title: Physical activity in daily life in Brazilian COPD patients during and after exacerbation.
abstract: BACKGROUND
  Although hospitalization is recognized as an important cause of reduction in physical activity in daily life (PADL) in COPD, there is only one study evaluating this effect, and it was performed in European COPD patients who have a lower PADL than that of South American COPD patients.
  
  
  OBJECTIVE
  To investigate the effect of hospitalization due to acute exacerbation of PADL in Brazilian COPD patients and to evaluate the factors that determines the physical activity levels during hospitalization and after discharge.
  
  
  METHODS
  PADL was quantified using a 3-axis accelerometer on the 3rd day of hospitalization and 1 month after discharge in Brazilian COPD patients who were hospitalized due to disease exacerbation. Six-minute walking distance (6MWD), lower limb strength and pulmonary function were also evaluated.
  
  
  RESULTS
  A total of 20 patients completed the study. During hospitalization, patients spent most of the time (87%) lying down or sitting; however, 1 month after they were walking >40 min/day. In addition, patients with prior hospitalization had a lower level of physical activity compared to those without a previous history of hospitalization. The time spent walking during hospitalization was significantly explained by the quadriceps strength (r(2) = 0.29; p < 0.05), while 1 month after, the time spent walking was only significantly explained by the 6MWD (r(2) = 0.51; p = 0.02).
  
  
  CONCLUSIONS
  Brazilian COPD patients are inactive during hospitalization but become active 1 month after discharge. Previously hospitalized are more inactive both during and after exacerbation. The quadriceps strength and 6MWD explain the physical activity levels during hospitalization and at home, respectively.
authors.affiliation: Physical Therapy Department, School of Medicine, University of São Paulo, São Paulo, São Paulo, Brazil.
authors.forename: Rodrigo Cerqueira
authors.initials: RC
authors.lastname: Borges
authors.forename: Celso Ricardo Fernandes
authors.initials: CR
authors.lastname: Carvalho
mesh_terms: D061725:Accelerometry; D000203:Activities of Daily Living; D000368:Aged; D001938:Brazil; D003131:Combined Modality Therapy; D018450:Disease Progression; D005080:Exercise Test; D005260:Female; D006760:Hospitalization; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D053580:Muscle Strength; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology* / Q000628:therapy; D052097:Quadriceps Muscle / Q000502:physiology; D013147:Spirometry; D016896:Treatment Outcome; D016138:Walking