Physical activity trajectories and their determinants in patients with chronic obstructive pulmonary disease: A cohort study

Abstract

Aims and objectives: The aim was to identify latent trajectories in physical activity (PA) and their determinants in adults with chronic obstructive pulmonary disease (COPD) based on the socio-ecological model.

Background: PA has been linked to poor long-term outcomes in patients with COPD. However, few studies have explored their PA trajectories and their predictors.

Design: Cohort study.

Methods: We used data from a national cohort and included 215 participants. PA was quantified using a short PA questionnaire, and group-based trajectory modelling was used to explore the PA trajectories. Multinomial logistic regression was conducted to identify the predictors of PA trajectories. Generalised linear mixed models were used to elucidate the associations between predictors and PA during follow-up. A STROBE checklist was used to guide the reporting of this study.

Results: Three PA trajectory patterns were identified among 215 COPD participants with an average age of 60.51 ± 8.87: stable inactive group (66.7%), sharp decline group (25.7%) and stable active group (7.5%). The logistic regression showed that age, sex, income, peak expiratory flow, upper limb capacity, depressive symptoms, the frequency of contact with children were PA predictors. Upper limb capacity weakness and depressive symptoms were found to be associated with a sharp decline in PA during follow-up.

Conclusions: This study revealed three PA trajectories among patients with COPD. In addition to strengthening the physical functions and mental health of patients, support from the family, community and society also play a crucial role in promoting PA of patients with COPD.

Relevance to clinical practice: It is essential to identify distinct PA trajectories in patients with COPD to develop future interventions that promote PA.

No patient or public contribution: A national cohort study was used and no patients or the public were involved in the design and implementation of this study.

Keywords: COPD; physical activity; socio-ecological model; trajectory.