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Physical Activity Behaviour in People with COPD Residing in Spain: A Cross-Sectional Analysis



Chronic obstructive pulmonary disease (COPD) represents a major public health problem due to its high prevalence, morbidity and health cost. It has been demonstrated that physical activity (PA) is one of the most beneficial measures to prevent chronic diseases. The aim of this study was to examine PA levels of adults with COPD residing in Spain, and to analyse the differences by sex, age, education, marital status, cohabiting, tobacco consumption, alcohol consumption and body mass index.


A total of 615 adults aged 15 to 69 years participated in this study. Data from the Spanish National Health Survey 2017 were used. This survey included the short version of IPAQ to measure PA levels. PA was expressed in total volume (MET·min/week), classified as low, moderate and high, and analysed according to sample characteristics. Statistical significance was set at p < 0.05 (CI = 95%).


Level of PA was higher in men than in women (1808.8 vs. 1575.6 MET·min/week; p = 0.016), in those aged under 30 years than in those older than 60 years (2129.4 vs. 1381.4 MET·min/week; p = 0.047) and in those who drank alcohol than in those who did not drink (1912.8 vs. 1248.2 MET·min/week; p = 0.004). Also, underweight and obese participants participated in lower levels of PA than normal weight participants (p= 0.001). When classifying PA level, a total of 37.9% had a low level, 47.5% had a moderate level and only 14.6% had a high level of PA (p < 0.001).


It is recommendable to implement programs to raise awareness of the importance and benefits of PA in the control of COPD, and these programs should focus on those with lower levels of PA.

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  1. Global Initiative for Chronic Obstructive Lung Disease (2017) Guía de bolsillo para el diagnóstico, manejo y prevención de la EPOC. [Internet]. pp 1–44.

  2. Gómez Sáenz JT, Quintano Jiménez JA, Hidalgo Requena A et al (2014) Enfermedad pulmonar obstructiva crónica: morbimortalidad e impacto sanitario. Semergen 40(4):198–204

    Article  PubMed  Google Scholar 

  3. Murray CJ, Lopez AD (1997) Global mortality, disability, and the contribution of risk factors: Global Burden of Disease Study. Lancet 349(9063):1436–1442

    Article  CAS  PubMed  Google Scholar 

  4. World Health Organization (2009) Mortality and burden of disease attributable to selected major risks [Internet]. Accessed 20 Jun 2019

  5. Miravitlles M, Soriano JB, García-Río F, Muñoz L, Duran-Tauleria E, Sanchez G et al (2009) Prevalence of COPD in Spain: impact of undiagnosed COPD on quality of life and daily life activities. Thorax 64(10):863–868

    Article  CAS  PubMed  Google Scholar 

  6. Miravitlles M, Soler-Cataluña JJ, Calle M et al (2014) Guía española de la EPOC (GesEPOC). Actualización 2014. Arch Bronconeumol 50(Supl 1):1–16

    PubMed  Google Scholar 

  7. Franssen FME, Rochester CL (2014) Comorbidities in patients with COPD and pulmonary rehabilitation: do they matter? Eur Respir Rev 23(131):131–141

    Article  PubMed  Google Scholar 

  8. Benck LR, Cuttica MJ, Colangelo LA et al (2017) Association between cardiorespiratory fitness and lung health from young adulthood to middle age. Am J Respir Crit Care Med 195(9):1236–1243.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Castro-Sánchez M, Zurita-Ortega F, Pérez-Turpin JA et al (2019) Physical activity in natural environments is associated with motivational climate and the prevention of harmful habits: structural equation analysis. Front Psychol 10:1113

    Article  PubMed  PubMed Central  Google Scholar 

  10. Chacón-Cuberos R, Zurita-Ortega F, Olmedo-Moreno E, Padial-Ruz R, Castro-Sánchez M (2018) An exploratory model of psychosocial factors and healthy habits in university students of physical education depending on gender. Int J Environ Res Public Health 15(11):2430

    Article  PubMed Central  Google Scholar 

  11. Chacón-Cuberos R, Zurita-Ortega F, Ubago-Jiménez JL, González-Valero G, Sánchez-Zafra M (2018) Condición física, dieta y ocio digital según práctica de actividad física en estudiantes universitarios de Granada. Sport TK-Revista Euroam Ciencias del Deport 7:7–12

    Article  Google Scholar 

  12. Haskell WL, Lee I-M, Pate RR et al (2007) Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Circulation 116(9):1081–1093

    Article  PubMed  Google Scholar 

  13. Warburton DER, Nicol CW, Bredin SSD (2006) Health benefits of physical activity: the evidence. CMAJ 174(6):801–809

    Article  PubMed  PubMed Central  Google Scholar 

  14. Troosters T, van der Molen T, Polkey M et al (2013) Improving physical activity in COPD: towards a new paradigm. Respir Res 14(1):115

    Article  PubMed  PubMed Central  Google Scholar 

  15. Van Helvoort HA, Willems LM, Dekhuijzen PR, van Hees HW, Heijdra YF (2016) Respiratory constraints during activities in daily life and the impact on health status in patients with early-stage COPD: a cross-sectional study. NPJ Prim care Respir Med 26(1):16054

    Article  PubMed  PubMed Central  Google Scholar 

  16. Van Remoortel H, Hornikx M, Demeyer H et al (2013) Daily physical activity in subjects with newly diagnosed COPD. Thorax 68(10):962–963

    Article  PubMed  Google Scholar 

  17. Garcia-Aymerich J, Lange P, Benet M, Schnohr P, Antó JM (2006) Regular physical activity reduces hospital admission and mortality in chronic obstructive pulmonary disease: A population based cohort study. Thorax 61(9):772–778

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Garcia-Rio F, Rojo B, Casitas R et al (2012) Prognostic value of the objective measurement of daily physical activity in patients with COPD. Chest 142(2):338–346

    Article  PubMed  Google Scholar 

  19. Waschki B, Kirsten A, Holz OM et al (2011) Physical activity is the strongest predictor of all-cause mortality in patients with COPD. Chest 140(2):331–342

    Article  CAS  PubMed  Google Scholar 

  20. Gimeno-Santos E, Frei A, Steurer-Stey C et al (2014) Determinants and outcomes of physical activity in patients with COPD: a systematic review. Thorax 69(8):731–739

    Article  PubMed  Google Scholar 

  21. Cebollero P, Antón M, Hernández M, Hueto J (2018) Walking program for copd patients: clinical impact after two years of follow-up. Arch Bronconeumol 54(8):439–440.

    Article  PubMed  Google Scholar 

  22. Garcia-Aymerich J, Farrero E, Félez MA, Izquierdo J, Marrades RM, Antó JM (2003) Risk factors of readmission to hospital for a COPD exacerbation: a prospective study. Thorax 58:100–105

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Garcia-Aymerich J, Gómez FP, Antó JM (2009) Caracterización fenotípica y evolución de la EPOC en el estudio PAC-COPD: diseño y metodología. Arch Bronconeumol 45(1):4–11

    Article  CAS  PubMed  Google Scholar 

  24. Benzo RP, Chang C-CH, Farrell MH et al (2010) Physical activity, health status and risk of hospitalization in patients with severe chronic obstructive pulmonary disease. Respiration 80:10–18

    Article  PubMed  PubMed Central  Google Scholar 

  25. Lores V, García-Río F, Rojo B, Alcolea S, Mediano O (2006) Registro de la actividad física cotidiana mediante un acelerómetro en pacientes con EPOC. Análisis de concordancia y reproducibilidad. Arch Bronconeumol 42(12):627–632.

    Article  PubMed  Google Scholar 

  26. Marín-Royo M, Pellicer-Císcar C, González-Villaescusa C et al (2011) Actividad física y su relación con el estado de salud en pacientes EPOC estables. Arch Bronconeumol 47(7):335–342

    Article  PubMed  Google Scholar 

  27. Sánchez-Castillo S, Cepeda-Qintanar S, Díaz Suárez A, Smith L, López-Sánchez GF (2019) Physical activity in people with COPD residing in Spain: differences according to sex and age. J Sport Heal Res 11:59–68

    Article  Google Scholar 

  28. Ministerio de Sanidad, Consumo y Bienestar Social, Instituto Nacional de Estadística (2017) Encuesta Nacional de Salud 2017: Metodología.[Internet]. Accessed 12 May 2019

  29. IPAQ Group (2005) International Physical Activity Questionnaire [Internet]. Accessed 11 Sept 2019

  30. IPAQ Group (2005) Guidelines for Data Processing and Analysis of the International Physical Activity Questionnaire (IPAQ) [Internet]. Accessed 12 May 2019

  31. Craig CL, Marshall AL, Sjöström M, Sjöstro S, Sjöström S, Bauman AE et al (2003) International Physical Activity Questionnaire: 12-Country Reliability and Validity. Med Sci Sport Exerc [Internet]. 35(8):1381–1395. Accessed 20 Jun 2019

  32. Garcia-Rio F, Lores V, Mediano O et al (2009) Daily physical activity in patients with chronic obstructive pulmonary disease is mainly associated with dynamic hyperinflation. Am J Respir Crit Care Med 180(6):506–512

    Article  PubMed  Google Scholar 

  33. Mesquita R, Spina G, Pitta F et al (2017) Physical activity patterns and clusters in 1001 patients with COPD. Chron Respir Dis 14(3):256–269

    Article  PubMed  PubMed Central  Google Scholar 

  34. Soriano JB, Ancochea J, Miravitlles M et al (2010) Recent trends in COPD prevalence in Spain: a repeated cross-sectional survey 1997–2007. Eur Respir J 36(4):758–765

    Article  CAS  PubMed  Google Scholar 

  35. US Department of Health and Human Services (2018) Physical Activity Guidelines for Americans 2nd edition [Internet]. Washington, DC:U.S. Department of Health an Human Services. Accessed May 22, 2019

  36. World Health Organization (2010) Global recommendations on Physical activity for health [Internet].;jsessionid=93A2695A26E9AE1D656E3E82E2C4F2F2?sequence=1. May 22, 2019

  37. Carsin AE, Fuertes E, Schaffner E et al (2019) Restrictive spirometry pattern is associated with low physical activity levels. A population based international study. Respir Med 146:116–123.

    Article  PubMed  Google Scholar 

  38. Burney PGJ, Luczynska C, Chinn S et al (1994) The European Community Respiratory Health Survey. Eur Respir J 7:954–960

    Article  CAS  PubMed  Google Scholar 

  39. Ackermann-Liebrich U, Kuna-Dibbert B, Probst-Hensch NM et al (2005) Follow-up of the Swiss Cohort Study on air pollution and lung diseases in adults (SAPALDIA 2) 1991–2003: methods and characterization of participants. Sozial-und Präventivmedizin SPM 50(4):245–263

    Article  Google Scholar 

  40. Pitta F, Troosters T, Probst VS, Langer D, Decramer M, Gosselink R (2008) Are patients with COPD more active after pulmonary rehabilitation? Chest 134(2):273–280

    Article  PubMed  Google Scholar 

  41. Rodó-Pin A, Balañá A, Molina L, Gea J, Rodríguez DA (2017) Grado de actividad física diaria de los pacientes con enfermedad pulmonar obstructiva crónica (EPOC) y su relación con la clasificación Global Initiative for Chronic Obstructive Lung Disease (GOLD). Med Clin (Barc) 148(3):114–117

    Article  Google Scholar 

  42. López Sánchez GF, Smith L, Raman R et al (2019) Physical activity behaviour in people with diabetes residing in India: a cross-sectional analysis. Sci Sports 34(1):e59–e66

    Article  Google Scholar 

  43. Rodríguez-Romo G, Boned-Pascual C, Garrido-Muñoz M (2009) Motivos y barreras para hacer ejercicio y practicar deportes en Madrid. Rev Panam Salud Pública 26(3):244–254

    Article  PubMed  Google Scholar 

  44. Halbert RJ, Natoli JL, Gano A, Badamgarav E, Buist AS, Mannino DM (2006) Global burden of COPD: systematic review and meta-analysis. Eur Respir J 28(3):523–532

    Article  CAS  PubMed  Google Scholar 

  45. Fukuchi Y, Nishimura M, Ichinose M et al (2004) COPD in Japan: the Nippon COPD Epidemiology study. Respirology 9(4):458–465

    Article  PubMed  Google Scholar 

  46. Breyer MK, Breyer-Kohansal R, Funk GC et al (2010) Nordic Walking improves daily physical activities in COPD: a randomised controlled trial. Respir Res 11:112–120

    Article  PubMed  PubMed Central  Google Scholar 

  47. Barberan-Garcia A, Arbillaga-Etxarri A, Gimeno-Santos E et al (2015) Nordic walking enhances oxygen uptake without increasing the rate of perceived exertion in patients with chronic obstructive pulmonary disease. Respiration 89(3):221–225

    Article  CAS  PubMed  Google Scholar 

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Sheila Sánchez Castillo is funded by the Seneca Foundation- an Agency for Science and Technology of the Region of Murcia, Spain. 20773/FPI/18.

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Correspondence to Sheila Sánchez Castillo or Guillermo Felipe López Sánchez.

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Sánchez Castillo, S., Smith, L., Díaz Suárez, A. et al. Physical Activity Behaviour in People with COPD Residing in Spain: A Cross-Sectional Analysis. Lung 197, 769–775 (2019).

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  • Physical exercise
  • Lung disease
  • Public health
  • Adults