Impact of extrapulmonary comorbidities on physical activity in chronic obstructive pulmonary disease in Japan: A cross-sectional study

• Published in: PloS one 2022-07, Vol.17 (7), p.e0270836-e0270836
• Main Authors: Yoshida, Makoto, Hiramoto, Tetsuya, Moriwaki, Atsushi, Osoreda, Hisayuki, Iwanaga, Tomoaki, Inoue, Hiromasa
• Format: Article
• Language: English
• Subjects: Accelerometers; Air flow; Anxiety; Biology and Life Sciences; Body mass; Body mass index; Body size; Care and treatment; Cholesterol; Chronic obstructive pulmonary disease; Comorbidity; Complications and side effects; Cross-sectional studies; Dyspnea; Echocardiography; Energy expenditure; Exercise; Health risks; Hemoglobin; Hospitalization; Inflammation; Lean body mass; Lung diseases; Lung diseases, Obstructive; Lungs; Medical prognosis; Medicine and Health Sciences; Mental depression; Metabolism; Mortality; Multivariate analysis; Muscles; Musculoskeletal system; Obstructive lung disease; Parameters; Patients; Physical activity; Physical fitness; Physiological aspects; Pulmonary arteries; Pulmonary artery; Regression analysis; Regression models; Respiratory function; Signs and symptoms; Skeletal muscle; Variables; Variance analysis
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0270836

Physical activity, which can be affected by airflow limitation and extrapulmonary comorbidities, has been reported to be reduced in patients with chronic obstructive pulmonary disease, and reduced physical activity is associated with higher risks of exacerbation and mortality. The aim of the present study is to elucidate the comprehensive effect of extrapulmonary comorbidities on physical activity in Japanese patients with chronic obstructive pulmonary disease, of which evidence is lacking. We conducted a cross-sectional study with a series of tests, including lung function, physical activity, symptom scores, and parameters for comorbidities. Sixty outpatients with stable disease were enrolled, and the relationship between the parameters and physical activity was evaluated. Physical activity was assessed over 7 consecutive days using a triaxial accelerometer, which records total daily energy expenditure, step count, and walking time. Cardiovascular status was assessed via echocardiography, and pulmonary artery pressure was estimated using Doppler sonography. As to mental status, depression and anxiety were assessed using the Self-Rating Depression Scale and State-Trait Anxiety Inventory, respectively. Physical activity level was significantly correlated with step count, walking time, body mass index, lean body mass index, lung function, pulmonary artery pressure, depression, anxiety, and serum total cholesterol level. In a median regression model analysis, low lung function, low lean body mass index, depression, and low serum total cholesterol level were independently associated with decreased physical activity level. These findings suggest that physical inactivity is affected by multiple extrapulmonary factors, including skeletal muscle dysfunction, depressive symptoms, and nutritional state, in Japanese patients with chronic obstructive pulmonary disease.