Daily Physical Activity in Patients With COPD After Hospital Discharge in a Minority Population

Low physical activity in patients with chronic obstructive pulmonary disease (COPD) is associated with increased morbidity and mortality. To inform the design of a home-based physical activity promotion program for patients with COPD recently discharged from a minority-serving hospital, we conducted...

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Published inChronic obstructive pulmonary diseases Vol. 6; no. 4; pp. 332 - 340
Main Authors Prieto-Centurion, Valentin, Casaburi, Richard, Coultas, David B, Kansal, Mayank M, Kitsiou, Spyros, Luo, Julia J, Ma, Jun, Rand, Cynthia S, Tan, Ai-Yui M, Krishnan, Jerry A
Format Journal Article
LanguageEnglish
Published United States COPD Foundation Inc 23.10.2019
Subjects
Original Research
post-hospital discharge
copd
physical activity
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Summary:Low physical activity in patients with chronic obstructive pulmonary disease (COPD) is associated with increased morbidity and mortality. To inform the design of a home-based physical activity promotion program for patients with COPD recently discharged from a minority-serving hospital, we conducted a cohort study to evaluate objectively measured daily physical activity and patient-reported outcomes. This was a 12-week prospective cohort study of patients with a physician diagnosis of COPD recently hospitalized (≤ 12 weeks) for respiratory symptoms. Daily physical activity was recorded using wrist-based and "clip-on" pedometers, and analyzed as mean daily step counts averaged over 7 days. Twenty-two patients were enrolled a median (interquartile range, [IQR]) of 14 (7 to 29) days after hospital discharge. The median daily step count (IQR) in the first week after enrollment (week 1) was 3710 (1565 to 5129) steps. The median within-person change in daily step count (IQR) from week 1 to week 12 was 314 (-30 to 858) steps ( =0.28). Within-person correlation of week-to-week daily step counts was high (r ≥ 0.75). Time from hospital discharge to enrollment was not correlated with mean daily step counts on week 1 (r= -0.13) and only weakly correlated with change in mean daily step counts from week 1 to week 12 (r=0.37). Daily physical activity was variable in this cohort of recently hospitalized patients with COPD, but with little within-person change over a 12-week period. These observations highlight the need for flexible physical activity promotion programs addressing the needs of a heterogeneous patient population.
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Dr. Prieto-Centurion reports receiving grants from the National Institutes of Health/National Heart, Lung, and Blood Institute during the time of this study. Dr. Krishnan reports grants from the National Institutes of Health/Patient-Centered Outcomes Research Institute not related to this study and Dr. Tan reports a grant from the National Institutes of Health. All other authors have nothing to declare.
We thank the patients and clinicians who assisted in the implementation of the study. We also thank members of the independent Data and Safety Monitoring Board (Sherita Chapman-Smith, MD; Kerri Morgan, PhD, and Meghan Lane-Falls, MD, MSHP).
Author Contributions: VP had full access to all data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. VP contributed to the study conception, data acquisition, analysis and interpretation, writing and revision of the manuscript. RC, DBC, MK, JM, and CSR contributed to the study conception, data interpretation, writing and revision of the manuscript. JJL and AMT contributed to the data acquisition and analysis, writing and revision of the manuscript. JK contributed to the study conception, data analysis and interpretation, writing and revision of the manuscript.
ISSN:2372-952X
2372-952X
DOI:10.15326/jcopdf.6.4.2019.0136