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Physical Activity and the Frequency of Acute Exacerbations in Patients with Chronic Obstructive Pulmonary Disease

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Abstract

Purpose

Acute exacerbations (AE) in patients with COPD are associated with a decline in lung function, increased risk of hospitalization, and mortality. In this cross-sectional study we tested whether the level of objectively measured daily physical activity and exercise capacity are associated with the number of COPD exacerbations.

Methods

In 210 patients with COPD (67 % men; mean (SD) age: 63 (8) years) enrolled in The Obstructive Pulmonary Disease Outcomes Cohort of Switzerland (TOPDOCS) physical activity (PA) (steps per day, physical activity level, (PAL)), exercise capacity (6-min walking distance, (6MWD)), comorbidities, lung function, and medication were assessed. Differences between COPD patients with frequent (≥2 year) and infrequent (0–1 year) exacerbations were assessed. Univariate and multivariate analyses were performed to investigate whether the level of objectively measured daily physical activity and exercise capacity are associated with the number of COPD exacerbations.

Results

Patients with frequent AE had a significantly lower FEV1 and 6MWD compared to patients with infrequent AE. In univariate analysis, the number of exacerbations was inversely associated with FEV1, 6MWD, BMI, and smoking status while there was a positive association with RV/TLC and combined inhaled medication. However, there was no significant association with PAL and steps per day. In multivariate analysis, FEV1 and the use of combined inhaled medication were independently associated with the number of AE, after correction for covariates.

Conclusions

The findings of this study imply that FEV1, independent of inhaled medication, is significantly associated with COPD exacerbations. Neither physical activity nor exercise capacity was independently associated with COPD exacerbations.

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Conflict of interest

There are no conflicts of interest.

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Authors and Affiliations

  1. Clinical Director Division of Pulmonology, University Hospital of Zurich, Raemistrasse 100, 8091, Zurich, Switzerland

    M. Schönmann, N. A. Sievi, C. F. Clarenbach & M. Kohler

  2. Pulmonary Division, Cantonal Hospital of Glarus, Glarus, Switzerland

    T. Brack

  3. Pulmonary Division, Cantonal Hospital of St. Gallen, St. Gallen, Switzerland

    M. Brutsche & J. Ruediger

  4. Pulmonary Division, Clinic Barmelweid, Barmelweid, Switzerland

    M. Frey

  5. Pulmonary Division, Cantonal Hospital of Aarau, Aarau, Switzerland

    S. Irani

  6. University Clinic of Internal Medicine, Cantonal Hospital Baselland and University of Basel, Basel, Switzerland

    J. D. Leuppi

  7. Institute of General Practice and Health Services Research, University of Zurich, Zurich, Switzerland

    O. Senn

  8. Pulmonary Division, Cantonal Hospital of Münsterlingen, Münsterlingen, Switzerland

    R. Thurnheer

Authors
  1. M. Schönmann
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  2. N. A. Sievi
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  3. C. F. Clarenbach
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  4. T. Brack
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  5. M. Brutsche
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  6. M. Frey
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  7. S. Irani
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  8. J. D. Leuppi
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  9. J. Ruediger
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  10. O. Senn
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  11. R. Thurnheer
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  12. M. Kohler
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Corresponding author

Correspondence to M. Kohler.

Additional information

M. Schönmann and N.A. Sievi shared first authorship.

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Schönmann, M., Sievi, N.A., Clarenbach, C.F. et al. Physical Activity and the Frequency of Acute Exacerbations in Patients with Chronic Obstructive Pulmonary Disease. Lung 193, 63–70 (2015). https://doi.org/10.1007/s00408-014-9673-7

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  • DOI: https://doi.org/10.1007/s00408-014-9673-7

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