@article{3102759,
    title = "Patterns of Physical Activity Progression in Patients With COPD [Patrones de progresión de la actividad física en pacientes con EPOC]",
    author = "Koreny, M. and Demeyer, H. and Benet, M. and Arbillaga-Etxarri, A. and Balcells, E. and Barberan-Garcia, A. and Gimeno-Santos, E. and Hopkinson, N.S. and De Jong, C. and Karlsson, N. and Louvaris, Z. and Polkey, M.I. and Puhan, M.A. and Rabinovich, R.A. and Rodríguez-Roisin, R. and Vall-Casas, P. and Vogiatzis, I. and Troosters, T. and Garcia-Aymerich, J. and Delgado, A. and Torrent-Pallicer, J. and Vilaró, J. and Rodriguez-Roisín, R. and Chiaradía, D.A.R. and Marín, A. and Ortega, P. and Celorrio, N. and Monteagudo, M. and Montellà, N. and Muñoz, L. and Toran, P. and Simonet, P. and Jané, C. and Martín-Cantera, C. and Borrell, E. and Ivanoff, N. and Corriol-Rohou, S. and Jarrod, I. and Erzen, D. and Brindicci, C. and Higenbottam, T. and Scuri, M. and McBride, P. and Kamel, N. and Tabberer, M. and Dobbels, F. and de Boer, P. and Kulich, K. and Glendenning, A. and Rudell, K. and Wilson, F.J. and Hopkinson, N.S. and Nikai, E. and van der Molen, T. and MacNee, B. and Frei, A. and The Urban Training Study Group and PROactive Consortium members and The Urban Training Study Group and The PROactive Consortium members",
    journal = "Archivos de Bronconeumologia",
    year = "2021",
    volume = "57",
    number = "3",
    pages = "214-223",
    publisher = "Elsevier España (Elsevier Doyma)",
    issn = "2173-5751",
    doi = "10.1016/j.arbres.2020.08.001",
    keywords = "6 min walking distance;  aged;  Article;  chronic obstructive lung disease;  cohort analysis;  controlled study;  exercise;  female;  follow up;  human;  major clinical study;  male;  modified medical research council dyspnea score;  observational study;  physical activity;  respiratory tract disease assessment;  sedentary time;  step count;  walking distance;  walking intensity;  walking parameters;  dyspnea;  lung function test, Dyspnea;  Exercise;  Female;  Humans;  Male;  Pulmonary Disease, Chronic Obstructive;  Respiratory Function Tests;  Sedentary Behavior",
    abstract = "Introduction: Although mean physical activity in COPD patients declines by 400–500 steps/day annually, it is unknown whether the natural progression is the same for all patients. We aimed to identify distinct physical activity progression patterns using a hypothesis-free approach and to assess their determinants. Methods: We pooled data from two cohorts (usual care arm of Urban Training [NCT01897298] and PROactive initial validation [NCT01388218] studies) measuring physical activity at baseline and 12 months (Dynaport MoveMonitor). We identified clusters (patterns) of physical activity progression (based on levels and changes of steps/day) using k-means, and compared baseline sociodemographic, interpersonal, environmental, clinical and psychological characteristics across patterns. Results: In 291 COPD patients (mean ± SD 68 ± 8 years, 81% male, FEV1 59 ± 19%pred) we identified three distinct physical activity progression patterns: Inactive (n = 173 [59%], baseline: 4621 ± 1757 steps/day, 12-month change (Δ): −487 ± 1201 steps/day), Active Improvers (n = 49 [17%], baseline: 7727 ± 3275 steps/day, Δ: + 3378 ± 2203 steps/day) and Active Decliners (n = 69 [24%], baseline: 11 267 ± 3009 steps/day, Δ: −2217 ± 2085 steps/day). After adjustment in a mixed multinomial logistic regression model using Active Decliners as reference pattern, a lower 6-min walking distance (RRR [95% CI] 0.94 [0.90–0.98] per 10 m, P =.001) and a higher mMRC dyspnea score (1.71 [1.12–2.60] per 1 point, P =.012) were independently related with being Inactive. No baseline variable was independently associated with being an Active Improver. Conclusions: The natural progression in physical activity over time in COPD patients is heterogeneous. While Inactive patients relate to worse scores for clinical COPD characteristics, Active Improvers and Decliners cannot be predicted at baseline. © 2020 SEPAR"
}