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Published on: March 7, 2019
Bidirectional Associations Between Physical Activity, Sedentary Behavior, and Daily Symptoms in Patients With Chronic
Banchia Palmen1,2, Zjala Ebadi3,4, Maarten van Herck2
1Institute of Nutrition and Translational Research in Metabolism, Care and Public Health Research Institute, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
Physical activity (PA) and sedentary time (ST) have bidirectional associations with symptoms in patients with chronic obstructive pulmonary disease (COPD). Increased PA linked to feeling relaxed, while higher step counts and ST correlated with shortness of breath, tiredness, and anxiety.
Area of Science:
- Pulmonary Medicine
- Behavioral Medicine
- Biomedical Engineering
Background:
- Questionnaire-based symptom assessment in chronic obstructive pulmonary disease (COPD) patients is limited by recall bias and lacks bidirectional exploration.
- The relationship between physical activity (PA), sedentary time (ST), and symptom experience in COPD patients remains unclear.
- Understanding these associations is crucial for developing effective symptom management strategies and improving patient quality of life.
Purpose of the Study:
- To investigate the directionality of associations between PA, ST, and symptoms in COPD patients.
- To utilize objective measures like accelerometry and ecological momentary assessment (EMA) for real-time data collection.
- To provide insights into the complex interplay between behavior and symptom perception in COPD.
Main Methods:
- A subsample of COPD patients from the FAntasTIGUE study participated, completing 8 EMA questionnaires daily for 5 days.
- Ten symptoms were assessed using a 7-point Likert scale, alongside objective measurement of step count and ST via accelerometry (ActiGraph GT9X Link).
- Multilevel models analyzed the relationship between PA/ST (15 and 30 minutes pre/post-EMA) and symptom scores, controlling for covariates and using patient ID as a random intercept.
Main Results:
- Feeling more relaxed was associated with higher step counts 15 minutes post-EMA (P=.046).
- Conversely, higher pre-EMA step counts were linked to feeling less relaxed (P=.02, P=.009), increased shortness of breath (P<.001), and tiredness (P=.02).
- Elevated pre-EMA ST correlated with increased anxiety (P=.03, P=.04).
Conclusions:
- A bidirectional relationship exists between feeling relaxed and PA in COPD patients.
- Increased physical activity (higher step count) was associated with greater shortness of breath and fatigue.
- Higher sedentary time was linked to heightened feelings of anxiety.
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