title: Relationship between pulmonary exacerbations and daily physical activity in adults with cystic fibrosis.
abstract: BACKGROUND
  The aim of this study was to examine the relationship between pulmonary exacerbations and physical activity (PA) in adults with cystic fibrosis (CF).
  
  
  METHODS
  We grouped adults with CF according to their exacerbation status in the year before study enrollment: (1) <1 exacerbation/year; (2) 1-2 exacerbations/year; and (3) >2 exacerbations/year. PA was assessed objectively by means of an accelerometer at the time of study enrollment.
  
  
  RESULTS
  Patients with >2 exacerbations/year spent less time in PA; specifically, fewer activities of mild intensity [>3 metabolic equivalents (METs)], and lower active energy expenditure (P = 0.01 and P = 0.03, respectively). After correcting for relevant confounders, PA levels were not related to the exacerbation frequency in the preceding year. PA at moderate intensity (4.8-7.2 METs) or greater (> 7.2 METs) was independently associated with gender and FEV1 % predicted (P = 0.007 and P = 0.04, respectively). Compared with men, women had reduced vigorous activities (P = 0.01) and active energy expenditure (P = 0.01).
  
  
  CONCLUSIONS
  Adult CF patients with more pulmonary exacerbations in the preceding year have more advanced disease and are less active than their peers. PA was independently associated with gender and airflow obstruction. Gender differences in PA are evident in CF adults.
authors.affiliation: Department of Pediatrics and Pediatric Neurology, Cystic Fibrosis Center, Sapienza University of Rome, Viale Regina Elena, 324-00185, Rome, Italy. danielasavi1@virgilio.it.|Department of Cystic Fibrosis, Royal Brompton Hospital and Imperial College, London, SW3 6NP, UK. danielasavi1@virgilio.it.
authors.forename: Daniela
authors.initials: D
authors.lastname: Savi
authors.affiliation: Department of Cystic Fibrosis, Royal Brompton Hospital and Imperial College, London, SW3 6NP, UK. n.simmonds@imperial.ac.uk.|NIHR Respiratory BRU, Royal Brompton Hospital NHS Foundation Trust, London, SW3 6NP, UK. n.simmonds@imperial.ac.uk.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Simmonds
authors.affiliation: Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185, Rome, Italy. marcello.dp@hotmail.com.
authors.forename: Marcello
authors.initials: M
authors.lastname: Di Paolo
authors.affiliation: Department of Pediatrics and Pediatric Neurology, Cystic Fibrosis Center, Sapienza University of Rome, Viale Regina Elena, 324-00185, Rome, Italy. serena.quattrucci@uniroma1.it.
authors.forename: Serena
authors.initials: S
authors.lastname: Quattrucci
authors.affiliation: Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185, Rome, Italy. paolo.palange@uniroma1.it.|Eleonora Lorrillard-Spencer Cenci Foundation, 00185, Rome, Italy. paolo.palange@uniroma1.it.
authors.forename: Paolo
authors.initials: P
authors.lastname: Palange
authors.affiliation: NIHR Respiratory BRU, Royal Brompton Hospital NHS Foundation Trust, London, SW3 6NP, UK. w.banya@imperial.ac.uk.
authors.forename: Winston
authors.initials: W
authors.lastname: Banya
authors.affiliation: NIHR Respiratory BRU, Royal Brompton Hospital NHS Foundation Trust, London, SW3 6NP, UK. n.hopkinson@imperial.ac.uk.
authors.forename: Nicholas S
authors.initials: NS
authors.lastname: Hopkinson
authors.affiliation: Department of Cystic Fibrosis, Royal Brompton Hospital and Imperial College, London, SW3 6NP, UK. D.Bilton@rbht.nhs.uk.
authors.forename: Diana
authors.initials: D
authors.lastname: Bilton
mesh_terms: D061725:Accelerometry; D000328:Adult; D003550:Cystic Fibrosis / Q000503:physiopathology*; D018450:Disease Progression; D004734:Energy Metabolism; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008297:Male; D055686:Metabolic Equivalent; D008875:Middle Aged; D009043:Motor Activity; D011653:Pulmonary Diffusing Capacity; D012737:Sex Factors; D014109:Total Lung Capacity; D014797:Vital Capacity; D055815:Young Adult