title: Effects of pharmacologic treatment based on airflow limitation and breathlessness on daily physical activity in patients with chronic obstructive pulmonary disease.
abstract: BACKGROUND
  Improvement in the daily physical activity (PA) is important for the management of chronic obstructive pulmonary disease (COPD). However, the effects of pharmacologic treatment on PA are not well understood. We evaluated the effects of additional medications, including bronchodilator with or without inhaled corticosteroid, based on airflow limitation and breathlessness on the PA in COPD patients and the factors that could predict or affect the improvement in PA.
  
  
  METHODS
  A prospective non-randomized observational study was employed. Twenty-one COPD subjects without any other diseases that might reduce PA were recruited. The PA was measured with a triaxial accelerometer for 2 weeks, and pulmonary function tests and incremental shuttle walking tests were administered before and after 4-week treatment with an additional medication.
  
  
  RESULTS
  Bronchodilation was obtained by additional medication. The mean values of PA evaluated by metabolic equivalents (METs) at ≥3.0 METs and the duration of PA at ≥3.0 METs and ≥3.5 METs were improved by medication. The % change in the duration of PA at ≥3.5 METs was significantly correlated with the baseline functional residual capacity (FRC), residual volume, and inspiratory capacity/total lung capacity. However, the % change in the duration of PA at any intensity was not correlated with the % changes of any values of the pulmonary function tests or incremental shuttle walking test except the PA at ≥2.5 METs with FRC.
  
  
  CONCLUSIONS
  Medication could improve the PA in patients with COPD, especially at a relatively high intensity of activity when medication was administered based on airflow limitation and breathlessness. The improvement was seen in the patients with better baseline lung volume, but was not correlated with the improvements in the pulmonary function tests or exercise capacity.
authors.affiliation: Department of Respiratory Medicine, National Hospital Organization Wakayama Hospital, Mihama-cho, Hidaka-gun, Wakayama, Japan.
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Minakata
authors.affiliation: Department of Respiratory Medicine, Naga Municipal Hospital, Kinokawa, Wakayama, Japan.
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Morishita
authors.affiliation: Third Department of Internal Medicine, Wakayama Medical University, Wakayama, Wakayama, Japan.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Ichikawa
authors.affiliation: Third Department of Internal Medicine, Wakayama Medical University, Wakayama, Wakayama, Japan.
authors.forename: Keiichiro
authors.initials: K
authors.lastname: Akamatsu
authors.affiliation: Third Department of Internal Medicine, Wakayama Medical University, Wakayama, Wakayama, Japan.
authors.forename: Tsunahiko
authors.initials: T
authors.lastname: Hirano
authors.affiliation: Third Department of Internal Medicine, Wakayama Medical University, Wakayama, Wakayama, Japan.
authors.forename: Masanori
authors.initials: M
authors.lastname: Nakanishi
authors.affiliation: Third Department of Internal Medicine, Wakayama Medical University, Wakayama, Wakayama, Japan.
authors.forename: Kazuto
authors.initials: K
authors.lastname: Matsunaga
authors.affiliation: Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.
authors.forename: Masakazu
authors.initials: M
authors.lastname: Ichinose
mesh_terms: D056044:Actigraphy; D000280:Administration, Inhalation; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D058666:Adrenergic beta-2 Receptor Agonists / Q000008:administration & dosage; D000368:Aged; D001993:Bronchodilator Agents / Q000008:administration & dosage*; D004338:Drug Combinations; D004417:Dyspnea / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D005080:Exercise Test; D017079:Exercise Tolerance / Q000187:drug effects*; D005260:Female; D006801:Humans; D008168:Lung / Q000187:drug effects* / Q000503:physiopathology; D008176:Lung Volume Measurements; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000187:drug effects*; D018727:Muscarinic Antagonists / Q000008:administration & dosage; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D020127:Recovery of Function; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones; D058666:Adrenergic beta-2 Receptor Agonists; D001993:Bronchodilator Agents; D004338:Drug Combinations; D018727:Muscarinic Antagonists
keywords: COPD; accelerometer; bronchodilator; predictor; pulmonary function