The following is a summary of “Factors associated to physical activity in patients with COPD: An ecological approach,” published in the NOVEMBER 2023 issue of Pulmonology by Blondeel, et al.
Patients diagnosed with Chronic Obstructive Pulmonary Disease (COPD) typically exhibit low levels of physical activity (PA). Understanding PA’s influencing factors, whether modifiable or not, is essential for tailoring interventions to enhance PA in this population. Given that PA is a complex and multi-faceted behavior, a comprehensive framework is necessary to explore various physiological, psychological, socio-demographic, and environmental factors. For a study, researchers sought to identify the correlates of PA in a diverse COPD population. A broad ecological model was employed to achieve it, encompassing various dimensions such as physiological, psychological, socio-demographic, and environmental factors.
In the study, PA was objectively measured using the Dynaport Movemonitor. Additionally, a comprehensive dataset was collected, covering an array of physiological, psychological, socio-demographic, and environmental variables. The research methodology included bivariable and multivariable regression analyses incorporating principal component analysis.
For this particular cross-sectional analysis, they included a cohort of 148 patients diagnosed with COPD who had valid data regarding their physical activity (PA) (average age 68 years, standard deviation 7 years; forced expiratory volume in one second (FEV1) 57% predicted, with a standard deviation of 17%; daily step count averaging 5,613 steps, with a standard deviation of 3,596 steps). They observed noteworthy bivariable associations encompassing a spectrum of physiological factors such as exercise capacity, muscle strength, lung function, symptom severity, and comorbid conditions. Psychological aspects, including factors like fatigue, motivation, and the perceived difficulty of engaging in PA, also displayed significant correlations. In the socio-demographic domain, variables like dog ownership and the utilization of activity trackers were associated with PA levels. Furthermore, environmental factors like seasonal variations, exposure to daylight, and temperature demonstrated significant associations. Subsequently, utilizing a multivariable regression model, we identified several independent factors that were linked to the average daily step count (R2 = 0.35). These independent correlates included exercise capacity, specific motivational beliefs, perceived importance of PA, self-confidence in performing PA, and weather conditions. Moreover, when examining the intensity of movement during walking, this was independently associated with exercise capacity and age (R2 = 0.41).
Despite the extensive range of factors investigated, the results underscored the intricate nature of PA. Consequently, the study highlighted the importance of personalized interventions to promote PA in the context of COPD.