expenditure. The MIDs for MVPA were 8 to 26 and 13 to 58 min/wk using the anchor-based method for waist activity monitor and IPAQ-LF data, respectively. The distribution-based MID estimate for MVPA was 104 to 242 min/wk. The IPAQ-LF has acceptable validity and internal consistency for measuring daily physical activity in patients with fibrotic ILD. The IPAQ-LF was responsive at detecting increases in physical activity but limited in its ability to detect declines or changes in inactivity. Using an anchor-based approach, the MID for MVPA measured by a waist activity monitor is approximately 26 min/wk.

Objective Improvement in Daily Physical Activity in Heart Failure Remains Elusive: A Systematic Review

Purpose: The purpose was to comprehensively review the literature for exercise- and psychosocial-based rehabilitation interventions for improving daily physical activity (PA) in patients with heart failure (HF). Methods: A search of the PubMed/MEDLINE, CINAHL, ProQuest Medical, PsycINFO, and Web of Science databases was conducted. Articles were included if they (1) were written in English, (2) included subjects with HF, (3) assessed physical or psychosocial rehabilitation interventions to improve daily PA, and (4) measured daily PA qualitatively or quantitatively. Case reports, non–peer-reviewed research, and articles without full text available were excluded. Two authors completed the screening independently, and conflicts were resolved by a third author. Results: One thousand four hundred sixty-two unique records were identified, and of these, 47 were selected for full-text review. Ultimately 15 were included: 13 randomized controlled trials and 2 case series, published from 1999 to 2016. No studies using only exercise interventions resulted in objective increases in daily PA. All 3 studies using only psychosocial interventions resulted in an increase, but only 1 of these used an objective measure and that study was a case series. One study using a combination of exercise and psychosocial interventions showed an objective increase in daily PA, but that result was not replicated later in a similar study. Conclusions: Exercise interventions alone do not result in improvement in daily PA in patients with HF. Further investigation concerning psychosocial interventions, with objective outcome measurement, is warranted.

CLINICAL RELEVANCE BETWEEN DAILY PHYSICAL ACTIVITY AND RESPIRATORY MUSCLE STRENGTH IN PATIENTS SCHEDULED TO UNDERGO SURGERY FOR NON‐SMALL CELL LUNG CANCER

RespirologyVolume 22, Issue S3 p. 231-231 APSR Poster Abstracts CLINICAL RELEVANCE BETWEEN DAILY PHYSICAL ACTIVITY AND RESPIRATORY MUSCLE STRENGTH IN PATIENTS SCHEDULED TO UNDERGO SURGERY FOR NON-SMALL CELL LUNG CANCER First published: 23 November 2017 https://doi.org/10.1111/resp.13207_375Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume22, IssueS3Supplement: 22nd Congress of the Asian Pacific Society of Respirology, International Convention Centre, Sydney, Australia, 23–26 November 2017November 2017Pages 231-231 RelatedInformation