Determinants and outcomes of physical activity in patients with COPD: a systematic review
Identifieur interne : 000259 ( Main/Merge ); précédent : 000258; suivant : 000260Determinants and outcomes of physical activity in patients with COPD: a systematic review
Auteurs : Elena Gimeno-Santos [Espagne] ; Anja Frei [Suisse] ; Claudia Steurer-Stey [Suisse] ; Jordi De Batlle [Espagne, France] ; Roberto A. Rabinovich [Royaume-Uni] ; Yogini Raste [Royaume-Uni] ; Nicholas S. Hopkinson [Royaume-Uni] ; Michael I. Polkey [Royaume-Uni] ; Hans Van Remoortel [Belgique] ; Thierry Troosters [Belgique] ; Karoly Kulich [Suisse] ; Niklas Karlsson [Suède] ; Milo A. Puhan [Suisse, États-Unis] ; Judith Garcia-Aymerich [Espagne]Source :
- Thorax [ 0040-6376 ] ; 2014.
Abstract
The relationship between physical activity, disease severity, health status and prognosis in patients with COPD has not been systematically assessed. Our aim was to identify and summarise studies assessing associations between physical activity and its determinants and/or outcomes in patients with COPD and to develop a conceptual model for physical activity in COPD.
We conducted a systematic search of four databases (Medline, Embase, CINAHL and Psychinfo) prior to November 2012. Teams of two reviewers independently selected articles, extracted data and used the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) to assess quality of evidence.
86 studies were included: 59 were focused on determinants, 23 on outcomes and 4 on both. Hyperinflation, exercise capacity, dyspnoea, previous exacerbations, gas exchange, systemic inflammation, quality of life and self-efficacy were consistently related to physical activity, but often based on cross-sectional studies and low-quality evidence. Results from studies of pharmacological and non-pharmacological treatments were inconsistent and the quality of evidence was low to very low. As outcomes, COPD exacerbations and mortality were consistently associated with low levels of physical activity based on moderate quality evidence. Physical activity was associated with other outcomes such as dyspnoea, health-related quality of life, exercise capacity and FEV1 but based on cross-sectional studies and low to very low quality evidence.
Physical activity level in COPD is consistently associated with mortality and exacerbations, but there is poor evidence about determinants of physical activity, including the impact of treatment.
Url:
DOI: 10.1136/thoraxjnl-2013-204763
PubMed: 24558112
PubMed Central: 4112490
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</nlm:aff>
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<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
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</nlm:aff>
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<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
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</nlm:aff>
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<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
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<author><name sortKey="Kulich, Karoly" sort="Kulich, Karoly" uniqKey="Kulich K" first="Karoly" last="Kulich">Karoly Kulich</name>
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</nlm:aff>
<country xml:lang="fr">Suisse</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
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<author><name sortKey="Karlsson, Niklas" sort="Karlsson, Niklas" uniqKey="Karlsson N" first="Niklas" last="Karlsson">Niklas Karlsson</name>
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</nlm:aff>
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</nlm:aff>
<country xml:lang="fr">Suisse</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="af13"><addr-line>Department of Epidemiology</addr-line>
,<institution>Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University</institution>
,<addr-line>Baltimore, Maryland</addr-line>
,<country>USA</country>
</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Garcia Aymerich, Judith" sort="Garcia Aymerich, Judith" uniqKey="Garcia Aymerich J" first="Judith" last="Garcia-Aymerich">Judith Garcia-Aymerich</name>
<affiliation wicri:level="1"><nlm:aff id="af1"><institution>Center for Research in Environmental Epidemiology (CREAL)</institution>
,<addr-line>Barcelona</addr-line>
,<country>Spain</country>
</nlm:aff>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="af2"><institution>CIBER Epidemiología y Salud Pública (CIBERESP)</institution>
,<addr-line>Barcelona</addr-line>
,<country>Spain</country>
</nlm:aff>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="af3"><institution>Universitat Pompeu Fabra (UPF)</institution>
,<addr-line>Barcelona</addr-line>
,<country>Spain</country>
</nlm:aff>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
</analytic>
<series><title level="j">Thorax</title>
<idno type="ISSN">0040-6376</idno>
<idno type="eISSN">1468-3296</idno>
<imprint><date when="2014">2014</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass></textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en"><sec><title>Background</title>
<p>The relationship between physical activity, disease severity, health status and prognosis in patients with COPD has not been systematically assessed. Our aim was to identify and summarise studies assessing associations between physical activity and its determinants and/or outcomes in patients with COPD and to develop a conceptual model for physical activity in COPD.</p>
</sec>
<sec><title>Methods</title>
<p>We conducted a systematic search of four databases (Medline, Embase, CINAHL and Psychinfo) prior to November 2012. Teams of two reviewers independently selected articles, extracted data and used the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) to assess quality of evidence.</p>
</sec>
<sec><title>Results</title>
<p>86 studies were included: 59 were focused on determinants, 23 on outcomes and 4 on both. Hyperinflation, exercise capacity, dyspnoea, previous exacerbations, gas exchange, systemic inflammation, quality of life and self-efficacy were consistently related to physical activity, but often based on cross-sectional studies and low-quality evidence. Results from studies of pharmacological and non-pharmacological treatments were inconsistent and the quality of evidence was low to very low. As outcomes, COPD exacerbations and mortality were consistently associated with low levels of physical activity based on moderate quality evidence. Physical activity was associated with other outcomes such as dyspnoea, health-related quality of life, exercise capacity and FEV<sub>1</sub>
but based on cross-sectional studies and low to very low quality evidence.</p>
</sec>
<sec><title>Conclusions</title>
<p>Physical activity level in COPD is consistently associated with mortality and exacerbations, but there is poor evidence about determinants of physical activity, including the impact of treatment.</p>
</sec>
</div>
</front>
<back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Garcia Aymerich, J" uniqKey="Garcia Aymerich J">J Garcia-Aymerich</name>
</author>
<author><name sortKey="Lange, P" uniqKey="Lange P">P Lange</name>
</author>
<author><name sortKey="Benet, M" uniqKey="Benet M">M Benet</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Garcia Aymerich, J" uniqKey="Garcia Aymerich J">J Garcia-Aymerich</name>
</author>
<author><name sortKey="Lange, P" uniqKey="Lange P">P Lange</name>
</author>
<author><name sortKey="Serra, I" uniqKey="Serra I">I Serra</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Pitta, F" uniqKey="Pitta F">F Pitta</name>
</author>
<author><name sortKey="Troosters, T" uniqKey="Troosters T">T Troosters</name>
</author>
<author><name sortKey="Spruit, Ma" uniqKey="Spruit M">MA Spruit</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Troosters, T" uniqKey="Troosters T">T Troosters</name>
</author>
<author><name sortKey="Sciurba, F" uniqKey="Sciurba F">F Sciurba</name>
</author>
<author><name sortKey="Battaglia, S" uniqKey="Battaglia S">S Battaglia</name>
</author>
</analytic>
</biblStruct>
<biblStruct></biblStruct>
<biblStruct><analytic><author><name sortKey="Hartman, Je" uniqKey="Hartman J">JE Hartman</name>
</author>
<author><name sortKey="Boezen, Hm" uniqKey="Boezen H">HM Boezen</name>
</author>
<author><name sortKey="De Greef, Mh" uniqKey="De Greef M">MH de Greef</name>
</author>
</analytic>
</biblStruct>
<biblStruct></biblStruct>
<biblStruct><analytic><author><name sortKey="Higgins, Jpt" uniqKey="Higgins J">JPT Higgins</name>
</author>
<author><name sortKey="Green, S" uniqKey="Green S">S Green</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Liberati, A" uniqKey="Liberati A">A Liberati</name>
</author>
<author><name sortKey="Altman, Dg" uniqKey="Altman D">DG Altman</name>
</author>
<author><name sortKey="Tetzlaff, J" uniqKey="Tetzlaff J">J Tetzlaff</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Caspersen, Cj" uniqKey="Caspersen C">CJ Caspersen</name>
</author>
<author><name sortKey="Powell, Ke" uniqKey="Powell K">KE Powell</name>
</author>
<author><name sortKey="Christenson, Gm" uniqKey="Christenson G">GM Christenson</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Guyatt, Gh" uniqKey="Guyatt G">GH Guyatt</name>
</author>
<author><name sortKey="Oxman, Ad" uniqKey="Oxman A">AD Oxman</name>
</author>
<author><name sortKey="Schunemann, Hj" uniqKey="Schunemann H">HJ Schunemann</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Schunemann, H" uniqKey="Schunemann H">H Schunemann</name>
</author>
<author><name sortKey="Hill, S" uniqKey="Hill S">S Hill</name>
</author>
<author><name sortKey="Guyatt, G" uniqKey="Guyatt G">G Guyatt</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Bauerle, O" uniqKey="Bauerle O">O Bauerle</name>
</author>
<author><name sortKey="Chrusch, Ca" uniqKey="Chrusch C">CA Chrusch</name>
</author>
<author><name sortKey="Younes, M" uniqKey="Younes M">M Younes</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Foglio, K" uniqKey="Foglio K">K Foglio</name>
</author>
<author><name sortKey="Carone, M" uniqKey="Carone M">M Carone</name>
</author>
<author><name sortKey="Pagani, M" uniqKey="Pagani M">M Pagani</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Gosselink, R" uniqKey="Gosselink R">R Gosselink</name>
</author>
<author><name sortKey="Troosters, T" uniqKey="Troosters T">T Troosters</name>
</author>
<author><name sortKey="Decramer, M" uniqKey="Decramer M">M Decramer</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Garcia Aymerich, J" uniqKey="Garcia Aymerich J">J Garcia-Aymerich</name>
</author>
<author><name sortKey="Lange, P" uniqKey="Lange P">P Lange</name>
</author>
<author><name sortKey="Benet, M" uniqKey="Benet M">M Benet</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Spirduso, Ww" uniqKey="Spirduso W">WW Spirduso</name>
</author>
<author><name sortKey="Cronin, Dl" uniqKey="Cronin D">DL Cronin</name>
</author>
</analytic>
</biblStruct>
</listBibl>
</div1>
</back>
</TEI>
</record>
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