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Barriers associated with reduced physical activity in COPD patients.

Amorim PB, Stelmach R, Carvalho CR, Fernandes FL, Carvalho-Pinto RM, Cukier A - J Bras Pneumol (2014)

Bottom Line: The most common self-reported barriers to performing ADL were lack of infrastructure, social influences, and lack of willpower.The 6MWT distance correlated with the results obtained with the accelerometer but not with the LCADL scale results.Physical inactivity and the barriers to performing ADL have immediate implications for clinical practice, calling for early intervention measures.

View Article: PubMed Central - PubMed

Affiliation: Heart Institute, School of Medicine Hospital das Clínicas, University of São Paulo, São Paulo, Brazil.

ABSTRACT

Objective: To evaluate the ability of COPD patients to perform activities of daily living (ADL); to identify barriers that prevent these individuals from performing ADL; and to correlate those barriers with dyspnea severity, six-minute walk test (6MWT), and an ADL limitation score.

Methods: In COPD patients and healthy, age-matched controls, the number of steps, the distance walked, and walking time were recorded with a triaxial accelerometer, for seven consecutive days. A questionnaire regarding perceived barriers and the London Chest Activity of Daily Living (LCADL) scale were used in order to identify the factors that prevent the performance of ADL. The severity of dyspnea was assessed with two scales, whereas submaximal exercise capacity was determined on the basis of the 6MWT.

Results: We evaluated 40 COPD patients and 40 controls. In comparison with the control values, the mean walk time was significantly shorter for COPD patients (68.5 ± 25.8 min/day vs. 105.2 ± 49.4 min/day; p < 0.001), as was the distance walked (3.9 ± 1.9 km/day vs. 6.4 ± 3.2 km/day; p < 0.001). The COPD patients also walked fewer steps/day. The most common self-reported barriers to performing ADL were lack of infrastructure, social influences, and lack of willpower. The 6MWT distance correlated with the results obtained with the accelerometer but not with the LCADL scale results.

Conclusions: Patients with COPD are less active than are healthy adults of a comparable age. Physical inactivity and the barriers to performing ADL have immediate implications for clinical practice, calling for early intervention measures.

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Related in: MedlinePlus

Questionnaire regarding perceived barriers to physical activity: proportionof participants with scores = 5 on each domain in the COPD and controlgroups.
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f01: Questionnaire regarding perceived barriers to physical activity: proportionof participants with scores = 5 on each domain in the COPD and controlgroups.

Mentions: Among the COPD patients, lack of infrastructure was the most common self-reportedbarrier to physical activity. Table 2 shows thescores obtained by the COPD patients and controls on the questionnaire regardingbarriers to ADL. There were no significant differences between the COPD and controlgroups in terms of measures of central tendency. However, when divided by questionnairevalues of intrinsic significance (5 points), approximately 80% of the patients with COPDand 35% of the controls (p < 0.001) reported that they did not perform physicalactivities because they had no access to exercise facilities or because they had noresources to exercise. Lack of willpower was the second most common self-reportedbarrier to performing ADL, reported by 63% of the patients with COPD and 55% of thecontrols, followed by social influences, reported by 53% of the patients with COPD and32.5% of the controls (p < 0.05). The social influence domain includes having no one(e.g., family members or friends) to exercise with (or receiving no encouragement fromfamily members or friends to exercise), as well as feeling embarrassed when performingphysical activities. The remaining scores on the questionnaire regarding barriers to ADLare shown in Figure 1. A significant differencewas found between the COPD and control groups regarding the lack of ability domain,indicating that patients with COPD feel that they are unable to perform ADL.


Barriers associated with reduced physical activity in COPD patients.

Amorim PB, Stelmach R, Carvalho CR, Fernandes FL, Carvalho-Pinto RM, Cukier A - J Bras Pneumol (2014)

Questionnaire regarding perceived barriers to physical activity: proportionof participants with scores = 5 on each domain in the COPD and controlgroups.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4263331&req=5

f01: Questionnaire regarding perceived barriers to physical activity: proportionof participants with scores = 5 on each domain in the COPD and controlgroups.
Mentions: Among the COPD patients, lack of infrastructure was the most common self-reportedbarrier to physical activity. Table 2 shows thescores obtained by the COPD patients and controls on the questionnaire regardingbarriers to ADL. There were no significant differences between the COPD and controlgroups in terms of measures of central tendency. However, when divided by questionnairevalues of intrinsic significance (5 points), approximately 80% of the patients with COPDand 35% of the controls (p < 0.001) reported that they did not perform physicalactivities because they had no access to exercise facilities or because they had noresources to exercise. Lack of willpower was the second most common self-reportedbarrier to performing ADL, reported by 63% of the patients with COPD and 55% of thecontrols, followed by social influences, reported by 53% of the patients with COPD and32.5% of the controls (p < 0.05). The social influence domain includes having no one(e.g., family members or friends) to exercise with (or receiving no encouragement fromfamily members or friends to exercise), as well as feeling embarrassed when performingphysical activities. The remaining scores on the questionnaire regarding barriers to ADLare shown in Figure 1. A significant differencewas found between the COPD and control groups regarding the lack of ability domain,indicating that patients with COPD feel that they are unable to perform ADL.

Bottom Line: The most common self-reported barriers to performing ADL were lack of infrastructure, social influences, and lack of willpower.The 6MWT distance correlated with the results obtained with the accelerometer but not with the LCADL scale results.Physical inactivity and the barriers to performing ADL have immediate implications for clinical practice, calling for early intervention measures.

View Article: PubMed Central - PubMed

Affiliation: Heart Institute, School of Medicine Hospital das Clínicas, University of São Paulo, São Paulo, Brazil.

ABSTRACT

Objective: To evaluate the ability of COPD patients to perform activities of daily living (ADL); to identify barriers that prevent these individuals from performing ADL; and to correlate those barriers with dyspnea severity, six-minute walk test (6MWT), and an ADL limitation score.

Methods: In COPD patients and healthy, age-matched controls, the number of steps, the distance walked, and walking time were recorded with a triaxial accelerometer, for seven consecutive days. A questionnaire regarding perceived barriers and the London Chest Activity of Daily Living (LCADL) scale were used in order to identify the factors that prevent the performance of ADL. The severity of dyspnea was assessed with two scales, whereas submaximal exercise capacity was determined on the basis of the 6MWT.

Results: We evaluated 40 COPD patients and 40 controls. In comparison with the control values, the mean walk time was significantly shorter for COPD patients (68.5 ± 25.8 min/day vs. 105.2 ± 49.4 min/day; p < 0.001), as was the distance walked (3.9 ± 1.9 km/day vs. 6.4 ± 3.2 km/day; p < 0.001). The COPD patients also walked fewer steps/day. The most common self-reported barriers to performing ADL were lack of infrastructure, social influences, and lack of willpower. The 6MWT distance correlated with the results obtained with the accelerometer but not with the LCADL scale results.

Conclusions: Patients with COPD are less active than are healthy adults of a comparable age. Physical inactivity and the barriers to performing ADL have immediate implications for clinical practice, calling for early intervention measures.

Show MeSH
Related in: MedlinePlus