Physical activity monitoring in COPD patients



Albert, Paul
Physical activity monitoring in COPD patients. [Unspecified]

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Abstract

The importance of physical activity in health and disease is recognised, and its relevance in COPD is of increasing interest since it is related to patient outcomes. This thesis primarily sets out to examine physical activity levels in COPD patients in three clinical situations: The early stages of recovery and the subsequent 4 months after hospitalisation for exacerbation (a prospective cohort study of 60 patients), after a course of pulmonary rehabilitation and 6 months later (a prospective cohort study of 37 patients) and at a stage of disease where long term oxygen therapy is being considered (a retrospective cohort study of 35 patients). We have measured physical activity levels using two types of accelerometer: the DynaPort and the Actiwatch. We have also made measures of lung physiology, exercise capacity, peripheral muscle strength and health status. COPD patients have very low levels of physical activity when stable, worse still while in hospital recovering from an exacerbation. Across the 3 patient groups, levels of physical activity do not consistently correlate with other measures, suggesting that what patients actually do does not correlate with what they can do or say they can do. Exacerbating patients who receive early discharge have higher levels of physical activity than those who remain in hospital, and baseline physical activity predicts re exacerbation and readmission at 4 months but not 12 months. Improvements in levels of physical activity are lost 6 months after completing pulmonary rehabilitation despite preservation of peripheral muscle strength and exercise capacity, suggesting that methods to sustain the benefits of PR should focus on changing patient behaviour rather than simply improving physiology. COPD patients who use LTOT show comparable levels of physical activity to a similar patient group with better FEV11 % predicted who do not use LTOT, suggesting that the potential physical constraints of being connected to oxygen tubing for much of the day do not cause patients to be more sedentary. Measuring levels of physical activity in COPD patients with accelerometers offers additional information about patients that may help to determine prognosis and appropriate management. However, further work is needed to determine clinically relevant measures and clinically significant changes.

Item Type: Unspecified
Additional Information: Date: 2012-02 (completed)
Divisions: ?? sch_health ??
Depositing User: Symplectic Admin
Date Deposited: 10 Jan 2013 12:05
Last Modified: 16 Mar 2020 09:25
URI: http://livrepository.liverpool.ac.uk/id/eprint/7173