Daily Physical Activity in Patients with Chronic Obstructive Pulmonary Disease Is Mainly Associated with Dynamic Hyperinflation
Daily Physical Activity in Patients with Chronic Obstructive Pulmonary Disease Is Mainly Associated with Dynamic Hyperinflation
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DOI：
10.1164/rccm.200812-1873oc
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发表时间：
2009-09-15
影响因子：
24.7
通讯作者：
Alvarez-Sala, Rodolfo
中科院分区：
文献类型：
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作者：
Garcia-Rio, Francisco;Lores, Vanesa;Alvarez-Sala, Rodolfo
基本原理：虽然COPD患者的运动表现的主要限制是动态过度充气，很少有人知道它与日常体力activity.Objectives的关系：分析动态过度充气，运动耐量和气道氧化应激对体力活动的贡献在COPD patients.Methods：在一项横断面研究中，我们包括110例中度至非常严重的COPD患者。使用三轴加速度计测量日常身体活动，提供1分钟运动时期的平均值作为向量幅度单位（VMU）。患者进行了6分钟步行试验，递增运动试验，测量呼吸模式和操作肺容量，并在75%的最大工作率恒定的工作率测试。测量和主要结果：使用黄金阶段和BODE指数，我们确定了动脉血气，肺容量，弥散能力，呼出气冷凝物和生物标志物。89例发生动态过度充气的患者的每日体力活动低于21例未发生动态过度充气的患者（n = 161 [SD 70] vs. n = 288 [SD 85] VMU; P = 0.001）。体力活动主要与6分钟步行距离有关（r = 0.72; P = 0.001），Vo（2）（r = 0.63; P = 0.001），运动时呼气末肺容积的变化（r = -0.73; P = 0.001）、耐受时间（r = 0.61; P = 0.001）和呼出气冷凝液中的8-异前列烷（r = -0.67; P = 0.001）。在以VMU为因变量的多元线性回归分析中，动态肺过度充气、呼气末肺容积变化和6 min步行距离仍保留在预测模型中（r（2）= 0.84; P = 0.001）。
Rationale: Although the major limitation to exercise performance in patients with COPD is dynamic hyperinflation, little is known about its relation to daily physical activity.Objectives: To analyze the contribution of dynamic hyperinflation, exercise tolerance, and airway oxidative stress to physical activity in patients with COPD.Methods: In a cross-sectional study, we included 110 patients with moderate to very severe COPD. Daily physical activity was measured using a triaxial accelerometer providing a mean of 1-minute movement epochs as vector magnitude units (VMU). Patients performed the 6-minute walk test, incremental exercise test with measurement of breathing pattern and operating lung volumes, and constant-work rate test at 75% of maximal work rate.Measurements and Main Results: Using the GOLD stage and BODE index, we determined arterial blood gases, lung volumes, diffusing capacity, and biomarkers in exhaled breath condensate. Daily physical activity was lower in the 89 patients who developed dynamic hyperinflation than in the 21 who did not (n = 161 [SD 70] vs. n = 288 [SD 85] VMU; P = 0.001). Physical activity was mainly related to distance walked in 6 minutes (r = 0.72; P = 0.001), Vo(2) (r = 0.63; P = 0.001), change in end-expiratory lung volume during exercise (r = -0.73; P = 0.001), endurance time (r = 0.61; P = 0.001), and 8-isoprostane in exhaled breath condensate (r = -0.67; P = 0.001). In a multivariate linear regression analysis using VMU as a dependent variable, dynamic hyperinflation, change in end-expiratory lung volume, and distance walked in 6 minutes were retained in the prediction model (r(2) = 0.84; P = 0.001).Conclusions: Daily physical activity of patients with COPD is mainly associated with dynamic hyperinflation, regardless of severity classification.