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Socio-environmental correlates of physical activity in patients with chronic obstructive pulmonary disease (COPD).

ABSTRACT: Study of the causes of the reduced levels of physical activity in patients with COPD has been scarce and limited to biological factors.To assess the relationship between novel socio-environmental factors, namely dog walking, grandparenting, neighbourhood deprivation, residential surrounding greenness and residential proximity to green or blue spaces, and amount and intensity of physical activity in COPD patients.This cross-sectional study recruited 410 COPD patients from five Catalan municipalities. Dog walking and grandparenting were assessed by questionnaire. Neighbourhood deprivation was assessed using the census Urban Vulnerability Index, residential surrounding greenness by the satellite-derived Normalized Difference Vegetation Index, and residential proximity to green or blue spaces as living within 300?m of such a space. Physical activity was measured during 1?week by accelerometer to assess time spent on moderate-to-vigorous physical activity (MVPA) and vector magnitude units (VMU) per minute.Patients were 85% male, had a mean (SD) age of 69 (9) years, and post-bronchodilator FEV1 of 56 (17) %pred. After adjusting for age, sex, socio-economic status, dyspnoea, exercise capacity and anxiety in a linear regression model, both dog walking and grandparenting were significantly associated with an increase both in time in MVPA (18?min/day (p<0.01) and 9?min/day (p<0.05), respectively) and in physical activity intensity (76?VMU/min (p=0.05) and 59?VMUs/min (p<0.05), respectively). Neighbourhood deprivation, surrounding greenness and proximity to green or blue spaces were not associated with physical activity.Dog walking and grandparenting are associated with a higher amount and intensity of physical activity in COPD patients.Pre-results, NCT01897298.

SUBMITTER: Arbillaga-Etxarri A

PROVIDER: S-EPMC5738536 | biostudies-literature | 2017 Sep

REPOSITORIES: biostudies-literature

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Socio-environmental correlates of physical activity in patients with chronic obstructive pulmonary disease (COPD).

Arbillaga-Etxarri Ane A Gimeno-Santos Elena E Barberan-Garcia Anael A Benet Marta M Borrell Eulàlia E Dadvand Payam P Foraster Maria M Marín Alicia A Monteagudo Mònica M Rodriguez-Roisin Robert R Vall-Casas Pere P Vilaró Jordi J Garcia-Aymerich Judith J

Thorax 20170301 9

<h4>Background</h4>Study of the causes of the reduced levels of physical activity in patients with COPD has been scarce and limited to biological factors.<h4>Aim</h4>To assess the relationship between novel socio-environmental factors, namely dog walking, grandparenting, neighbourhood deprivation, residential surrounding greenness and residential proximity to green or blue spaces, and amount and intensity of physical activity in COPD patients.<h4>Methods</h4>This cross-sectional study recruited ...[more]

PMID: 28250201

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Project description:RATIONALE:Physical inactivity among patients with chronic obstructive pulmonary disease is associated with exacerbations requiring high-cost health care utilization including urgent, emergent, and hospital care. OBJECTIVES:To examine the effectiveness of a behavioral lifestyle physical activity intervention combined with chronic obstructive pulmonary disease self-management education to prevent high-cost health care utilization. METHODS:This was an analysis of secondary outcomes of the Chronic Obstructive Pulmonary Disease Self-Management Activation Research Trial, a two-arm randomized trial of stable adult outpatients with chronic obstructive pulmonary disease recruited from primary care and pulmonary clinics. Following a 6-week self-management education run-in period, participants were randomized to usual care or to a telephone-delivered home-based health coaching intervention over 20 weeks. Secondary outcomes of physical activity and health care utilization were determined by self-report 6, 12, and 18 months after randomization. Associations between treatment allocation arm and these secondary outcomes were examined using log-binomial and Poisson regression models. RESULTS:A total of 325 outpatients with stable chronic obstructive pulmonary disease were enrolled in the trial. Their average age was 70.3 years (standard deviation, 9.5), and 50.5% were female; 156 were randomized to usual care and 149 to the intervention. A greater proportion of participants reported being persistently active over the 18-month follow-up period in the intervention group (73.6%) compared with the usual care group (57.8%) (mean difference, 15.8%; 95% confidence interval, 4.0-27.7%). This association varied by severity of forced expiratory volume in 1 second impairment (P for interaction?=?0.09). Those in the intervention group with moderate impairment (forced expiratory volume in 1 second, 50-70% predicted), more frequently reported being persistently active compared with the usual care (86.0 vs. 65.1%; mean difference, 20.9%; 95% confidence interval, 5.7-36.1%). Patients with severe and very severe forced expiratory volume in 1 second impairment (forced expiratory volume in 1 second?<?50% predicted) in the intervention group also reported being persistently active more frequently compared with usual care (63.3 vs. 50.8%; mean difference, 12.6%; 95% confidence interval, -4.7 to 29.8). The intervention was associated with a lower rate of lung-related utilization (adjusted rate ratio, 0.38; 95% confidence interval, 0.23-0.63) only among participants with severe spirometric impairment. CONCLUSIONS:Our results demonstrate that a feasible and generalizable home-based coaching intervention may decrease sedentary behavior and increase physical activity levels. In those with severe chronic obstructive pulmonary disease, this intervention may reduce lung disease-related health care utilization. Clinical trial registered with www.clinicaltrials.gov (NCT01108991).

Dataset Information

Socio-environmental correlates of physical activity in patients with chronic obstructive pulmonary disease (COPD).

Publications

Socio-environmental correlates of physical activity in patients with chronic obstructive pulmonary disease (COPD).

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