Factors associated with a low level of physical activity in patients with chronic obstructive pulmonary disease.
BACKGROUND
Physical activity such as walking is strongly recommended for patients with chronic obstructive pulmonary disease (COPD).


METHODS
We undertook a multicenter observational study on COPD patients, collecting the daily walking time, COPD severity score (COPDSS), functional status [London Chest Activity of Daily Living (LCADL) questionnaire], health-related quality of life (QoL) rating [five-item EuroQL (EQ-5D) and Airways Questionnaire 20 (AQ20)], and anxiety and depression rating (Hospital Anxiety and Depression Scale). Multivariate logistic regression modeling was performed to identify the independent predictors of a low walking time (<30 min/day).


RESULTS
We included 4,574 patients with a mean (±standard deviation) age of 67.1 ± 10.0 years, with a mean FEV1 (%) of 54.0 ± 23.7. The mean daily walking time was 73.6 ± 67.1 min (58.9 % at ≥60 min and 13.7 % at <30 min). A strong direct relationship was observed between daily walking time and better QoL (EQ-5D and AQ20) and functional status (LCADL; p < 0.001 in all cases). The independent predictors of a low walking time were a worse score in EQ-5D [odds ratio (OR) (95 % confidence interval per one-point increase of 0.23 (0.15-0.35)], a higher COPDSS [OR per one-point increase of 1.04 (1.02-1.07)], and the presence of depression [OR 1.58 (1.25-2.01)].


CONCLUSIONS
After adjustment for age and severity of symptoms, poor health status, severity of COPD, and depression are the main factors associated with a low walking time in COPD patients.
Department of Pneumology, Ciber de Enfermedades Respiratorias (Ciberes), Hospital Universitari Vall d'Hebron, P. Vall d'Hebron 119-129, 08035, Barcelona, Spain, mmiravitlles@vhebron.net.
Marc
M
Miravitlles
Jordi
J
Cantoni
Karlos
K
Naberan
D000203:Activities of Daily Living; D000368:Aged; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D005260:Female; D005541:Forced Expiratory Volume; D015438:Health Behavior; D006304:Health Status; D006801:Humans; D016015:Logistic Models; D008168:Lung / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D015999:Multivariate Analysis; D016017:Odds Ratio; D011379:Prognosis; D011569:Psychiatric Status Rating Scales; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology; D011788:Quality of Life; D012307:Risk Factors; D012720:Severity of Illness Index; D013030:Spain; D011795:Surveys and Questionnaires; D013997:Time Factors; D016138:Walking