Physical activity patterns and clusters in 1001 patients with COPD

We described physical activity measures and hourly patterns in patients with chronic obstructive pulmonary disease (COPD) after stratification for generic and COPD-specific characteristics and, based on multiple physical activity measures, we identified clusters of patients. In total, 1001 patients with COPD (65% men; age, 67 years; forced expiratory volume in the first second [FEV1], 49% predicted) were studied cross-sectionally. Demographics, anthropometrics, lung function and clinical data were assessed. Daily physical activity measures and hourly patterns were analysed based on data from a multisensor armband. Principal component analysis (PCA) and cluster analysis were applied to physical activity measures to identify clusters. Age, body mass index (BMI), dyspnoea grade and ADO index (including age, dyspnoea and airflow obstruction) were associated with physical activity measures and hourly patterns. Five clusters were identified based on three PCA components, which accounted for 60% of variance of the data. Importantly, couch potatoes (i.e. the most inactive cluster) were characterised by higher BMI, lower FEV1, worse dyspnoea and higher ADO index compared to other clusters (p < 0.05 for all). Daily physical activity measures and hourly patterns are heterogeneous in COPD. Clusters of patients were identified solely based on physical activity data. These findings may be useful to develop interventions aiming to promote physical activity in COPD.

Oliver Amft | Kenneth Meijer | Dina Brooks | Malcolm Kohler | Philippe Gagnon | Gabriele Spina | Ruth Tal-Singer | Albertus C den Brinker | David Donaire-Gonzalez | Christine Jenkins | Martijn A Spruit | Kylie Hill | Beatriz Abascal-Bolado | François Maltais | Richard W Costello | Fabio Pitta | Henrik Watz | Judith Garcia-Aymerich | Jennifer Alison | Rafael Mesquita | David R Hillman | Peter R Eastwood | Sally J. Singh | R. Zuwallack | D. Brooks | C. Jenkins | H. Magnussen | H. Watz | F. Maltais | K. Meijer | D. Donaire-Gonzalez | S. Kon | M. Polkey | W. Man | R. Benzo | E. Wouters | R. Tal-Singer | N. Hopkinson | J. Alison | Z. McKeough | P. Calverley | D. Hillman | O. Amft | J. Garcia-Aymerich | E. G. Gil | F. Pitta | V. Probst | M. Spruit | P. Eastwood | J. Leuppi | D. Miedinger | A. Vaes | R. Goldstein | R. Mesquita | K. Hill | M. Kohler | K. Mitchell | M. Groenen | D. Shrikrishna | P. Paggiaro | R. Costello | C. Clarenbach | Roger Goldstein | Anouk W Vaes | B. Waschki | A. Kirsten | Mehul S Patel | Roberto P Benzo | Zoe J McKeough | Peter MA Calverley | Nicholas S Hopkinson | Benjamin Waschki | Paul S Albert | Dinesh Shrikrishna | William D-C Man | Helgo Magnussen | Michael I Polkey | S. Jenkins | E. Rutten | F. Smeenk | Brenda M. Deering | N. Hernandes | T. Sant'anna | S. Wootton | Gabriele Spina | L. W. Cindy Ng | Selina Dürr | Pierluigi Paggiaro | Anne Kirsten | Frank WJM Smeenk | Christian F Clarenbach | A. D. den Brinker | David Miedinger | B. Vagaggini | Thaís J P Sant'anna | Vanessa S Probst | Nidia A Hernandes | Katy E Mitchell | Sally J Singh | Jörg D Leuppi | Selina Dürr | P. Gagnon | Emiel FM Wouters | Brenda M Deering | A. V. van Gestel | Marco Gramm | D. Jarreta | S. Zogg | D. Savi | Sue C Jenkins | Marco Gramm | Diana Jarreta | Barbara Vagaggini | Stefanie Zogg | Arnoldus JR van Gestel | Elisabeth APM Romme | Samantha SC Kon | Daniela Savi | Sally Wootton | Karina C Furlanetto | Li W Cindy Ng | Thaís Sant’Anna | Erica PA Rutten | Esther Garcia Gil | Miriam TJ Groenen | Richard L ZuWallack | P. Albert | E. Romme | B. Abascal-Bolado | K. C. Furlanetto | E. Gil | Philippe Gagnon | David Donaire-Gonzalez

[1]  Marsha Dowda,et al.  A cluster analysis of physical activity and sedentary behavior patterns in middle school girls. , 2012, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.

[2]  R. Goldbohm,et al.  Clustering of energy balance-related behaviors in 5-year-old children: Lifestyle patterns and their longitudinal association with weight status development in early childhood , 2012, International Journal of Behavioral Nutrition and Physical Activity.

[3]  C. Jenkins,et al.  Ground-based walking training improves quality of life and exercise capacity in COPD , 2014, European Respiratory Journal.

[4]  M. Steiner,et al.  Can we identify patients with different illness schema following an acute exacerbation of COPD: a cluster analysis. , 2014, Respiratory medicine.

[5]  E. Russi,et al.  Predicting Daily Physical Activity in Patients with Chronic Obstructive Pulmonary Disease , 2012, PloS one.

[6]  Benjamin Littenberg,et al.  Effects of television viewing reduction on energy intake and expenditure in overweight and obese adults: a randomized controlled trial. , 2009, Archives of internal medicine.

[7]  D. Brooks,et al.  Defining the relationship between average daily energy expenditure and field-based walking tests and aerobic reserve in COPD. , 2012, Chest.

[8]  M. Polkey,et al.  Skeletal muscle adiposity is associated with physical activity, exercise capacity and fibre shift in COPD , 2014, European Respiratory Journal.

[9]  M. Jetté,et al.  Metabolic equivalents (METS) in exercise testing, exercise prescription, and evaluation of functional capacity , 1990, Clinical cardiology.

[10]  H. Magnussen,et al.  Aclidinium improves exercise endurance, dyspnea, lung hyperinflation, and physical activity in patients with COPD: a randomized, placebo-controlled, crossover trial , 2014, BMC Pulmonary Medicine.

[11]  D. Donaire-Gonzalez,et al.  Benefits of physical activity on COPD hospitalisation depend on intensity , 2015, European Respiratory Journal.

[12]  F. Pitta,et al.  Energy expenditure during daily activities as measured by two motion sensors in patients with COPD. , 2011, Respiratory medicine.

[13]  Lynn Rochester,et al.  Gait and gait-related activities and fatigue in Parkinson's disease: What is the relationship? , 2006, Disability and rehabilitation.

[14]  D. Donaire-Gonzalez,et al.  Physical activity and clinical and functional status in COPD. , 2009, Chest.

[15]  F. Pitta,et al.  Effects of 2 Exercise Training Programs on Physical Activity in Daily Life in Patients With COPD , 2011, Respiratory Care.

[16]  F. Pitta,et al.  Step counting and energy expenditure estimation in patients with chronic obstructive pulmonary disease and healthy elderly: accuracy of 2 motion sensors. , 2010, Archives of physical medicine and rehabilitation.

[17]  H. Magnussen,et al.  Disease Progression and Changes in Physical Activity in Patients with Chronic Obstructive Pulmonary Disease. , 2015, American journal of respiratory and critical care medicine.

[18]  I. Vogiatzis,et al.  Interval training as an alternative modality to continuous exercise in patients with COPD , 2002, European Respiratory Journal.

[19]  P. Jones,et al.  Usefulness of the Medical Research Council (MRC) dyspnoea scale as a measure of disability in patients with chronic obstructive pulmonary disease , 1999, Thorax.

[20]  E. Wouters,et al.  Efficacy of lower-limb muscle training modalities in severely dyspnoeic individuals with COPD and quadriceps muscle weakness: results from the DICES trial , 2014, Thorax.

[21]  Ilse de Bourdeaudhuij,et al.  Associations of physical activity and sedentary time with weight and weight status among 10‐ to 12‐year‐old boys and girls in Europe: a cluster analysis within the ENERGY project , 2013, Pediatric obesity.

[22]  M. Polkey,et al.  Quadriceps wasting and physical inactivity in patients with COPD , 2012, European Respiratory Journal.

[23]  Ulrike Held,et al.  Expansion of the prognostic assessment of patients with chronic obstructive pulmonary disease: the updated BODE index and the ADO index , 2009, The Lancet.

[24]  C. Karpman,et al.  Correlations Between Gait Speed, 6-Minute Walk Distance, Physical Activity, and Self-Efficacy in Patients With Severe Chronic Lung Disease , 2013, Respiratory Care.

[25]  M. Weatherall,et al.  Distinct clinical phenotypes of airways disease defined by cluster analysis , 2009, European Respiratory Journal.

[26]  E. Wouters,et al.  Nordic Walking improves daily physical activities in COPD: a randomised controlled trial , 2010, Respiratory research.

[27]  B. Franklin,et al.  American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. , 2011, Medicine and science in sports and exercise.

[28]  H. Magnussen,et al.  Physical activity in patients with COPD , 2008, European Respiratory Journal.

[29]  A. Sinclair,et al.  Associations of mutually exclusive categories of physical activity and sedentary time with markers of cardiometabolic health in English adults: a cross-sectional analysis of the Health Survey for England , 2015, BMC Public Health.

[30]  C. Matthews,et al.  Sedentary time and cardio-metabolic biomarkers in US adults: NHANES 2003-06. , 2011, European heart journal.

[31]  Johannes B. J. Bussmann,et al.  To total amount of activity….. and beyond: perspectives on measuring physical behavior , 2013, Front. Psychol..

[32]  Jane L. Canavan,et al.  Phenotypic characteristics associated with reduced short physical performance battery score in COPD. , 2014, Chest.

[33]  Martijn A Spruit,et al.  Clusters of comorbidities based on validated objective measurements and systemic inflammation in patients with chronic obstructive pulmonary disease. , 2013, American journal of respiratory and critical care medicine.

[34]  J. Leuppi,et al.  Daily Physical Activity, Functional Capacity and Quality of Life in Patients with COPD , 2014, COPD.

[35]  Genevieve N Healy,et al.  Feasibility of reducing older adults' sedentary time. , 2011, American journal of preventive medicine.

[36]  C. Karpman,et al.  Measuring Gait Speed in the Out-Patient Clinic: Methodology and Feasibility , 2014, Respiratory Care.

[37]  Thierry Troosters,et al.  Physical Activity Characteristics across GOLD Quadrants Depend on the Questionnaire Used , 2016, PloS one.

[38]  B. Fullen,et al.  Acupuncture as an Adjunct to Pulmonary Rehabilitation , 2011, Journal of cardiopulmonary rehabilitation and prevention.

[39]  L. Straker,et al.  Changing physical activity and sedentary behaviour in people with COPD , 2016, Respirology.

[40]  Martijn A Spruit,et al.  Short term and long term effects of pulmonary rehabilitation on physical activity in COPD. , 2012, Respiratory medicine.

[41]  F. Pitta,et al.  Relationship between pulmonary function and physical activity in daily life in patients with COPD. , 2008, Respiratory medicine.

[42]  S. Dolnicar A Review of Unquestioned Standards in Using Cluster Analysis for Data-Driven Market Segmentation , 2002 .

[43]  Ariel Hecht,et al.  Methodology for Using Long-Term Accelerometry Monitoring to Describe Daily Activity Patterns in COPD , 2009, COPD.

[44]  R. Zuwallack,et al.  Pulmonary Rehabilitation and Physical Activity in Patients with Chronic Obstructive Pulmonary Disease. , 2015, American journal of respiratory and critical care medicine.

[45]  Sally J. Singh,et al.  A self-management programme for COPD: a randomised controlled trial , 2014, European Respiratory Journal.

[46]  Ahmed S. BaHammam,et al.  Sleep estimation using BodyMedia's SenseWear™ armband in patients with obstructive sleep apnea , 2013, Annals of thoracic medicine.

[47]  Massimiliano Pau,et al.  Effect of light and vigorous physical activity on balance and gait of older adults. , 2014, Archives of gerontology and geriatrics.

[48]  G. Healy,et al.  Physical activity and sedentary behaviour: applying lessons to chronic obstructive pulmonary disease , 2015, Internal medicine journal.

[49]  Paul D Loprinzi,et al.  Daily movement patterns and biological markers among adults in the United States. , 2014, Preventive medicine.

[50]  Nicholas D Gilson,et al.  Validation of a Novel, Objective Measure of Occupational Sitting , 2012, Journal of occupational health.

[51]  Eva Balcells,et al.  Physical activity in COPD patients: patterns and bouts , 2012, European Respiratory Journal.

[52]  Kylie Hill,et al.  Does exercise training change physical activity in people with COPD? A systematic review and meta-analysis , 2012, Chronic respiratory disease.

[53]  J. Leuppi,et al.  Differences in classification of COPD patients into risk groups A-D: a cross-sectional study , 2014, BMC Research Notes.

[54]  M. Tremblay,et al.  Letter to the Editor: Standardised use of the terms sedentary and sedentary behaviours , 2012 .

[55]  E. Wouters,et al.  Differential response to pulmonary rehabilitation in COPD: multidimensional profiling , 2015, European Respiratory Journal.

[56]  Charles E Matthews,et al.  Comparative validity of physical activity measures in older adults. , 2011, Medicine and science in sports and exercise.

[57]  Karin Taube,et al.  Home-Based Exercise Training as Maintenance after Outpatient Pulmonary Rehabilitation , 2008, Respiration.

[58]  P. Geusens,et al.  Bone stiffness and failure load are related with clinical parameters in men with chronic obstructive pulmonary disease , 2013, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[59]  H. Magnussen,et al.  The metabolic syndrome in patients with chronic bronchitis and COPD: frequency and associated consequences for systemic inflammation and physical inactivity. , 2009, Chest.

[60]  Ruth Tal-Singer,et al.  Physical activity monitoring in COPD: compliance and associations with clinical characteristics in a multicenter study. , 2012, Respiratory medicine.

[61]  N. Owen,et al.  Recommendations for physical activity in older adults , 2015, BMJ : British Medical Journal.

[62]  P. Lee,et al.  A cluster analysis of patterns of objectively measured physical activity in Hong Kong , 2012, Public Health Nutrition.

[63]  Josep Roca,et al.  Identification and prospective validation of clinically relevant chronic obstructive pulmonary disease (COPD) subtypes , 2010, Thorax.

[64]  D. Caillaud,et al.  Clinical COPD phenotypes: a novel approach using principal component and cluster analyses , 2010, European Respiratory Journal.

[65]  Annemarie Koster,et al.  Validation of an armband to measure daily energy expenditure in older adults. , 2011, The journals of gerontology. Series A, Biological sciences and medical sciences.

[66]  J. Alison,et al.  Estimating endurance shuttle walk test speed using the six-minute walk test in people with chronic obstructive pulmonary disease , 2014, Chronic respiratory disease.

[67]  H. P. van der Ploeg,et al.  Daily Sitting Time and All-Cause Mortality: A Meta-Analysis , 2013, PloS one.

[68]  Jo Salmon,et al.  Television time and continuous metabolic risk in physically active adults. , 2008, Medicine and science in sports and exercise.

[69]  D. Brooks,et al.  Measurement properties of the SenseWear armband in adults with chronic obstructive pulmonary disease , 2010, Thorax.

[70]  M. Polkey,et al.  Determinants and outcomes of physical activity in patients with COPD: a systematic review , 2014, Thorax.

[71]  Hans H. C. M. Savelberg,et al.  Minimal Intensity Physical Activity (Standing and Walking) of Longer Duration Improves Insulin Action and Plasma Lipids More than Shorter Periods of Moderate to Vigorous Exercise (Cycling) in Sedentary Subjects When Energy Expenditure Is Comparable , 2013, PloS one.

[72]  F. Martinez,et al.  Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. , 2007, American journal of respiratory and critical care medicine.

[73]  Lucas J Carr,et al.  Letter to the editor: standardized use of the terms "sedentary" and "sedentary behaviours". , 2012, Applied physiology, nutrition, and metabolism = Physiologie appliquee, nutrition et metabolisme.

[74]  E. V. van Beek,et al.  Bone attenuation on routine chest CT correlates with bone mineral density on DXA in patients with COPD , 2012, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[75]  W. MacNee,et al.  Interventions to modify physical activity in patients with COPD: a systematic review , 2016, European Respiratory Journal.

[76]  E. Wouters,et al.  Effect of ‘activity monitor-based’ counseling on physical activity and health-related outcomes in patients with chronic diseases: A systematic review and meta-analysis , 2013, Annals of medicine.