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Physical activity in COPD: Minimal clinically important difference for medical events
Merilee Teylan1, Ana Kantorowski1, Diana Homsy1
11 Pulmonary and Critical Care Medicine Section, VA Boston Healthcare System, Boston, MA, USA.
Chronic Respiratory Disease
|February 22, 2019
Summary
Estimating the minimal clinically important difference (MCID) for physical activity in chronic obstructive pulmonary disease (COPD) is crucial. This study found the MCID for daily steps in COPD patients ranges from 350 to 1100 steps.
Area of Science:
- Pulmonary Medicine
- Rehabilitation Science
- Digital Health
Background:
- Estimating the minimal clinically important difference (MCID) for physical activity (PA) is essential for managing chronic obstructive pulmonary disease (COPD).
- Current estimates for PA in COPD lack anchor-based data.
- Understanding the impact of medical events on daily step count is critical for patient management.
Purpose of the Study:
- To provide an anchor-based estimate of the MCID for daily step count in individuals with COPD.
- To determine the change in daily steps associated with medical events in COPD patients.
Main Methods:
- A 3-month intervention promoting PA using a pedometer alone or with an interactive website in 93 COPD participants.
- Daily step counts were monitored via pedometer, and medical events (worsening breathing, medication changes, ER visits, hospitalizations) were recorded monthly.
- Generalized linear regression models analyzed the association between daily step count changes and medical events.
Main Results:
- Participants experiencing a medical event showed a decrease in daily steps compared to those without events.
- The decrease in steps around the time of an event ranged from 351 to 983 steps/day, depending on the intervention group (pedometer alone vs. pedometer plus website).
- The estimated MCID for PA in COPD patients falls between 350 and 1100 steps/day.
Conclusions:
- The study provides an anchor-based MCID estimate for daily step count in COPD patients.
- This MCID range can inform clinical practice and research for PA interventions in COPD.
- PA monitoring and interventions should consider the impact of medical events on daily activity levels.
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