A Non-Interventional, Cross-Sectional Study to Evaluate Factors Relating to Daily Step Counts and Physical Activity in Japanese Patients with Chronic Obstructive Pulmonary Disease: STEP COPD

Masakazu Ichinose; Yoshiaki Minakata; Takashi Motegi; Tsuneyuki Takahashi; Munehiro Seki; Satoko Sugaya; Nobuya Hayashi; Ichiro Kuwahira

doi:10.2147/COPD.S277782

A Non-Interventional, Cross-Sectional Study to Evaluate Factors Relating to Daily Step Counts and Physical Activity in Japanese Patients with Chronic Obstructive Pulmonary Disease: STEP COPD

Int J Chron Obstruct Pulmon Dis. 2020 Dec 22:15:3385-3396. doi: 10.2147/COPD.S277782. eCollection 2020.

Authors

Masakazu Ichinose¹, Yoshiaki Minakata², Takashi Motegi³, Tsuneyuki Takahashi⁴, Munehiro Seki⁵, Satoko Sugaya⁵, Nobuya Hayashi⁶, Ichiro Kuwahira⁷

Affiliations

¹ Academic Center of Osaki Citizen Hospital, Osaki 989-6183, Japan.
² Respiratory Medicine, National Hospital Organization Wakayama Hospital, Wakayama 644-0044, Japan.
³ Respiratory Care Clinic Tokyo, Institute of Clinical Respirology, Tokyo 104-0031, Japan.
⁴ Department of Internal Medicine, Tohoku Medical and Pharmaceutical University Wakabayashi Hospital, Sendai 984-8560, Japan.
⁵ Medical Department, AstraZeneca K.K., Osaka 530-0011, Japan.
⁶ Biometrics Department, AstraZeneca K.K., Osaka 530-0011, Japan.
⁷ Department of Pulmonary Medicine, Tokai University Tokyo Hospital, Tokyo 151-0053, Japan.

Abstract

Purpose: Patients with chronic obstructive pulmonary disease (COPD) have decreased physical activity (PA) compared with healthy adults. As lower PA is associated with increased mortality, improving PA is an important objective for COPD management. This large-scale, multicenter, non-interventional, cross-sectional study examined the activity status of COPD patients in Japan and explored factors related to PA.

Patients and methods: Outpatients aged ≥40 years with confirmed COPD diagnosis and pulmonary function test data were enrolled. Primary study outcomes were measurement of daily steps (over 14 consecutive days, using an activity monitor), assessment of activity time by activity intensity (using metabolic equivalents [METs]), and evaluation of correlation between PA and patient characteristics. Secondary outcomes included further investigation of the influence of patient characteristics on PA.

Results: Data from 417 patients with Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages I (29.5%), II (43.9%), III (23.5%), and IV (3.1%) were evaluated. Median (Q1, Q3) daily step count was 3440.8 (1831.3, 5709.3). Median (Q1, Q3) durations of PA at ≥3 (moderate-to-vigorous) and ≥2 METs (light-to-vigorous) were 18.7 (6.5, 41.3) and 186.9 (126.9, 259.2) minutes, respectively. For >30% of patients, time spent in ≥3 METs activity was ≤10 minutes. Unemployment was significantly correlated with reduced activity time (≥3 and ≥2 METs) and step count. Severe GOLD stage was significantly correlated with reduced activity time (≥3 and ≥2 METs). High modified Medical Research Council (mMRC) dyspnea score was significantly correlated with reduced activity time (≥3 METs) and step count. Patients tended to overestimate the time spent in activities requiring ≥2 METs in their subjective reports compared with activity monitor measurements.

Conclusion: Reduced PA was observed in the Japanese COPD patients with the majority of them being GOLD stage I/II. Employment status, GOLD stage, and mMRC dyspnea score could help identify patients at risk of reduced PA.

Clinical trial registration: NCT03642613 (ClinicalTrials.gov); UMIN000032962 (UMIN-CTR, umin.ac.jp).

Keywords: COPD; activity monitor; physical activity; pulmonary function; step counts.

Publication types

Clinical Trial
Multicenter Study

MeSH terms

Cross-Sectional Studies
Dyspnea
Exercise
Humans
Japan / epidemiology
Pulmonary Disease, Chronic Obstructive* / diagnosis
Pulmonary Disease, Chronic Obstructive* / epidemiology
Pulmonary Disease, Chronic Obstructive* / therapy

Associated data

ClinicalTrials.gov/NCT03642613

Grants and funding

This study and its publication were funded by AstraZeneca K.K., Osaka, Japan. The funding source was involved in the study design, data collection, analysis and interpretation, and review of the manuscript.