Activities of Life: The COPD Patient

Figures & data

Figure 1 The biopsychosocial model proposed by the World Health Organization International Classification of Functioning, Disability and Health. Source: World Health Organization, International classification of functioning, disabilities, and health: ICF. 2001: Geneva ([11]).

Table 1 Methods of measuring physical activity

	Self-report instruments		Motion sensors
	PA record (diaries & logs)	Questionnaires	Pedometer	Accelerometer	Heart rate monitor
Advantages	-Easy to use and cheap for large scale epidemiological studies		-Direct measuring human movement		-Small unit -Low cost -Easy to use -Storage capacity (days)
	-Provide details PA in everyday life -Bouts of PA can be quantified -Recalling on a short period (days, weeks)	-Most comprehensive -Reflect the volume of PA (freq., intensity, duration) and type (occupational, recreational, etc) -Can estimate EE	-Small device -Low cost	-Large memory capacity (weeks) -Temporal information -Assess the volume of PA (freq., intensity, duration) -Can estimate EE -Reliability and validity fairly good
Constraints	-Prone to misrepresentation: • socially desirable responding • difficulty recalling the time and intensity of PA -Procedure of PA record may influence subjects to change their PA habits		-Only walking related activities are recorded -No distinction can be made between walking, running and climbing stairs -Can't assess effort or EE -No temporal information (don'tstore data) -Low level of accuracy at very low or high walking speed	-High cost -May cause discomfort over long period of time -May need frequent quality control -Under prediction EE for upper body movements	-Other factors than PE can cause change in the HR -Calibration curve based on simultaneous measurement HR and VO2
	-Intensive effort -High level of resource to data entry -Not provide accurate estimate of EE	-Implementing cost -quality control -Processing data -Burden imposed on subjects

*Methods of direct and indirect calorimetry, and direct observation are not presented.

PA = physical activity; EE = energy expenditure.

Figure 2 Impact of COPD on lifestyle and quality of life. Source: Rennard S, Decramer M, Calverley PM, et al., Impact of COPD in North America and Europe in 2000: subjects' perspective of Confronting COPD International Survey. Eur Respir J 2002; 20:799–805 ([24]).

Figure 3 COPD patients are markedly inactive in daily life. Source: Pitta F, et al. Am J Respir Crit Care Med 2005; 171:972–977 ([25]).

Table 2 Lifestyle modifications experienced by COPD patients who received a disease-specific self-management program

Lifestyle modification	COPD patients (%)
Physical condition
Learn to breathe	85
Maintain exercise	74
Walk	59
Use bicycle	44
Increase activities of daily living	74
Use relaxation techniques	63
Improve diet habits	52
Improve sleep habits	48
Psychosocial condition
Feel more self-confident	59
Feel more secure	52
Accept better their disease	52
Feel more support	48
Feel less panic	37
Feel less anxious	26

*Bourbeau J, Nault D, Dang-Tan T. Self-management and behavior modification in COPD. Patient Educ Couns 2004; 52:271–277 (50).

World Health Organization. International classification of functioning, disabilities, and health. ICF, Geneva 2001

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Rennard S, Decramer M, Calverley P M, Pride N B, Soriano J B, Vermeire P A, Vestbo J. Impact of COPD in North America and Europe in 2000: subjects' perspective of Confronting COPD International Survey. Eur Respir J Oct, 2002; 20(4)799–805

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Pitta F, Troosters T, Spruit M A, Probst V S, Decramer M, Gosselink R. Characteristics of physical activities in daily life in chronic obstructive pulmonary disease. Am J Respir Crit Care Med. May 1 2005; 171(9)972–977

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