Neighborhood environmental factors influence physical activity in people with COPD

Population density, pedestrian street length and slope and nitrogen dioxide exposure were all associated with physical activity levels and exercise capacity of patients with COPD living in highly populated areas, researchers reported.

“The ecological model of the determinants of physical activity suggests a major role for factors in the ‘environmental’ domain. In line with this notion, a range of studies have reported that environmental factors such as residential density or land-use mix, noise or noise annoyance and air pollution are associated with physical activity in the general population,” Maria Koreny, MSc, PhD, from the Barcelona Institute for Global Health, Spain, and colleagues wrote in Environmental Research. “Thus, it is likely that such environmental factors can influence the physical activity of COPD patients also.”

Researchers assessed 404 patients with mild to very severe COPD (mean age, 69 years; 85% men) from a multi-city study conducted in the Catalonia region of Spain. Measurements included objective physical activity, physical activity experience and exercise capacity. Researchers estimated individual population density, pedestrian street length, slope of the terrain and annual road traffic noise exposure, nitrogen dioxide exposure and particulate matter exposure.

Participants walked a mean 7,524 steps per day during the study period. Higher population density was associated with 507 fewer steps, 2 hours per day more sedentary time and worse exercise capacity (–13 m per interquartile range) in multi-exposure models, according to data.

Researchers reported 156 more steps and –0.1 hours per day less sedentary time were linked to pedestrian street length and better exercise capacity (15 m per interquartile range) was linked to steeper slope.

Higher exposure to nitrogen dioxide was associated with higher sedentary time of 0.2 hours per day and more difficulty in physical activity (–0.7 Clinical visit–PROactive Physical Activity in COPD difficulty score). However, particulate matter and noise were not associated with physical activity or exercise capacity in this patient population, the researchers wrote.

“These neighborhood environmental factors should be considered in clinical contacts with patients and when developing urban and transport planning policies that aim to promote physical activity in patients with chronic diseases,” they wrote.