title: Barriers associated with reduced physical activity in COPD patients.
abstract: OBJECTIVE
  To evaluate the ability of COPD patients to perform activities of daily living (ADL); to identify barriers that prevent these individuals from performing ADL; and to correlate those barriers with dyspnea severity, six-minute walk test (6MWT), and an ADL limitation score.
  
  
  METHODS
  In COPD patients and healthy, age-matched controls, the number of steps, the distance walked, and walking time were recorded with a triaxial accelerometer, for seven consecutive days. A questionnaire regarding perceived barriers and the London Chest Activity of Daily Living (LCADL) scale were used in order to identify the factors that prevent the performance of ADL. The severity of dyspnea was assessed with two scales, whereas submaximal exercise capacity was determined on the basis of the 6MWT.
  
  
  RESULTS
  We evaluated 40 COPD patients and 40 controls. In comparison with the control values, the mean walk time was significantly shorter for COPD patients (68.5 ± 25.8 min/day vs. 105.2 ± 49.4 min/day; p < 0.001), as was the distance walked (3.9 ± 1.9 km/day vs. 6.4 ± 3.2 km/day; p < 0.001). The COPD patients also walked fewer steps/day. The most common self-reported barriers to performing ADL were lack of infrastructure, social influences, and lack of willpower. The 6MWT distance correlated with the results obtained with the accelerometer but not with the LCADL scale results.
  
  
  CONCLUSIONS
  Patients with COPD are less active than are healthy adults of a comparable age. Physical inactivity and the barriers to performing ADL have immediate implications for clinical practice, calling for early intervention measures.
authors.affiliation: Heart Institute, School of Medicine Hospital das Clínicas, University of São Paulo, São Paulo, Brazil.
authors.forename: Priscila Batista
authors.initials: PB
authors.lastname: Amorim
authors.affiliation: Heart Institute, School of Medicine Hospital das Clínicas, University of São Paulo, São Paulo, Brazil.
authors.forename: Rafael
authors.initials: R
authors.lastname: Stelmach
authors.affiliation: Heart Institute, School of Medicine Hospital das Clínicas, University of São Paulo, São Paulo, Brazil.
authors.forename: Celso Ricardo Fernandes
authors.initials: CR
authors.lastname: Carvalho
authors.affiliation: Heart Institute, School of Medicine Hospital das Clínicas, University of São Paulo, São Paulo, Brazil.
authors.forename: Frederico Leon Arrabal
authors.initials: FL
authors.lastname: Fernandes
authors.affiliation: Heart Institute, School of Medicine Hospital das Clínicas, University of São Paulo, São Paulo, Brazil.
authors.forename: Regina Maria
authors.initials: RM
authors.lastname: Carvalho-Pinto
authors.affiliation: Heart Institute, School of Medicine Hospital das Clínicas, University of São Paulo, São Paulo, Brazil.
authors.forename: Alberto
authors.initials: A
authors.lastname: Cukier
mesh_terms: D061725:Accelerometry / Q000295:instrumentation; D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D005080:Exercise Test / Q000379:methods; D017079:Exercise Tolerance / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology*; D011795:Surveys and Questionnaires; D016138:Walking / Q000502:physiology* / Q000706:statistics & numerical data