title: Reasons persons with COPD do not walk and relationship with daily step count.
abstract: BACKGROUND
  Physical activity (PA) is significantly reduced in persons with COPD. Assessing reasons why persons with COPD do not engage in PA can guide development of effective interventions to promote PA.
  
  
  METHODS
  We queried 102 participants with stable COPD about disease-related and general reasons why they do not walk more. The StepWatch Activity Monitor (Orthocare Innovations, Mountlake Terrace, WA, USA) assessed daily step count, a direct measure of PA. Regression models assessed daily step count by response categories, adjusting for age and FEV1 % predicted.
  
  
  RESULTS
  Subjects had mean age 72 ± 8 years and mean FEV1 1.48 ± 0.55 L (52 ± 19% predicted). COPD-related worries of becoming short of breath (SOB), needing to use inhalers, or oxygen level becoming low were endorsed by 31, 14, and 12 subjects, respectively. Controlling for age and FEV1% predicted, those who worried about becoming SOB walked an average of 1,329 fewer steps per day than those who did not worry (p = 0.020). Those who worried about needing to use inhalers walked an average of 1,806 fewer steps per day than those who did not worry (p = 0.016). Subjects who were the most motivated and confident walked significantly more than those who were the least motivated and confident.
  
  
  CONCLUSIONS
  Presence of COPD-related reasons and lower motivation and confidence are associated with lower daily step count. Management of dyspnea and education about medication use during exercise, and strategies to increase motivation and confidence could facilitate walking in COPD.
authors.affiliation: 1Brown University School of Public Health, Department of Epidemiology , Providence, RI , USA.
authors.forename: Valery A
authors.initials: VA
authors.lastname: Danilack
authors.forename: Nicole A
authors.initials: NA
authors.lastname: Weston
authors.forename: Caroline R
authors.initials: CR
authors.lastname: Richardson
authors.forename: DeAnna L
authors.initials: DL
authors.lastname: Mori
authors.forename: Marilyn L
authors.initials: ML
authors.lastname: Moy
mesh_terms: D061725:Accelerometry; D000368:Aged; D000369:Aged, 80 and over; D001993:Bronchodilator Agents / Q000008:administration & dosage; D004417:Dyspnea / Q000523:psychology; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D010100:Oxygen / Q000097:blood; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology* / Q000523:psychology*; D020377:Self Efficacy; D011795:Surveys and Questionnaires; D016138:Walking / Q000502:physiology* / Q000523:psychology*
chemical_list: D001993:Bronchodilator Agents; D010100:Oxygen
keywords: accelerometer; exercise; physical activity; pulmonary disease; step count