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Title:	Determinants of change in physical activity during moderate-to-severe COPD exacerbation
Author:	Esteban, Cristóbal; Quintana, José María; García Gutiérrez, Susana; Antón Ladislao, Ane; González, Nerea; Baré, Marisa; Fernández de Larrea-Baz, Nerea; Rivas Ruiz, Francisco; Gea Guiral, Joaquim; IRYSS-COPD group
Abstract:	BACKGROUND: Data are scarce on patient physical activity (PA) level during exacerbations of chronic obstructive pulmonary disease (eCOPD). The objective of the study was to evaluate the level and determinants of change in PA during an eCOPD. MATERIALS AND METHODS: We conducted a prospective cohort study with recruitment from emergency departments (EDs) of 16 participating hospitals from June 2008 to September 2010. Data were recorded on socioeconomic characteristics, dyspnea, forced expiratory volume in 1 second (FEV1%), comorbidities, health-related quality of life, factors related to exacerbation, and PA in a stable clinical condition and during the eCOPD episode. RESULTS: We evaluated 2,487 patients. Common factors related to the change in PA during hospital admission or 7 days after discharge to home from the ED were lower PA at baseline and during the first 24 hours after the index evaluation. Age, quality of life, living alone, length of hospital stay, and use of anticholinergic or systemic corticosteroids in treating the exacerbation were associated with the change in PA among hospitalized patients. Predictors of change among patients not admitted to hospital were baseline FEV1% and dyspnea at rest on ED arrival. CONCLUSION: Among the patients evaluated in an ED for an eCOPD, the level and change in PA was markedly variable. Factors associated with exacerbation (PA 24 hours after admission, medication during admission, and length of hospital stay) and variables reflecting patients' stable clinical condition (low level of PA, age, quality of life, FEV1%) are predictors of the change in PA during a moderate-to-severe eCOPD.
Abstract:	This work was supported in part by grants from the Fondo de Investigación Sanitaria (PI 06/1010, PI06/1017,/nPI06/714, PI06/0326, PI06/0664); Department of Health of the Basque Country, Department of Education, Universities and Research of the Basque Government (UE09/62); the Research Committee of the Hospital Galdakao; and the thematic networks – Red IRYSS (Investigacion en Resultados y Servicios Sanitarios (G03/220) – of the Instituto de Salud Carlos III.
Subject(s):	-Pulmons -- Malalties obstructives -Exercici -COPD exacerbations -Physical activity -Prospective cohort study
Rights:	© 2016 Esteban et al. This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution – Non Commercial (unported, v3.0) License. The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further/npermission from Dove Medical Press Limited, provided the work is properly attributed. Permissions beyond the scope of the License are administered by Dove Medical Press Limited. http://creativecommons.org/licenses/by-nc/3.0/
Document type:	Article Article - Published version
Published by:	Dove Medical Press
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