A Non-Interventional, Cross-Sectional Study to Evaluate Factors Relating to Daily Step Counts and Physical Activity in Japanese Patients with Chronic Obstructive Pulmonary Disease: STEP COPD
A Non-Interventional, Cross-Sectional Study to Evaluate Factors Relating to Daily Step Counts and Physical Activity in Japanese Patients with Chronic Obstructive Pulmonary Disease: STEP COPD
复制标题
一项评价日本慢性阻塞性肺疾病患者每日步数和体力活动相关因素的非干预性横断面研究：STEP COPD
DOI：
10.2147/copd.s277782
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发表时间：
2020-12-22
影响因子：
2.8
通讯作者：
Kuwahira I
中科院分区：
文献类型：
--
作者：
Ichinose M;Minakata Y;Motegi T;Takahashi T;Seki M;Sugaya S;Hayashi N;Kuwahira I
与健康成人相比，慢性阻塞性肺疾病（COPD）患者的身体活动（PA）减少。由于低PA与死亡率增加相关，因此改善PA是COPD管理的重要目标。这项大规模、多中心、非介入、横断面研究考察了日本COPD患者的活动状况，并探讨了与PA相关的因素。年龄≥40岁、确诊COPD并有肺功能检查数据的门诊患者入组。主要研究结果是测量每日步数（连续14天，使用活动监测器），通过活动强度评估活动时间（使用代谢当量[METs]），以及评估PA与患者特征之间的相关性。次要结局包括进一步研究患者特征对PA的影响。对417例全球慢性阻塞性肺疾病倡议（GOLD） I期（29.5%）、II期（43.9%）、III期（23.5%）和IV期（3.1%）患者的数据进行了评估。中位数（第一季度，第三季度）每日步数为3440.8（1831.3,5709.3）。≥3 METs（中度至剧烈）和≥2 METs（轻度至剧烈）时PA的中位（Q1, Q3）持续时间分别为18.7（6.5,41.3）和186.9（126.9,259.2）分钟。对于约30%的患者，≥3 METs活动时间≤10分钟。失业与减少活动时间（≥3和≥2 METs）和步数显著相关。严重的GOLD分期与活动时间减少显著相关（≥3和≥2 METs）。高修正医学研究委员会（mMRC）呼吸困难评分与减少活动时间（≥3 METs）和步数显著相关。与活动监测测量相比，患者在主观报告中倾向于高估需要≥2 METs的活动所花费的时间。在日本COPD患者中观察到PA降低，其中大多数为GOLD期I/II期。就业状况、GOLD分期和mMRC呼吸困难评分可以帮助识别PA降低风险的患者。NCT03642613 (ClinicalTrials.gov);UMIN000032962 （UMIN-CTR, min.ac.jp）。
Patients with chronic obstructive pulmonary disease (COPD) have decreased physical activity (PA) compared with healthy adults. As lower PA is associated with increased mortality, improving PA is an important objective for COPD management. This large-scale, multicenter, non-interventional, cross-sectional study examined the activity status of COPD patients in Japan and explored factors related to PA. Outpatients aged ≥40 years with confirmed COPD diagnosis and pulmonary function test data were enrolled. Primary study outcomes were measurement of daily steps (over 14 consecutive days, using an activity monitor), assessment of activity time by activity intensity (using metabolic equivalents [METs]), and evaluation of correlation between PA and patient characteristics. Secondary outcomes included further investigation of the influence of patient characteristics on PA. Data from 417 patients with Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages I (29.5%), II (43.9%), III (23.5%), and IV (3.1%) were evaluated. Median (Q1, Q3) daily step count was 3440.8 (1831.3, 5709.3). Median (Q1, Q3) durations of PA at ≥3 (moderate-to-vigorous) and ≥2 METs (light-to-vigorous) were 18.7 (6.5, 41.3) and 186.9 (126.9, 259.2) minutes, respectively. For >30% of patients, time spent in ≥3 METs activity was ≤10 minutes. Unemployment was significantly correlated with reduced activity time (≥3 and ≥2 METs) and step count. Severe GOLD stage was significantly correlated with reduced activity time (≥3 and ≥2 METs). High modified Medical Research Council (mMRC) dyspnea score was significantly correlated with reduced activity time (≥3 METs) and step count. Patients tended to overestimate the time spent in activities requiring ≥2 METs in their subjective reports compared with activity monitor measurements. Reduced PA was observed in the Japanese COPD patients with the majority of them being GOLD stage I/II. Employment status, GOLD stage, and mMRC dyspnea score could help identify patients at risk of reduced PA. NCT03642613 (ClinicalTrials.gov); UMIN000032962 (UMIN-CTR, umin.ac.jp).