Physical Inactivity In Patients Research Articles

The Association between Glaucoma Severity and Hip Fractures in California Medicare Beneficiaries

PurposeTo examine the association between glaucoma severity and hip fractures in older adults. DesignRetrospective cross-sectional study. Subjects2019 California Medicare beneficiaries with Parts A & B coverage. MethodsMultivariable logistic regression was used to analyze the association between glaucoma severity (mild, moderate, and severe vs. no glaucoma) and hip fracture, after adjusting for age, sex, race and ethnicity, and Charlson Comorbidity Index score. A subgroup analysis was performed only in individuals with glaucoma to examine the odds of hip fracture for those with moderate and severe glaucoma compared to those with mild glaucoma. Main Outcome MeasuresThe variations in the odds of hip fractures for patients with and without glaucoma and for patients with moderate and severe glaucoma compared to those with mild glaucoma. ResultsOf the 2,717,346 beneficiaries in the study population, 220,662 (8.1%) had glaucoma. In multivariate regression analysis, those with mild (odds ratio [OR]: 0.83, 95% confidence interval [CI]: 0.78-0.88) and moderate glaucoma (OR: 0.88, 95% CI: 0.84-0.92) had reduced odds of hip fracture compared to those with no glaucoma. There was no statistically significant association between severe versus no glaucoma and hip fracture (OR: 0.96, 95% CI: 0.91-1.02). Among individuals with glaucoma, the odds of hip fracture were higher for those with moderate (OR: 1.07; 95% CI: 0.99-1.15) and severe glaucoma (OR: 1.17; 95% CI: 1.08-1.27), compared to those with mild glaucoma. ConclusionsIn the California Medicare population, the presence of glaucoma was associated with decreased likelihood of hip fracture. However, in those with glaucoma, increased glaucoma severity was associated with an increased likelihood of hip fracture. Potential mediating mechanisms requiring further study include fear of falls and physical inactivity in patients with glaucoma.

Longitudinal description and prediction of physical inactivity among patients with borderline personality disorder and personality-disordered comparison subjects

BackgroundThe physical and psychological benefits of physical activity are well-known, and physical activity has been proven to be a helpful adjunct to psychotherapeutic treatment for many symptomatic disorders, including mood and anxiety disorders. The current study explores physical inactivity levels in patients with borderline personality disorder (BPD). The first aim of this study is to describe the 12-year course of physical inactivity in patients with BPD. The second aim is to examine predictors of physical inactivity, including adversity experiences, comorbid symptomatic (formerly axis I) disorders, medical disorders, and demographic factors.MethodsTwo hundred and forty-five patients with BPD were interviewed seven times over 12-years of prospective follow-up as part of the McLean Study of Adult Development (MSAD). Patients were categorized as ever-recovered (i.e., patient had experienced a symptomatic and psychosocial recovery from BPD) or never-recovered. At each follow-up, patients reported physical activity levels (minutes of exercise per week) via a semi-structured interview— the Medical History and Services Utilization Interview (MHSUI). Data was collected from June 1992 to December 2018.ResultsNever-recovered patients with BPD were significantly more inactive than their ever-recovered counterparts (p < 0.001). These rates of inactivity remained stable over time for both groups. Two significant multivariate predictors of inactivity were found: obesity (p = 0.003) and PTSD (p < 0.001).ConclusionsNon-recovered BPD patients are more likely to be inactive than patients who have recovered. Both clinical and medical factors appear to contribute to inactivity levels in patients with BPD.

Revitalizing the Gut Microbiome in Chronic Kidney Disease: A Comprehensive Exploration of the Therapeutic Potential of Physical Activity.

Both physical inactivity and disruptions in the gut microbiome appear to be prevalent in patients with chronic kidney disease (CKD). Engaging in physical activity could present a novel nonpharmacological strategy for enhancing the gut microbiome and mitigating the adverse effects associated with microbial dysbiosis in individuals with CKD. This narrative review explores the underlying mechanisms through which physical activity may favorably modulate microbial health, either through direct impact on the gut or through interorgan crosstalk. Also, the development of microbial dysbiosis and its interplay with physical inactivity in patients with CKD are discussed. Mechanisms and interventions through which physical activity may restore gut homeostasis in individuals with CKD are explored.

Mobile Health Intervention Reduces Sedentary Time and Physical Inactivity in Patients with Cardiovascular Diseases after Discharge: Systematic Review and Meta-Analysis

Abstract Background: Long sedentary time and physical inactivity negatively impact patients with cardiovascular diseases (CVD). Although more and more studies are exploring the effects of mobile health (mHealth), whether an intervention using mHealth reduces sedentary time and physical inactivity is controversial. Objective: This systematic review aimed to investigate whether mHealth can reduce sedentary time and physical inactivity in patients with CVD via a comprehensive search and evaluation of relevant articles and review of the effects of mHealth on sedentary time and physical inactivity. Methods: We searched articles on three databases PubMed, Web of Science, and CiNii using “mHealth,” “CVD,” and “clinical trials” as keywords. All studies using mHealth to reduce sedentary time and physical inactivity were included. We assessed risk of bias in the included studies and conducted a meta-analysis using a random effects model. Results: After screening 502 articles, we included five randomized controlled trials. In one study, sedentary time was shorter in the intervention group than the control group by 61.5 min/day at 24 weeks. Three studies using physical inactivity as outcome measures were included in a meta-analysis, and the pooled odds ratio was 0.38 (95% confidence interval, 0.22–0.65), favoring the intervention group. All studies showed high risk of performance bias and low risk of selection bias and reporting bias. Conclusion: The mHealth intervention may remind patients with CVD of exercise training and help them reduce sedentary time and physical inactivity. Future studies need to show for how long mHealth can reduce sedentary time and clarify the cost-effectiveness of the mHealth intervention.

Risk of sarcopenia, fear of COVID-19, anxiety, depression and physical activity levels: Associations across patients on hemodialysis within Greece.

The purpose of this multicenter cross-sectional study was to investigate the association between SARC-F, fear of COVID 19, anxiety, depression and physical activity in patients undergoing hemodialysis. This study was conducted in 3 hemodialysis centers in Greece during the period of the COVID-19 pandemic. Sarcopenia risk was assessed using the Greek version of SARC-F (≥4). Demographic and medical history were collected from the patient's medical charts. The participants were also asked to fill the Fear of COVID-19 Scale (FCV-19S), the Hospital Anxiety and Depression Scale (HADS), and the International Physical Activity Questionnaire (IPAQ) questionnaire. A hundred and thirty-two (132) patients on hemodialysis (92 men, 70.75±13.14 years) were enrolled. Sarcopenia risk (utilizing the SARC-F) was found in 41.7% of patients on hemodialysis. The average duration of hemodialysis was 3.94±4.58 years. The mean score values for SARC-F, FCV-19S and HADS were 3.9±2.57, 21.08±5.32, and 15.02±6.69, respectively. The majority of patients were physically inactive. The SARC-F scores were strongly associated with age (r=56; p<0.001), HADS (r=0.55; p<0.001), levels of physical activity (r=0.5; p<0.001), but not with FCV-19S (r=0.27; p<0.001). A statistically significant relationship was recorded between sarcopenia risk and age, anxiety/depression and levels of physical inactivity in patients on hemodialysis. Future studies are necessary in order to evaluate the association of specific characteristics of patients.

Post-acute sequelae of SARS-CoV-2 associates with physical inactivity in a cohort of COVID-19 survivors

The aim of this study was to determine whether Post-acute Sequelae of SARS-CoV-2 Infection (PASC) are associated with physical inactivity in COVID-19 survivors. This is a cohort study of COVID-19 survivors discharged from a tertiary hospital in Sao Paulo, Brazil. Patients admitted as inpatients due to laboratory-confirmed COVID-19 between March and August 2020 were consecutively invited for a follow-up in-person visit 6 to 11 months after hospitalization. Ten symptoms of PASC were assessed using standardized scales. Physical activity was assessed by questionnaire and participants were classified according to WHO Guidelines. 614 patients were analyzed (age: 56 ± 13 years; 53% male). Frequency of physical inactivity in patients exhibiting none, at least 1, 1–4, and 5 or more symptoms of PASC was 51%, 62%, 58%, and 71%, respectively. Adjusted models showed that patients with one or more persistent PASC symptoms have greater odds of being physically inactive than those without any persistent symptoms (OR: 1.57 [95% CI 1.04–2.39], P = 0.032). Dyspnea (OR: 2.22 [1.50–3.33], P < 0.001), fatigue (OR: 2.01 [1.40–2.90], P < 0.001), insomnia (OR: 1.69 [1.16–2.49], P = 0.007), post-traumatic stress (OR: 1.53 [1.05–2.23], P = 0.028), and severe muscle/joint pain (OR: 1.53 [95% CI 1.08–2.17], P = 0.011) were associated with greater odds of being physically inactive. This study suggests that PASC is associated with physical inactivity, which itself may be considered as a persistent symptom among COVID-19 survivors. This may help in the early identification of patients who could benefit from additional interventions tailored to combat inactivity (even after treatment of PASC), with potential beneficial impacts on overall morbidity/mortality and health systems worldwide.

Gait speed predictors and gait-speed cut-off score to discriminate asthma control status and physical activity in patients with asthma.

As a "vital sign" of health and functional capacity, gait speed is commonly used. However, there is insufficient evidence for possible determinants of gait speed in patients with asthma. The primary objective of the present study was to determine predictors of gait speed in patients with asthma. The second objective was to determine the cut-off point for the 4-minute Gait Speed (4MGS) to better discriminate asthma control status and physical activity in asthma. Fifty-seven patients with asthma were included in this cross-sectional study. Demographic and clinic characteristics, pulmonary function, asthma control status (ACT, Asthma Control Test), dyspnea, gait speed (4MGS), physical activity [International Physical Activity Questionnaire-Short Form (IPAQ-SF)] and activities of daily living were evaluated. Stepwise multiple linear regression analysis was used to investigate the possible predictors of gait speed. Receiver operating characteristic (ROC) curve analysis was used to determine whether usual gait speed had a discriminative value. The stepwise multiple regression analysis revealed that the ACT score and the IPAQ-SF score were significant and independent predictors of the 4MGS in patients with asthma explaining 40% of the variance in 4MGS (p < 0.001). The ROC curve showed a cut-off point of 1.06 m/s for the 4MGS for poorly controlled asthma and physical inactivity (p < 0.05). Our findings indicate that asthma control status and physical activity can be independent predictors of gait speed in patients with asthma. In addition, gait speed may be discriminative to determine poorly controlled asthma and physical inactivity in patients with asthma.

Association between Social Support and Physical Activity in Patients with Coronary Artery Disease: Multiple Mediating Roles of Self-Efficacy and Autonomous Motivation.

Physical inactivity in patients with coronary artery disease is linked to recurrent cardiac events. Given that social support may be an enduring major factor for physical activity, the mechanism underlying the multiple mediating effects of self-efficacy and autonomous motivation on the relationship between social support and physical activity in patients with coronary artery disease has hardly been examined. Therefore, this study aimed to clarify the multiple mediating roles of social support and physical activity on the relationship between self-efficacy and autonomous motivation in patients with coronary artery disease. This descriptive cross-sectional study included 190 inpatients who were diagnosed with coronary artery disease and admitted to a cardiology ward university hospital in Korea. Parallel multiple mediated models were tested using the SPSS PROCESS macro. The direct effects of social support on physical activity and the indirect effects of self-efficacy and autonomous motivation on social support and physical activity were statistically significant. Thus, positive social support from health-care providers has an important role to play in promoting physical activity by increasing self-efficacy and autonomous motivation for physical activity in patients with coronary artery disease.

Lockdown measures for COVID-19 outbreak and variation in physical activity in patients with heart failure and cardiac implantable devices.

AimsThe present study analysed the patterns of physical activity pre-, during and post-lockdown measures for COVID-19 pandemic in patients with chronic heart failure (CHF) and cardiac implantable electronic devices (CIED) under remote monitoring (RM), and assessed the physical activity patterns during these periods.MethodsThe raw data from 95 patients with CHF (age 67,7 15,1 years, 71,5% male) corresponding to 2238 RM transmissions of the Medtronic Carelink™ network platform was obtained. The physical exercise profiles and the impact of the lockdown measures on the physical behaviour during and after the measures were analysed. According to the level of activity duration in the pre-lockdown, lockdown and post-lockdown periods, the patterns of behaviour were identified (non-recoverees, incomplete recoverees, recoverees and full-recoverees).ConclusionRM of CHF patients with CIED using the Carelink™ network is useful for close follow-up and identification of heart failure risk status variations. After relieving the confinement measures there were two groups of patients that did not recover the previous physical activity levels. Physical inactivity in patients with CHF can have a significant impact on outcomes.

Depression Leads to Physical Inactivity in Patients with Beta-Thalassemia Major

Beta-thalassemia major (BTM) is difficult to treat chronic disease, causing physical and psychological burdens for the patient. Several studies have confirmed a decrease in physical activity and depression in thalassemia patients, but limited studies examine the relationship between these two conditions. This study aims to analyze the relationship between depression and physical activity in BTM patients in Bandung city. It was analytical observational research with a cross-sectional design. Data were collected during September–December 2018 by interviewing 65 patients selected by simple random sampling from 300 thalassemia patients registered at the Association of Parents with Thalassemia Indonesia/Perhimpunan Orangtua Penderita Thalassemia Indonesia (POPTI) Bandung city. The instruments used were the Global Physical Activity Questionnaire (GPAQ) to measure physical activity and the Beck Depression Inventory (BDI) to assess depressive symptoms. Data were analyzed by chi-square test using SPSS for Windows ver. 23.0. The results showed that most BTM patients in Bandung city were depressed (52%) and had low physical activity levels (65%). Furthermore, there was a statistically significant relationship between depression and physical activity in thalassemia patients in Bandung city (p=0.04, p&lt;0.05). Therefore, it can be concluded that BTM patients in Bandung city with depression have lower physical activity. DEPRESI BERDAMPAK PADA AKTIVITAS FISIK YANG RENDAH PADA PASIEN TALASEMIA BETA MAYORTalasemia beta mayor merupakan penyakit kronis yang sulit disembuhkan sehingga menimbulkan beban fisik dan psikologis bagi pasien. Beberapa penelitian telah mengonfirmasi penurunan aktivitas fisik dan depresi pada pasien talasemia, namun studi yang mengkaji hubungan antara kedua kondisi ini masih terbatas jumlahnya. Penelitian ini bertujuan menganalisis hubungan antara kondisi depresi dan tingkat aktivitas fisik pada penderita talasemia beta mayor di Kota Bandung. Desain penelitian bersifat observasional analitik dengan rancangan potong lintang. Pengambilan data dilakukan selama September–Desember 2018 dengan mewawancarai 65 pasien yang dipilih secara simple random sampling dari 300 pasien talasemia yang terdaftar di Perhimpunan Orangtua Penderita Thalassemia Indonesia (POPTI) Kota Bandung. Instrumen yang digunakan adalah Global Physical Activity Questionnaire (GPAQ) untuk mengukur aktivitas fisik dan Beck Depression Inventory (BDI) untuk menilai gejala depresi. Data dianalisis dengan uji chi-square menggunakan SPSS for Windows ver. 23.0. Hasil penelitian menunjukkan mayoritas penderita talasemia beta mayor di Kota Bandung mengalami depresi (52%) dan memiliki tingkat aktivitas fisik rendah (65%). Selanjutnya, terdapat hubungan bermakna secara statistik antara depresi dan aktivitas fisik pada penderita talasemia di Kota Bandung (p=0,04; p&lt;0,05). Oleh karena itu, dapat disimpulkan bahwa penderita talasemia beta mayor di Kota Bandung yang mengalami depresi memiliki aktivitas fisik yang lebih rendah.

Galectin-3 Binding Protein, Depression, and Younger Age Were Independently Associated With Alexithymia in Adult Patients With Type 1 Diabetes.

Aims: Alexithymia has been linked to cardiovascular disease. The aim was to explore whether the immuno-inflammatory variables galectin-3 binding protein (Gal3BP), soluble (s)CD163 and galectin-3 were independently associated with alexithymia, while controlling for known risk factors for cardiovascular disease, such as depression, anxiety, impaired glycemic control, obesity, smoking, and physical inactivity in patients with type 1 diabetes (T1D).Methods: Cross-sectional design. The participants were consecutively recruited from one diabetes out-patient clinic. Alexithymia, depression and anxiety were assessed by self-report instruments. Blood samples, anthropometrics, and blood pressure were collected, supplemented with data from electronic health records. High Gal3BP was defined as ≥3.3 μg/ml, high sCD163 as ≥0.6 μg/ml, high galectin-3 as ≥2.6 ng/ml, impaired glycemic control as HbA1c >70 mmol/mol (>8.6%) and abdominal obesity as waist circumference ≥ 1.02 m for men and ≥ 0.88 m for women.Results: Two hundred and ninety two patients participated (men 56%, aged 18–59 years, alexithymia prevalence 15%). Patients with alexithymia had higher prevalence of depression (34 vs. 6%, p < 0.001), anxiety (61 vs. 30%, p < 0.001), high Gal3BP levels (39 vs. 17%, p = 0.004), high HbA1c levels (46 vs. 24%, p = 0.006), and abdominal obesity (29 vs. 15%, p = 0.045). Depression [adjusted odds ratio (AOR) 6.5, p < 0.001], high Gal3BP levels (AOR 2.4, p = 0.035), and age (AOR 0.96, p = 0.027) were independently associated with alexithymia. Abdominal obesity (AOR 4.0, p < 0.001), high Gal3BP levels (AOR 2.8, p = 0.002), and depression (AOR 2.9, p = 0.014) were associated with high HbA1c. Abdominal obesity and anxiety were associated [Crude odds ratio (COR) 2.4, p = 0.006].Conclusions: T1D patients with alexithymia had higher prevalence of high Gal3BP levels, depression, impaired glycemic control, anxiety, and abdominal obesity, which are known risk factors for cardiovascular disease. Only high Gal3BP levels, depression, and younger age were independently associated with alexithymia in adult patients with T1D.

Utility of single-item questions to assess physical inactivity in patients with chronic heart failure.

AimThe purpose of this study was to explore the utility of two single‐item self‐report (SR) questions to assess physical inactivity in patients with heart failure (HF).Methods and resultsThis is a cross‐sectional study using data from 106 patients with HF equipped with accelerometers for 1 week each. Two SR items relating to physical activity were also collected. Correlations between accelerometer activity counts and the SR items were analysed. Patients were classified as physically active or inactive on the basis of accelerometer counts, and the SR items were used to try to predict that classification. Finally, patients were classified as having high self‐reported physical activity or low self‐reported physical activity, on the basis of the SR items, and the resulting groups were analysed for differences in actual physical activity. There were significant but weak correlations between the SR items and accelerometer counts: ρ = 0.24, P = 0.016 for SR1 and ρ = 0.21, P = 0.033 for SR2. Using SR items to predict whether a patient was physically active or inactive produced an area under the curve of 0.62 for SR1, with a specificity of 92% and a sensitivity of 30%. When dividing patients into groups on the basis of SR1, there was a significant difference of 1583 steps per day, or 49% more steps in the high self‐reported physical activity group (P < 0.001).ConclusionsThere might be utility in the single SR question for high‐specificity screening of large populations to identify physically inactive patients in order to assign therapeutic interventions efficiently where resources are limited.

Nonorgan manifestations of sarcoidosis.

The current review discusses the diagnosis and management of nonorgan-related symptoms that commonly arise in the setting of systemic sarcoidosis. Fatigue, small fiber neuropathy (SFN) and neuropsychological symptoms are highlighted. The debilitating effects of chronic nonorgan-based symptoms in sarcoidosis have led to recent studies focusing on incidence rates, contributing factors and potential therapeutic strategies. In a web-based survey of over 1000 sarcoidosis patients, the most common symptom was fatigue, which was reported by over 90% of participants, whereas memory loss and concentration problems were reported in 50%. SFN was also common, and may be diagnosed with tools such as skin biopsy measurement of intraepidermal nerve fibers and corneal confocal microscopy. In a recent cohort study of SFN patients, serologic evaluation demonstrated other contributing causes such as diabetes and vitamin B12 deficiency, which warrant-specific treatment. Finally, physical inactivity in patients with sarcoidosis correlated with lower quality-of-life (QOL) scores and possibly fatigue. Multidisciplinary programs that include physical therapy, patient education and psychological support were found to improve fatigue and mood disorders. Recognition of nonorgan-related symptoms and their impact on patient QOL is essential to optimal treatment of the sarcoidosis patient.

Prominent physical inactivity in acute dementia care: Psychopathology seems to be more important than the dose of sedative medication.

IntroductionTo objectively quantify patients' physical activity and analyze the relationships between physical activity levels, psychopathology, and sedative medication in acute hospital dementia care.Materials and MethodsIn this cross‐sectional study, we assessed the patients' physical activity based on data collection by hybrid motion sensors attached on their lower back. Daily doses of antipsychotics have been converted to olanzapine‐equivalents and daily benzodiazepine medication is reported as diazepam‐equivalents. We assessed patients' neuropsychiatric symptoms with the Neuropsychiatric Inventory and the Cohen‐Mansfield Agitation Inventory.ResultsWe analyzed motion sensor data from 64 patients (MMSE M = 18.6). On average, patients were lying for 11.5 hours, sitting/standing sedentary for 10.3 hours, sitting/standing active for 1.0 hours, and walking for 1.2 hours per day. The analysis revealed no correlations between patients' physical activity and antipsychotic or benzodiazepine medication. More severe neuropsychiatric symptoms were associated with a decrease in the patients' physical activity (r = .32, P = .01). In particular, patients with apathy symptoms were less physically active than patients without apathy symptoms.DiscussionThe results reveal that most of the patients in acute dementia care had very low levels of physical activity. Their physical inactivity may be due to the severity of their neuropsychiatric symptoms, especially apathy. Antipsychotic and benzodiazepine medication appeared to have less impact on patients' physical activity. Dementia care should pay more attention to prevent physical inactivity in patients.

The impact of pulmonary rehabilitation on severe physical inactivity in patients with chronic obstructive pulmonary disease: a pilot study.

IntroductionIn patients with COPD, severe physical inactivity (SPI, which is defined as total daily energy expenditure/resting energy expenditure; physical activity level [PAL] ratio, <1.4) is associated with increased morbidity and mortality. Pulmonary rehabilitation (PR) increases physical capacity in COPD, but the impact on SPI is unknown. In this study, we aimed at elucidating the prevalence of SPI in COPD patients attending standard PR, the impact of PR on SPI prevalence, and the relationship between SPI and time spent in moderate physical activity thus whether American College of Sports Medicine (ACSM) recommendations are clinically useful in excluding SPI in COPD.MethodsThis is a prospective non-interventional pilot study on patients with COPD completing PR, consenting to wear an accelerometer (Sensewear© Armband) for a week before and after completing PR to assess changes in energy expenditure, time spent in physical activity, and number of daily steps. Low level of daily physical activity was not an inclusion criterion.ResultsIn total, 57 patients completed the study and 31 (54%) had SPI at baseline. In patients with SPI, baseline median FEV1 was 48 (range, 28–86) % of predicted and GOLD B, n=11 (35%)/GOLD D, n=20 (65%). Surprisingly, 31 of SPI patients (97%) spent ≥150 minutes/week in moderate physical activity. After rehabilitation, 24 (78%) did not change activity level and were persistently SPI. We observed no differences at baseline between patient responding (n=7) vs not responding (n=24) to PR. Responders increased number of daily steps and time spent in lighter but not moderate physical activity during rehabilitation.ConclusionIn this pilot study, SPI was prevalent, and PR had limited impact. Contraintui-tively, most patients with SPI complied with general recommendations of weekly hours spent in moderate physical activity. Our study highlights that increasing time spent in light activity rather than improving time spent in moderate activity is important in COPD patients with chronic dyspnea.

Sedentary Behaviour and Physical Inactivity in Patients with Chronic Obstructive Pulmonary Disease: Two Sides of the Same Coin?

Despite the growing interest in sedentarism, there is no available information on the profile of patients with COPD according to sedentary behaviour (SB) and with a detailed analysis of minute-by-minute bouts. Hence, the aims of this study were to quantify the time spent in SB, light activities and moderate-to-vigorous physical activities (MVPA) and to verify the relationship of MVPA and SB in individuals with COPD, as well as to identify the profile of those physically (in)active and (non)-sedentary. A cross-sectional study in which physical activity in daily life was objectively assessed through the use of SenseWear Pro 2 Armband (BodyMedia) during 2 consecutive weekdays, 12 h/day. Analysis was performed minute-by-minute for each day of each patient. MVPA comprised time spent >3 metabolic equivalents (MET), whereas light activities corresponded to time spent between 1.5 and 3 MET and SB to time spent <1.5 MET. A total of 137 subjects with COPD (66 ± 8years; FEV1 46 [31–57] %pred; BMI 26 [22–30] kg/m2) were analysed. Time spent in MVPA and SB presented strong negative correlation (r = −0.72, P < 0.001). Minute-by-minute analysis showed that patients with COPD spend most of their time in SB. SB accounted for 40% of all bouts >1 minute, whereas only 14% these bouts concern MVPA. Patients combining two positive characteristics (physically active and non-sedentary) have better clinical profile than others. In conclusion, SB is negatively correlated with MVPA in patients with COPD. Furthermore, patients classified as physically active (i.e., those who reach MVPA recommendations) in combination with a non-sedentary lifestyle present markedly better clinical conditions.

Falls and Physical Inactivity in Patients with Gastrointestinal Cancer and Hand–Foot Syndrome

Objective:This study aims to ascertain the incidence and association of falls and physical inactivity in patients with gastrointestinal cancer and hand–foot syndrome (HFS) after receiving chemotherapy or targeted therapy.Methods:The present cross-sectional study was conducted on 50 outpatients with HFS of Grade 1 or above, according to the National Cancer Institute Common Terminology Criteria for Adverse Events, following the receipt of chemotherapy or targeted therapy for gastrointestinal cancer in Japan between November 2016 and February 2017. For measurement, Dermatology Life Quality Index (DLQI) and the International Physical Activity Questionnaire were used. Data were analyzed by logistic regression analysis.Results:Of the participants, 18% experienced falls and 60% reported physical inactivity. Multivariate logistic regression revealed that the DLQI treatment domain score was the only factor associated with falls (odds ratio [OR] =8.01, 95% confidence interval [CI] =1.27–50.63, P = 0.027). Physical inactivity was associated with DLQI symptom and feeling domain scores (OR = 5.54, 95% CI = 1.26–24.33, P = 0.023) and the with-oxaliplatin or paclitaxel regimen (OR = 3.71, 95% CI = 1.06–13.03, P = 0.041).Conclusions:The results of the present study suggest patients should be informed that HFS is a risk factor for physical inactivity and falls.

Efficacy of an mHealth intervention to stimulate physical activity in COPD patients after pulmonary rehabilitation.

Physical inactivity in patients with chronic obstructive pulmonary disease (COPD) is associated with poor health status and increased disease burden. The present study aims to test the efficacy of a previously developed mobile (m)Health intervention to improve or maintain physical activity in patients with COPD after pulmonary rehabilitation.A randomised controlled trial was performed in 32 physiotherapy practices in the Netherlands. COPD patients were randomised into intervention or usual care groups. The intervention consisted of a smartphone application for the patients and a monitoring website for the physiotherapists. Measurements were performed at 0, 3, 6 and 12 months. Physical activity, functional exercise capacity, lung function, health-related quality of life and body mass index were assessed.157 patients started the study and 121 completed it. There were no significant positive effects of the intervention on physical activity (at 0 months: intervention 5824±3418 steps per weekday, usual care 5717±2870 steps per weekday; at 12 months: intervention 4819±2526 steps per weekday, usual care 4950±2634 steps per weekday; p=0.811) or on the secondary end-points. There was a significant decrease over time in physical activity (p<0.001), lung function (p<0.001) and mastery (p=0.017), but not in functional exercise capacity (p=0.585).Although functional exercise capacity did not deteriorate, our mHealth intervention did not improve or maintain physical activity in patients with COPD after a period of pulmonary rehabilitation.

Sarcopenia and Physical Inactivity in Patients With Chronic Kidney Disease.

Sarcopenia and physical inactivity synergistically progress in patients with chronic kidney disease (CKD) and are strong predictors of mortality in this population. Exercise training and essential amino acids and vitamin D supplements may contribute to improving sarcopenia and physical inactivity in CKD patients.

AB1187-HPR Rheumatologist and Rheumatology Health Care Professionals' Current Practice and Beliefs around Physical Activity Promotion in Rheumatoid Arthritis

BackgroundRegular physical activity (PA) in rheumatoid arthritis (RA) is beneficial for people with RA (Van Den Ende et al 2000). However, people with RA are less physically active than their...