title: Benefits of physical activity on COPD hospitalisation depend on intensity.
abstract: The present study aims to disentangle the independent effects of the quantity and the intensity of physical activity on the risk reduction of chronic obstructive pulmonary disease (COPD) hospitalisations.177 patients from the Phenotype Characterization and Course of COPD (PAC-COPD) cohort (mean±sd age 71±8 years, forced expiratory volume in 1 s 52±16% predicted) wore the SenseWear Pro 2 Armband accelerometer (BodyMedia, Pittsburgh, PA, USA) for eight consecutive days, providing data on quantity (steps per day, physically active days and daily active time) and intensity (average metabolic equivalent tasks) of physical activity. Information on COPD hospitalisations during follow-up (2.5±0.8 years) was obtained from validated centralised datasets. During follow-up 67 (38%) patients were hospitalised. There was an interaction between quantity and intensity of physical activity in their effects on COPD hospitalisation risk. After adjusting for potential confounders in the Cox regression model, the risk of COPD hospitalisation was reduced by 20% (hazard ratio (HR) 0.79, 95% CI 0.67-0.93; p=0.005) for every additional 1000 daily steps at low average intensity. A greater quantity of daily steps at high average intensity did not influence the risk of COPD hospitalisations (HR 1.01, p=0.919). Similar results were found for the other measures of quantity of physical activity. Greater quantity of low-intensity physical activity reduces the risk of COPD hospitalisation, but high-intensity physical activity does not produce any risk reduction.
authors.affiliation: Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain Departament de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra, Barcelona, Spain Physical Activity and Sports Sciences Department, Fundació Blanquerna, Barcelona, Spain.
authors.forename: David
authors.initials: D
authors.lastname: Donaire-Gonzalez
authors.affiliation: Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain Departament de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra, Barcelona, Spain.
authors.forename: Elena
authors.initials: E
authors.lastname: Gimeno-Santos
authors.affiliation: Departament de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra, Barcelona, Spain CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain Department of Pneumology, Hospital del Mar IMIM, Barcelona, Spain.
authors.forename: Eva
authors.initials: E
authors.lastname: Balcells
authors.affiliation: Section of Nutrition and Metabolism, International Agency for Research on Cancer (IARC), Lyon, France.
authors.forename: Jordi
authors.initials: J
authors.lastname: de Batlle
authors.affiliation: CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain Department of Pneumology, Hospital Universitari Vall d'Hebron, Barcelona, Spain Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Maria A
authors.initials: MA
authors.lastname: Ramon
authors.affiliation: CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain Department of Pneumology, Hospital Universitari Vall d'Hebron, Barcelona, Spain Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Esther
authors.initials: E
authors.lastname: Rodriguez
authors.affiliation: Department of Pneumology, Hospital Universitari de Bellvitge, Barcelona, Spain Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Barcelona, Spain.
authors.forename: Eva
authors.initials: E
authors.lastname: Farrero
authors.affiliation: Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain Departament de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra, Barcelona, Spain.
authors.forename: Marta
authors.initials: M
authors.lastname: Benet
authors.affiliation: Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain Departament de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra, Barcelona, Spain Arizona Respiratory Center, University of Arizona, Tucson, AZ, USA.
authors.forename: Stefano
authors.initials: S
authors.lastname: Guerra
authors.affiliation: CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain Department of Pneumology, Hospital Universitari Son Espases, Palma de Mallorca, Spain Institut d'Investigació Sanitària de Palma (IdISPa), Palma de Mallorca, Spain.
authors.forename: Jaume
authors.initials: J
authors.lastname: Sauleda
authors.affiliation: Departament de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra, Barcelona, Spain CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain Department of Pneumology, Hospital del Mar IMIM, Barcelona, Spain.
authors.forename: Antoni
authors.initials: A
authors.lastname: Ferrer
authors.affiliation: CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain Department of Pneumology, Hospital Universitari Vall d'Hebron, Barcelona, Spain Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Jaume
authors.initials: J
authors.lastname: Ferrer
authors.affiliation: CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain Servei de Pneumologia (Thorax Institute), Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain.
authors.forename: Joan A
authors.initials: JA
authors.lastname: Barberà
authors.affiliation: CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain Servei de Pneumologia (Thorax Institute), Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain.
authors.forename: Robert
authors.initials: R
authors.lastname: Rodriguez-Roisin
authors.affiliation: Departament de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra, Barcelona, Spain CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain Department of Pneumology, Hospital del Mar IMIM, Barcelona, Spain.
authors.forename: Joaquim
authors.initials: J
authors.lastname: Gea
authors.affiliation: CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain Servei de Pneumologia (Thorax Institute), Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain.
authors.forename: Alvar
authors.initials: A
authors.lastname: Agustí
authors.affiliation: Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain Departament de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra, Barcelona, Spain Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.
authors.forename: Josep M
authors.initials: JM
authors.lastname: Antó
authors.affiliation: Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain Departament de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra, Barcelona, Spain jgarcia@creal.cat.
authors.forename: Judith
authors.initials: J
authors.lastname: Garcia-Aymerich
mesh_terms: D061725:Accelerometry; D000368:Aged; D015444:Exercise; D005080:Exercise Test; D005260:Female; D005541:Forced Expiratory Volume; D006760:Hospitalization / Q000706:statistics & numerical data*; D006784:Hospitals, Teaching; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology*; D012307:Risk Factors; D013030:Spain; D014797:Vital Capacity