Factors associated to physical activity in patients with COPD: An ecological approach

Respir Med. 2023 Nov-Dec:219:107424. doi: 10.1016/j.rmed.2023.107424. Epub 2023 Oct 10.

Abstract

Background: Physical activity (PA) is low in patients with Chronic Obstructive Pulmonary Disease (COPD). Identifying modifiable and non-modifiable correlates of PA give understanding of the individual behavior and provide future directions for PA enhancing interventions. As PA is complex and multidimensional, it should be embedded within a thorough framework.

Objective: To identify correlates of PA in a comprehensive COPD population based on a broad ecological model, including physiological, psychological, socio-demographic and environmental dimensions.

Methods: PA was objectively measured using the Dynaport Movemonitor and a comprehensive data collection of physiological, psychological, socio-demographic and environmental factors were collected. Bivariable and multivariable regression analyses (including principle component analysis) were executed.

Results: For this cross-sectional analysis, we included 148 patients with COPD and valid PA data (mean (SD) age 68 (7) years, FEV1 57 (17) % predicted, 5613 (3596) steps per day). Significant bivariable associations were found for physiological (exercise capacity, muscle force, lung function, symptoms, comorbidities), psychological (e.g. fatigue, motivation, perceived difficulty with PA), socio-demographic (dog owning, use of activity tracker) and environmental (season, daylight, temperature) factors. Based on the multivariable regression model, exercise capacity, beliefs on motivation, importance and self-confidence regarding PA and weather conditions were independent correlates of mean steps per day (R2 = 0.35). Movement intensity during walking was only independently associated with exercise capacity and age (R2 = 0.41).

Conclusion: Although a wide range of potential influence factors were evaluated, variance in PA was only partly explained, supporting that PA is a complex behavior which is difficult to predict.

Keywords: Chronic obstructive pulmonary disease; Correlates; Physical activity.

MeSH terms

  • Aged
  • Animals
  • Comorbidity
  • Cross-Sectional Studies
  • Dogs
  • Humans
  • Pulmonary Disease, Chronic Obstructive*
  • Regression Analysis
  • Walking / physiology