Physical activity in adults with cystic fibrosis receiving intravenous antibiotics in hospital and in the community.
BACKGROUND
Intravenous antibiotic therapy (IVAT) for CF acute pulmonary exacerbations (APE) can be delivered in hospital or in the community. This study aimed to compare physical activity in CF patients receiving hospital and community-delivered IVAT, as well as other health outcomes.


METHODS
This was a non-randomised parallel group prospective observational study. Hospitalised and community-treated CF adults receiving IVAT for APE were asked to wear ActiGraph® activity monitors, complete the habitual activity estimation scale (HAES), food diary, modified shuttle test (MST) and CFQ-R at the start and end of therapy. Nutritional and clinical outcomes were also compared between the cohorts. The primary outcomes was physical activity measured by the ActiGraph® activity monitors at the beginning and end of treatment in both cohorts.


RESULTS
Physical activity (measured and self-reported) was no different between the cohorts, with both hospitalised and community-treated subjects being generally sedentary. Body weight increased significantly in the hospitalised cohort, whereas no difference was seen in the community-treated cohort. FEV1 % predicted and FVC % predicted increased in community-treated subjects, whereas only FVC % predicted increased in hospitalised subjects. CFQ-R respiratory domain increased to a greater extent in community-treated subjects.


CONCLUSIONS
CF adults receiving IVAT for APE, both in hospital and in the community, are generally sedentary and we found no difference in physical activity between the two groups. These findings suggests the need to further promote physical activity in suitable patients during APE where considered appropriate.
West Midlands Adult Cystic Fibrosis Centre, Heart of England NHS Foundation Trust, Birmingham Heartlands Hospital, Birmingham, B9 5SS, UK ; School of Clinical and Experimental Medicine, College of Medical and Dental Sciences, University of Birmingham, Birmingham, B15 2TT, UK.
Heena
H
Khiroya
West Midlands Adult Cystic Fibrosis Centre, Heart of England NHS Foundation Trust, Birmingham Heartlands Hospital, Birmingham, B9 5SS, UK.
Rebecca
R
Pound
West Midlands Adult Cystic Fibrosis Centre, Heart of England NHS Foundation Trust, Birmingham Heartlands Hospital, Birmingham, B9 5SS, UK.
Ushna
U
Qureshi
West Midlands Adult Cystic Fibrosis Centre, Heart of England NHS Foundation Trust, Birmingham Heartlands Hospital, Birmingham, B9 5SS, UK.
Catherine
C
Brown
West Midlands Adult Cystic Fibrosis Centre, Heart of England NHS Foundation Trust, Birmingham Heartlands Hospital, Birmingham, B9 5SS, UK.
Joanne
J
Barrett
West Midlands Adult Cystic Fibrosis Centre, Heart of England NHS Foundation Trust, Birmingham Heartlands Hospital, Birmingham, B9 5SS, UK.
Rifat
R
Rashid
West Midlands Adult Cystic Fibrosis Centre, Heart of England NHS Foundation Trust, Birmingham Heartlands Hospital, Birmingham, B9 5SS, UK.
Joanna L
JL
Whitehouse
School of Clinical and Experimental Medicine, College of Medical and Dental Sciences, University of Birmingham, Birmingham, B15 2TT, UK.
Alice M
AM
Turner
West Midlands Adult Cystic Fibrosis Centre, Heart of England NHS Foundation Trust, Birmingham Heartlands Hospital, Birmingham, B9 5SS, UK.
Edward F
EF
Nash
Cystic fibrosis; habitual; intravenous antibiotics; nutrition; physical activity.