Physical activity and hospitalization for exacerbation of COPD
Physical activity and hospitalization for exacerbation of COPD
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DOI：
10.1378/chest.129.3.536
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发表时间：
2006-03-01
期刊：
影响因子：
9.6
通讯作者：
Gosselink, R
中科院分区：
文献类型：
--
作者：
Pitta, F;Troosters, T;Gosselink, R
背景资料：急性加重（AEs）对COPD进展的各个方面都有负面影响，但因AEs住院对体力活动影响的客观详细数据尚不可用。目的和测量：我们旨在使用活动监测仪调查体力活动（DynaPort; McRoberts;海牙，荷兰），肺功能，肌肉力量，6分钟步行距离，和动脉血气水平在17名患者（平均年龄69 ± 9岁[+/- SD];体重指数24 ± 5 kg/m2）。结果：负重活动时间在住院第2天和第7天，（中位数，7%;四分位距[IQR]，白天时间的3 - 18%;中位数，9%; IQR，7 - 21%）和出院后1个月（中位数，19% [IQR，10 - 34%]; Friedman检验，p = 0.13）。在住院期结束时，负重活动时间与股四头肌力量呈正相关（r = 0.47; p = 0.048）。与最近未住院的患者相比，前一年因AE住院的患者的活动水平更低。此外，出院后1个月活动水平较低的患者更有可能在第二年再次入院。结论：COPD患者在住院期间和住院后因AE明显不活动。在AE期间和之后，努力加强体力活动应是疾病管理的目标之一。
Background: Acute exacerbations (AEs) have a negative impact on various aspects of the progression of COPD, but objective and detailed data on the impact of hospitalizations for an AE on physical activity are not available.Objective and measurements: We aimed to investigate physical activity using an activity monitor (DynaPort; McRoberts; the Hague, the Netherlands), pulmonary function, muscle force, 6-min walking distance, and arterial blood gas levels in 17 patients (mean age, 69 +/- 9 years [+/- SD]; body mass index, 24 +/- 5 kg/m(2)) at the beginning and end of a hospitalization period for an AE and I month after discharge.Results: Time spent on weight-bearing activities (walking and standing) was markedly low both at day 2 and day 7 of hospitalization (median, 7%; interquartile range [IQR], 3 to 18% of the time during the day; and median, 9%; IQR, 7 to 21%, respectively) and I month after discharge (median, 19% [IQR, 10 to 34%]; Friedman test, p = 0.13). Time spent on weight-bearing activities was positively correlated to quadiriceps force at the end of the hospitalization period (r = 0.47; p = 0.048). Patients with hospitalization for an AE in the previous year had an even lower activity level when compared to those without a recent hospitalization. In addition, patients with a lower activity level at 1 month after discharge were more likely to be readmitted in the following year.Conclusions: Patients with COPD are markedly inactive during and after hospitalization for an AE. Efforts to enhance physical activity should be among the aims of the disease management during and following the AE periods.