Low levels of physical activity linked to elevated symptom burden in COPD

Key takeaways:

• Reduced levels of moderate to vigorous intensity physical activity are linked to increased symptom burden in COPD.
• Physical activity was higher in undiagnosed vs. diagnosed patients.

In patients with COPD, having low levels of moderate to vigorous intensity physical activity, or MVPA, was linked to elevated symptom burden, according to results published in Chronic Obstructive Pulmonary Diseases.

“MVPA was found to be inversely related to symptom burden in a general population sample that included a large proportion of individuals with COPD who have not previously received a diagnosis by a physician and a high number of mild to moderate COPD individuals,” Loes Oostrik, MSc, of Utrecht University in the Netherlands, and colleagues wrote.

In a cross-sectional sub study, Oostrik and colleagues assessed 1,514 individuals from the Canadian Cohort of Obstructive Lung Disease to determine how MVPA is linked to symptom burden in COPD.

Within the total cohort, 406 patients had mild COPD (Global Initiative for Chronic Obstructive Lung Disease [GOLD] stage 1), 287 had moderate COPD (GOLD stage 2), 474 were at risk for COPD and 347 individuals were classified as healthy.

To figure out MVPA (kcal/week), researchers used the Community Healthy Activities Model Program for Seniors questionnaire, and to measure symptom burden, they used the COPD Assessment Test (CAT).

Prior to entering the cohort, 40% of patients classified as GOLD 2 received a COPD diagnosis, whereas fewer patients classified as GOLD 1 received this diagnosis (< 20%).

A high symptom burden, or a CAT score of 10 or higher, was found in 32% of those with COPD, according to researchers.

Among those with COPD, reduced MVPA was linked to high symptom burden in the analysis adjusted for age, sex, BMI, smoking status and any musculoskeletal disorders (beta, –717.09; 95% CI, –1,079.78 to –354.4).

After dividing the patients according to their COPD severity level, researchers observed this relationship again in those with GOLD stage 2 COPD (beta, –694.1, 95% CI, –1,206.54 to –181.66).

Using diagnosis status to group patients, researchers found heightened levels of MVPA among those with undiagnosed (72% of the those with COPD) vs. diagnosed COPD (beta, –592.41; 95% CI, –953.11 to –231.71).

Being diagnosed with COPD meant lower MVPA, and researchers indicated that this relationship was found in those with GOLD stage 2 COPD rather than GOLD stage 1 COPD.

A stepwise multivariate model uncovered several additional factors significantly linked to MVPA in those with COPD including continuous CAT score, FEV₁, a visit during the seasons of winter or autumn and past exercise habits.

“Assessment of symptom burden may help identify patients with lower MVPA, especially for moderate COPD and for relatively inactive individuals with mild COPD,” Oostrik and colleagues wrote.