All Title Author
Keywords Abstract


Telemonitoring of Daily Activity and Symptom Behavior in Patients with COPD

DOI: 10.1155/2012/438736

Full-Text   Cite this paper   Add to My Lib

Abstract:

Objectives. This study investigated the activity behavior of patients with COPD in detail compared to asymptomatic controls, and the relationship between subjective and objective activities (awareness), and readiness to change activity behavior. Methods. Thirty-nine patients with COPD (66.0 years; FEV1% predicted: 44.9%) and 21 healthy controls (57.0 years) participated. Objective daily activity was assessed by accelerometry and expressed as amount of activity in counts per minute (cpm). Patients' baseline subjective activity and stage of change were assessed prior to measurements. Results. Mean daily activity in COPD patients was significantly lower compared to the healthy controls ( ?cpm versus ?cpm, ). COPD patients showed a temporary decrease in objective activities in the early afternoon. Objective and subjective activities were significantly moderately related and most patients (55.3%) were in the maintenance phase of the stages of change. Conclusions. COPD patients show a distinctive activity decrease in the early afternoon. COPD patients are moderately aware of their daily activity but regard themselves as physically active. Therefore, future telemedicine interventions might consider creating awareness of an active lifestyle and provide feedback that aims to increase and balance activity levels. 1. Introduction Chronic Obstructive Pulmonary Disease (COPD) is a respiratory disease characterized by the progressive development of airflow limitation in the lungs, causing primarily shortness of breath (dyspnea) and diminishing physical exertion capabilities [1, 2]. Symptomatic patients with COPD are dyspnoeic even when they perform normal daily activities, which leads to inactivity and, subsequently, to physical deconditioning [1]. A vicious cycle develops that greatly affects quality of life [1, 2]. Regular physical activity in COPD has been associated with a reduction of the risk of hospital (re)admission [3–5], increase of life expectancy [6], and slowing the rate of decline in lung function [7]. The importance of an active lifestyle is underlined by several studies that showed the inactivity of COPD patients compared to healthy individuals, for example, [8–15]. This decrease in activity levels is not caused solely by airflow limitation, and other factors like dynamic hyperinflation and systemic inflammation seem to play an important role as well [16–18]. In addition to increasing activity levels, a more equally distributed daily activity pattern is assumed to improve patients’ well-being. In daily care healthcare professionals therefore advise

References

[1]  C. B. Cooper, “Airflow obstruction and exercise,” Respiratory Medicine, vol. 103, no. 3, pp. 325–334, 2009.
[2]  GOLD, “Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease,” 2010, http://www.goldcopd.com.
[3]  J. Garcia-Aymerich, E. Farrero, M. A. Félez, J. Izquierdo, R. M. Marrades, and J. M. Antó, “Risk factors of readmission to hospital for a COPD exacerbation: a prospective study,” Thorax, vol. 58, no. 2, pp. 100–105, 2003.
[4]  J. Garcia-Aymerich, P. Lange, M. Benet, P. Schnohr, and J. M. Antó, “Regular physical activity reduces hospital admission and mortality in chronic obstructive pulmonary disease: a population based cohort study,” Thorax, vol. 61, no. 9, pp. 772–778, 2006.
[5]  F. Pitta, T. Troosters, V. S. Probst, M. A. Spruit, M. Decramer, and R. Gosselink, “Physical activity and hospitalization for exacerbation of COPD,” Chest, vol. 129, no. 3, pp. 536–544, 2006.
[6]  A. M. Yohannes, R. C. Baldwin, and M. Connolly, “Mortality predictors in disabling chronic obstructive pulmonary disease in old age,” Age and Ageing, vol. 31, no. 2, pp. 137–140, 2002.
[7]  J. Garcia-Aymerich, P. Lange, M. Benet, P. Schnohr, and J. M. Antó, “Regular physical activity modifies smoking-related lung function decline and reduces risk of chronic obstructive pulmonary disease: a population-based cohort study,” The American Journal of Respiratory and Critical Care Medicine, vol. 175, no. 5, pp. 458–463, 2007.
[8]  S. McGlone, A. Venn, E. H. Walters, and R. Wood-Baker, “Physical activity, spirometry and quality-of-life in chronic obstructive pulmonary disease,” Journal of Chronic Obstructive Pulmonary Disease, vol. 3, no. 2, pp. 83–88, 2006.
[9]  R. Moore, D. Berlowitz, L. Denehy, B. Jackson, and C. F. McDonald, “Comparison of pedometer and activity diary for measurement of physical activity in chronic obstructive pulmonary disease,” Journal of Cardiopulmonary Rehabilitation and Prevention, vol. 29, no. 1, pp. 57–61, 2009.
[10]  B. Sch?nhofer, P. Ardes, M. Geibel, D. K?hler, and P. W. Jones, “Evaluation of a movement detector to measure daily activity in patients with chronic lung disease,” European Respiratory Journal, vol. 10, no. 12, pp. 2814–2819, 1997.
[11]  C. J. Sandland, S. J. Singh, A. Curcio, P. M. Jones, and M. D. L. Morgan, “A profile of daily activity in chronic obstructive pulmonary disease,” Journal of Cardiopulmonary Rehabilitation, vol. 25, no. 3, pp. 181–183, 2005.
[12]  S. Singh and M. D. L. Morgan, “Activity monitors can detect brisk walking in patients with chronic obstructive pulmonary disease,” Journal of Cardiopulmonary Rehabilitation, vol. 21, no. 3, pp. 143–148, 2001.
[13]  V. Lores, F. García-Río, B. Rojo, S. Alcolea, and O. Mediano, “Recording the daily physical activity of COPD patients with an accelerometer: an analysis of agreement and repeatability,” Archivos de Bronconeumologia, vol. 42, no. 12, pp. 627–632, 2006.
[14]  F. Pitta, T. Troosters, M. A. Spruit, V. S. Probst, M. Decramer, and R. Gosselink, “Characteristics of physical activities in daily life in chronic obstructive pulmonary disease,” The American Journal of Respiratory and Critical Care Medicine, vol. 171, no. 9, pp. 972–977, 2005.
[15]  M. J. Mador, A. N. Patel, and J. Nadler, “Effects of pulmonary rehabilitation on activity levels in patients with chronic obstructive pulmonary disease,” Journal of Cardiopulmonary Rehabilitation and Prevention, vol. 31, no. 1, pp. 52–59, 2011.
[16]  F. Garcia-Rio, V. Lores, O. Mediano et al., “Daily physical activity in patients with chronic obstructive pulmonary disease is mainly associated with dynamic hyperinflation,” The American Journal of Respiratory and Critical Care Medicine, vol. 180, no. 6, pp. 506–512, 2009.
[17]  F. Pitta, M. Y. Takaki, N. H. D. Oliveira et al., “Relationship between pulmonary function and physical activity in daily life in patients with COPD,” Respiratory Medicine, vol. 102, no. 8, pp. 1203–1207, 2008.
[18]  L. Bossenbroek, M. H. G. De Greef, J. B. Wempe, W. P. Krijnen, and N. H. T. Ten Hacken, “Daily physical activity in patients with chronic obstructive pulmonary disease: a systematic review,” Journal of Chronic Obstructive Pulmonary Disease, vol. 8, no. 4, pp. 306–319, 2011.
[19]  R. M. H. Evering, T. M. T?nis, and M. M. R. Vollenbroek-Hutten, “Deviations in daily physical activity patterns in patients with the chronic fatigue syndrome: a case control study,” Journal of Psychosomatic Research, vol. 71, no. 3, pp. 129–135, 2011.
[20]  M. G. H. van Weering, M. M. R. Vollenbroek-Hutten, T. M. T?nis, and H. J. Hermens, “Daily physical activities in chronic lower back pain patients assessed with accelerometry,” European Journal of Pain, vol. 13, no. 6, pp. 649–654, 2009.
[21]  M. G. H. Dekker-van Weering, M. M. R. Vollenbroek-Hutten, and H. J. Hermens, “Do personalized feedback messages about activity patterns stimulate patients with chronic low back pain to change their activity behavior on a short term notice?” Applied Psychophysiology Biofeedback, vol. 37, no. 2, pp. 81–89, 2012.
[22]  R. M. H. Evering and M. M. R. Vollenbroek-Hutten,, “Ambulatory activity-based feedback in treatment of the chronic fatigue syndrome,” In Press.
[23]  M. M. R. Vollenbroek-Hutten and H. J. Hermens, “Remote care nearby,” Journal of Telemedicine and Telecare, vol. 16, no. 6, pp. 294–301, 2010.
[24]  J. O. Prochaska and C. C. Diclemente, The Transtheoretical Approach, Dorsey Press, Homewood, Ill, USA, 1984.
[25]  C. V. C. Bouten, K. R. Westerterp, M. Verduin, and J. D. Janssen, “Assessment of energy expenditure for physical activity using a triaxial accelerometer,” Medicine and Science in Sports and Exercise, vol. 26, no. 12, pp. 1516–1523, 1994.
[26]  G. Plasqui and K. R. Westerterp, “Physical activity assessment with accelerometers: an evaluation against doubly labeled water,” Obesity, vol. 15, no. 10, pp. 2371–2379, 2007.
[27]  B. G. Steele, L. Holt, B. Belza, S. Ferris, S. Lakshminaryan, and D. M. Buchner, “Quantitating physical activity in COPD using a triaxial accelerometer,” Chest, vol. 117, no. 5, pp. 1359–1367, 2000.
[28]  H. Watz, B. Waschki, T. Meyer, and H. Magnussen, “Physical activity in patients with COPD,” European Respiratory Journal, vol. 33, no. 2, pp. 262–272, 2009.
[29]  A. Hecht, S. Ma, J. Porszasz, and R. Casaburi, “Methodology for using long-term accelerometry monitoring to describe daily activity patterns in COPD,” Journal of Chronic Obstructive Pulmonary Disease, vol. 6, no. 2, pp. 121–129, 2009.
[30]  F. Pitta, T. Troosters, V. S. Probst, M. A. Spruit, M. Decramer, and R. Gosselink, “Quantifying physical activity in daily life with questionnaaires and motion sensors in COPD,” European Respiratory Journal, vol. 27, no. 5, pp. 1040–1055, 2006.
[31]  M. G. H. Van Weering, M. M. R. Vollenbroek-Hutten, and H. J. Hermens, “The relationship between objectively and subjectively measured activity levels in people with chronic low back pain,” Clinical Rehabilitation, vol. 25, no. 3, pp. 256–263, 2011.
[32]  B. M. J. de Blok, M. H. G. de Greef, N. H. T. ten Hacken, S. R. Sprenger, K. Postema, and J. B. Wempe, “The effects of a lifestyle physical activity counseling program with feedback of a pedometer during pulmonary rehabilitation in patients with COPD: a pilot study,” Patient Education and Counseling, vol. 61, no. 1, pp. 48–55, 2006.
[33]  G. Hospes, L. Bossenbroek, N. H. T. ten Hacken, P. van Hengel, and M. H. G. de Greef, “Enhancement of daily physical activity increases physical fitness of outclinic COPD patients: results of an exercise counseling program,” Patient Education and Counseling, vol. 75, no. 2, pp. 274–278, 2009.
[34]  H. Q. Nguyen, D. P. Gill, S. Wolpin, B. G. Steele, and J. O. Benditt, “Pilot study of a cell phone-based exercise persistence intervention post-rehabilitation for COPD,” International Journal of Chronic Obstructive Pulmonary Disease, vol. 4, pp. 301–313, 2009.

Full-Text

comments powered by Disqus

Contact Us

service@oalib.com

QQ:3279437679

微信:OALib Journal