Physical Activity In Daily Life In Brazilian COPD Patients During and After Exacerbation

Figures & data

Figure 1 Flowchart of the study.

Table 1.  Clinical characteristics, quadriceps strength and BODE index of the studied patients

Variables	Day 2	After 1 month of hospital discharge	p
Age (years)	68.6 ± 10.7
Gender M/F	14/6
Blood gas
PaCO2 (mmHg)	45.9 ± 12.4	45.3 ± 8.8	0.77
PaO2 (mmHg)	48.6 ± 11.0	62.4 ± 9.8	<0.01*
GOLD (II/III/IV)	10/7/3	10/8/2	0.56
Quadriceps strength (Kg)	29.41 ± 10.3	30.40 ± 9.9	0.57
BODE (0–10)	6.1 ± 1.9	3.6 ± 2.5	<0.01*
Body mass index(kg/m2)	23.9 ± 4.8	24.9 ± 4.7	0.60
FEV1 (% do predicted)	45.2 ± 12.5	48.8 ± 13.5	0.01*
6MWD (meters)	267.5 ± 120.5	372.9 ± 135.4	<0.01*
MMRC (0–4)	3.5 ± 0.7	1.8 ± 1.3	<0.01*

Legend: Values are described as mean ± standard deviation, except for gender and GOLD that are described as number of patients. AE = acute exacerbation; M = male; F = female; PaCO₂ = partial pressure of carbon dioxide; PA0₂ = pressure arterial of oxygen; FEV₁ = forced expiratory volume in 1 second; 6MWD = 6-min walking distance; MMRC = modified Medical Research Council dyspnea scale. *p ≤ 0.01 compared with day 2.

Table 2.  Co-morbidities and variables recorded during hospitalization

Variables
Co-morbidities	n (%)
Type 2 Diabetes	7 (35)
Systemic arterial hypertension	12 (60)
Dyslipidemia	4 (20)
Chronic Heart Failure	4 (20)
Chronic Renal Failure	4 (20)
	Mean ± SD
Smoking history (pack-years)	52.2 ± 21.2
Hospitalizations in past year	1.6 ± 0.8
Variables recorded during hospitalization
Hospitalization days	8.9 ± 3.1
Hours of noninvasive ventilation	7.8 ± 7.2
Total amount of medication
Hydrocortisone (mg)	1,416.6 ± 999.8
Prednisone (mg)	296.2 ± 134.3
Budesonide (mcg)	4,914.2 ± 3,620.0

Legend: Values are described as mean ± standard deviation, except for the co-morbidities that are described as number of patients and percentage. The dosage of drugs refers to the total dose administered during hospitalization as well as the time in use of noninvasive ventilation.

Table 3.  Daily life physical activity during hospitalization and 1 month after hospital discharge

Physical activity	In-hospital	After 1 month of hospital discharge
Total inactive time (%)	86.7 ± 7.7	69.6 ± 16.1*
Lying (%)	57.6 ± 18.0	30.7 ± 20.2*
Sitting (%)	29.1 ± 15.4	38.9 ± 17.6
Total active time (%)	13.3 ± 7.7	30.4 ± 16.1*
Standing (%)	11.8 ± 7.1	22.7 ± 14.0*
Walking (%)	1.0 ± 1.1	6.1 ± 4.4*
Others (%)	0.5 ± 0.4	1.6 ± 0.9*
Number of steps /days	602 ± 610	3,575 ± 2,799*

Legend: Values are described as mean ± standard deviation. Data refer to the percentage of time each activity for 12 hours during hospitalization and after 1 month of hospital discharge. Inactive time = lying + sitting; active time = standing + walking + others. *≤ 0.001 compared to with the 2_nd day of hospitalization.

Figure 2. The bars represent the mean and standard deviation of the time spent walking during hospitalization and 1 month after hospital discharge of those patients with (n = 7) or without (n = 13) previous hospitalization in the last year. *p < 0.05 between groups.

Table 4.  Linear correlation between walking time and other outcomes during hospitalization and 1 month after hospital discharge

	In-hospital		After 1 month of hospital discharge
Variables	r	p	r	P
Age (years)	−0.18	NS	−0.06	NS
BODE (score)	−0.49	0.02*	−0.75	<0.01*
BMI (Kg/m2)	0.10	NS	0.06	NS
FEV1 (% of predicted)	0.13	NS	0.47	0.03*
Previous hospitalization (Y/N)	−0.40	NS	−0.55	0.01*
6MWD (meters)	0.57	<0.01*	0.71	<0.01*
MMRC (score)	−0.14	NS	−0.69	<0.01*
Quadriceps force (Kg)	0.54	<0.01*	0.11	NS
PaO2 (mmHg)	0.44	0.05*	0.43	0.05*
CRP	0.27	NS	−0.45	NS

Legend: BODE = multifunctional scale including BMI, FEV₁, 6MWD and MMRC; BMI = body mass index; FEV₁ = forced expiratory volume in one second; 6MWD = 6-min walking distance; MMRC = modified Medical Research Council dyspnea scale; PaO₂ = pressure arterial of oxygen; CRP = C-reactive protein. *p ≤ 0.05 level of significance for linear correlation between walking time and outcomes.