Associations of physical activity and quality of life in parapneumonic effusion patients

Pedro Lopez; Deirdre B Fitzgerald; Joanne A McVeigh; Arash Badiei; Sanjeevan Muruganandan; Robert U Newton; Leon Straker; Yun Chor Gary Lee; Carolyn J Peddle-McIntyre

doi:10.1183/23120541.00209-2023

Associations of physical activity and quality of life in parapneumonic effusion patients

ERJ Open Res. 2023 Sep 25;9(5):00209-2023. doi: 10.1183/23120541.00209-2023. eCollection 2023 Sep.

Authors

Pedro Lopez^{1

2

3}, Deirdre B Fitzgerald^{1

2

4

3}, Joanne A McVeigh^{5

6}, Arash Badiei^{7

8}, Sanjeevan Muruganandan⁹, Robert U Newton^{10

11}, Leon Straker^{5

6}, Yun Chor Gary Lee^{1

2

4

12}, Carolyn J Peddle-McIntyre^{1

10

11

12}

Affiliations

¹ Pleural Medicine Unit, Institute for Respiratory Health, Perth, Australia.
² Medical School, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Australia.
³ Joint first authors.
⁴ Respiratory Medicine, Sir Charles Gairdner Hospital, Nedlands, Australia.
⁵ Curtin School of Allied Health, Curtin University, Perth, Australia.
⁶ enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Australia.
⁷ Thoracic Medicine, Royal Adelaide Hospital, Adelaide, Australia.
⁸ Adelaide Medical School, Faculty of Health and Medical Science, University of Adelaide, Adelaide, Australia.
⁹ Respiratory Medicine, Northern Health, Epping, Australia.
¹⁰ Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Australia.
¹¹ School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia.
¹² Joint senior authors.

Abstract

Introduction: Little is known about activity behaviours and quality of life (QoL) of patients with parapneumonic pleural effusions (PPE) after hospital discharge. This study is a secondary analysis of a randomised trial (dexamethasone versus placebo) for hospitalised patients with PPE. We: 1) described the patients' activity behaviour patterns and QoL measured at discharge and at 30 days post-discharge; and 2) examined the association between activity behaviours and QoL scores.

Methods: Activity behaviour (7-day accelerometry; Actigraph GT3X+) and QoL (Medical Outcomes Study Short-Form 36) were assessed. Repeated measures analysis of covariance controlling for baseline values and a series of linear regression models were undertaken.

Results: 36 out of 53 eligible participants completed accelerometry assessments. Despite modest increases in light physical activity (+7.5%) and some domains of QoL (>2 points) from discharge to 30 days post-discharge, patients had persistently high levels of sedentary behaviour (>65% of waking wear time) and poor QoL (≤50 out of 100 points) irrespective of treatment group (p=0.135-0.903). Increasing moderate-to-vigorous physical activity was associated with higher scores on most QoL domains (p=0.006-0.037). Linear regression indicates that a clinically important difference of 5 points in physical composite QoL score can be achieved by reallocating 16.1 min·day^-1 of sedentary time to moderate-to-vigorous physical activity.

Conclusion: Patients with PPE had low levels of physical activity and QoL at discharge and 30 days post-discharge irrespective of treatment. Moderate-to-vigorous physical activity participation was associated with higher QoL scores. Increasing moderate-to-vigorous physical activity following discharge from the hospital may be associated with improvements in QoL.