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Moderate and Severe Exacerbations Accelerate Physical Activity Decline in COPD Patients

feb2018A new study published in the European Respiratory Journal, conducted by researchers from the Barcelona Institute for Global Health (ISGlobal), revealed that moderate and severe exacerbations among individuals with chronic obstructive pulmonary disease (COPD) have been linked to “a decline in their physical activity level.”

"Previous research showed an acute drop in physical activity during a COPD exacerbation. We now observed that this drop in physical activity has an important and lasting effect. Higher exacerbation frequencies were associated with more pronounced declines in physical activity," said Heleen Demeyer, first author of the study and researcher from KU Leuven and ISGlobal.

"An unexpected finding was that two or more moderate exacerbations (treated without hospital admission) resulted in a long-term decline in physical activity equivalent to that of a severe event (with hospitalization). This confirms the importance of prevention and early management of exacerbations regardless of the severity," added Demeyer.

Researchers analyzed data from 141 patients that received care from one of five European healthcare centers located throughout Greece, Scotland, England, Belgium and The Netherlands. Patients’ physical activity was measured and compared with the number and severity of exacerbations after one year. Researchers also evaluated each patient’s “perception of their physical activity.”

The researchers presented two hypotheses that explain the occurrence of patients’ decline in physical activity. The first hypothesis suggested that there may have been a decline resulting from patients’ loss of “functional exercise capacity.” The second hypothesis theorized that patients were continuously less active after “experiencing worsening of symptoms during an exacerbation.”

"Patients with frequent exacerbations constitute a specific disease phenotype with a worse prognosis, specifically a faster loss in lung function, a greater worsening of health status and a substantial reduction in the amount of physical activity," said Judith Garcia-Aymerich, ISGlobal researcher and coordinator of the study. "Our results support the promotion of interventions to increase physical activity after an exacerbation, such as behavioral programs combined, when needed, with pulmonary rehabilitation.”

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