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Physical Activity and Its Determinants in Severe Chronic Obstructive Pulmonary Disease


Medicine & Science in Sports & Exercise: October 2004 - Volume 36 - Issue 10 - p 1667-1673
doi: 10.1249/01.MSS.0000142378.98039.58
Clinical Sciences: Clinical Investigations

Background: Patients with chronic obstructive pulmonary disease (COPD) have a limited exercise capacity. Surprisingly, little is known about their levels of physical activity practice. We assessed the levels and determinants of physical activity practice in severe COPD patients.

Methods: A cross-sectional systematic sample of 346 COPD patients was recruited during 1 yr in four tertiary hospitals of the Barcelona area of Spain. Patients answered a questionnaire, which included physical activity assessment, and performed spirometric tests and blood gases.

Results: Seventy-eight percent of patients walked daily whereas 17% did not practice any physical activity. Median energy expenditure in physical activity was 109 kcal·d−1 (IQR 24–239). The following factors were independently associated with a lower physical activity level in a logistic regression analysis: female sex (OR 2.92, 95% CI 1.11–7.70), older age (1.04, 1.01–1.07 per year), higher socioeconomic status (2.23, 1.24–4.02), diabetes (2.66, 1.40–5.06), lower physical and mental quality of life (0.93, 0.90–0.96 and 0.96, 0.93–0.98, respectively, per unit), and long-term oxygen therapy (2.07, 1.19–3.60). Neither FEV1, previous COPD admissions, body mass index, nor other treatments were related to physical activity practice.

Conclusions: In conclusion, one third of severe COPD patients in our study reported a level of physical activity lower than the equivalent to walking less than 15 min·d−1. Apart from sociodemographic variables, comorbidity, health-related quality of life, and long-term oxygen therapy were the only factors independently associated with a low level of physical activity.

1Respiratory and Environmental Health Research Unit, Municipal Institute of Medical Research (IMIM), Barcelona, SPAIN; 2Department of Pneumology, Hospital of Mar, Barcelona, SPAIN; 3Department of Pneumology, University Hospital of Bellvitge, L’Hospitalet de Llobregat, SPAIN; 4Department of Pneumology, Hospital Clinic of Barcelona, SPAIN; 5Department of Pneumology, Germans Trias i Pujol Hospital, Badalona, SPAIN; 6Lipids and Cardiovascular Epidemiology Unit, Municipal Institute of Medical Research (IMIM), Barcelona, SPAIN; and 7Department of Experimental and Health Sciences, Pompeu Fabra University, Barcelona, SPAIN

Address for correspondence: Dr. Judith Garcia-Aymerich, Respiratory and Environmental Health Research Unit, Municipal Institute of Medical Research (IMIM), Doctor Aiguader 80, E-08003-Barcelona, Spain; E-mail:

Submitted for publication January 2004.

Accepted for publication June 2004.

The authors wish to thank Marta Macharé, Milors Maresma, Ana Martín, Ma José Rodríguez, Sandra Alonso, Rosa Reinón, Roser Pedreny, Núria Soler, and Angela Roig for their help in the field work, and Dr. Isabelle Romieu for her comments to a previous version of the results.

This work was supported in part by grants from Agència d’Avaluació de Tecnologia Mèdica (5/34/96) and Generalitat de Catalunya-DURSI 2001/SGR/00406. Judith Garcia-Aymerich was recipient of a grant from Instituto de Salud “Carlos III” (97/4365) from 1997 to 2000.

EFRAM: Estudi dels Factors de Risc d’Agudització de la MPOC (Risk Factors of COPD Exacerbation Study): The EFRAM investigators are: Josep M. Antó (Principal Investigator), Judith Garcia-Aymerich and Jordi Sunyer from the Respiratory and Environmental Health Research Unit, IMIM, Barcelona; Jordi Alonso from the Health Services Research Unit, IMIM, Barcelona; Esther Barreiro and Miquel A. Félez from the Department of Pneumology, Hospital del Mar, Barcelona; Joan Escarrabill, Eva Farrero, and Ma José Redondo from the Department of Pneumology, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat; Ramon M Marrades, Néstor Soler, and Antoni Torres from the Department of Pneumology, Hospital Clínic i Provincial de Barcelona, Barcelona; Glòria Bonet, José Izquierdo, Eduard Monsó, and Josep Morera from the Department of Pneumology, Hospital Germans Trias i Pujol, Badalona.

©2004The American College of Sports Medicine