Correlation of symptoms and physical activity level in chronic obstructive pulmonary disease patients: results from the observational SPACE study

ABSTRACT

Objectives

Chronic obstructive pulmonary disease (COPD) is characterized by persistent airflow limitation and high symptom burden that interferes with physical activity and results in a vicious cycle of inactivity and symptom worsening. The aim of this multicenter, observational study was to determine the prevalence and severity of morning, daytime and night-time symptoms as well as patterns of physical activity levels (PALs) and their interrelation in Belgian COPD patients, enrolled in the multinational SPACE study (NCT03031769).

Methods

Socio-demographic, socio-economic and disease characteristics data were collected from patients’ medical records as part of a routine visit to their primary care practice or pulmonologist. Dedicated questionnaires were used to evaluate respiratory symptoms for each part of the day. PAL was assessed by means of self- and interview-reported tools, and physician’s judgment. Patients were also classified according to GOLD recommendations 2013 and 2017.

Results

Overall, 102 Belgian patients participated in the study (mean age 67 years, 60.8% males). Over 85% of patients experienced respiratory symptoms throughout the day and about one-third were considered as ‘active’ (PAL ≥150 minutes/week). Physician-assessed PALs were higher than self-reported PALs, categorizing fewer patients as ‘inactive’ (17.6% versus 42.2%, respectively). PALs and symptoms were weakly interrelated. Inactive patients were present in all GOLD classification groups.

Conclusion

Stable Belgian COPD patients enrolled in the SPACE study presented 24-hour respiratory symptoms and insufficient PALs. Physicians tended to overestimate patients’ physical activity. Inactive patients were present across all GOLD classification groups. New approaches are deemed necessary to objectively identify and activate sedentary patients.

KEYWORDS:

• Chronic obstructive pulmonary disease
• health-related quality of life
• physical activity
• symptom prevalence

Acknowledgments

The authors would like to thank study participants and acknowledge the assistance of all the investigators, study nurses, clinicians, laboratory personnel and other staff members in conducting the study. The authors would also like to thank Anne-Theres Henze (Modis) for medical writing support provided in accordance with Good Publication Practice guidelines (http://www.ismpp.org/gpp3) and funded by AstraZeneca.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Abbreviations

BODEx: Body mass index, airflow Obstruction, Dyspnea and frequency of Exacerbations; CAT: COPD Assessment Test™; COPD: chronic obstructive pulmonary disease; COTE: COPD-specific comorbidity test; CVD, cardiovascular disease; EmSCI: Early Morning Symptoms of COPD Instrument; E-RS™: COPD: Evaluating Respiratory Symptoms in chronic obstructive pulmonary disease; Exercise Vital Sign; EXACT: EXAcerbations of Chronic pulmonary disease Tool; FEV₁: forced expiratory volume in 1 second; GOLD: Global initiative for chronic Obstructive Lung Disease; HRQoL: health-related quality of life; mMRC: modified Medical Research Council; NiSCI: Night-time Symptoms of COPD Instrument; YPAS: Yale Physical Activity Survey.

Supplementary material

Supplemental data for this article can be accessed here

Additional information

Funding

This work was supported by AstraZeneca.