Lorena Paltanin Schneider

Sedentary Behavior Is an Independent Predictor of Mortality in Subjects With COPD

BACKGROUND: The terms sedentary behavior and physical inactivity have been confusingly mixed. Although the association between physical inactivity and mortality has been shown previously in subjects with COPD, this association had not yet been investigated with regard to sedentarism. The aim of this work was to investigate the impact of sedentary behavior on mortality of subjects with COPD and to propose a cutoff point of sedentarism with prognostic value. METHODS: In this retrospective cohort study, sedentary behavior was assessed with 2 activity monitors (DynaPort and Sensewear armband) in 101 subjects with COPD from 2006 to 2011. Vital status was then ascertained in 2015. The following 6 variables of sedentary behavior were analyzed: average of metabolic equivalent of task (MET)/d (reflecting intensity); time spent/d lying, sitting, and lying + sitting (reflecting duration of sedentary postures); and time spent/d in activities requiring <1.5 MET and <2 MET (reflecting intensity and duration of sedentary time). Cutoff points for sedentarism and their respective prognostic values were investigated for each variable. RESULTS: Forty-one subjects (41%) died over a median (interquartile range) follow-up period of 62 (43–88) months. After adjusting for potential confounders in the Cox regression model, cutoff points from variables that combine duration of sedentary time and intensity <1.5 MET or <2 MET were associated with the increased risk of mortality. The strongest independent cutoff for predicting mortality was ≥8.5 h/d spent in sedentary activities <1.5 MET (area under the curve 0.76; hazard ratio 4.09, 95% CI 1.90–8.78; P < .001). CONCLUSIONS: Sedentary behavior was an independent predictor of mortality in subjects with COPD, even adjusting for moderate-to-vigorous physical activity and a number of other variables. Mortality was higher in subjects with COPD who spend ≥8.5 h/d in activities requiring <1.5 MET. These findings may open room for future studies aiming at decreasing sedentary time as a promising strategy to reduce mortality risk in subjects with COPD.

Does the wearing time of motion sensor interfere with the choice of physical activity in daily life outcomes of COPD patients

Este estudo analisa a atividade fisica na vida diaria (AFVD) de pacientes com doenca pulmonar obstrutiva cronica (DPOC), quantificada em tres diferentes periodos de uso diario do sensor de movimento: 8 horas, 12 horas e periodo de tempo acordado, a fim de identificar se os desfechos de AFVD diferem entre si. Trata-se de um estudo transversal com 45 pacientes (66±8 anos) classificados com DPOC de moderada a grave. A AFVD foi avaliada utilizando-se o monitor de atividade fisica SenseWear Armband (SAB) durante 7 dias consecutivos, 24 horas por dia. Compararam-se os resultados de AFVD fornecidos pelo monitor nos tres periodos de avaliacao dentro das 24 horas de uso. Os desfechos de sedentarismo e de atividade fisica (numero de passos e gasto energetico total) foram diferentes nos tres periodos de utilizacao do SAB, com maiores valores na avaliacao por periodo de tempo acordado. Quanto aos desfechos de atividade fisica estratificados por idade - 3 ou 2 equivalentes metabolicos (MET) -, os resultados foram similares na avaliacao por 12 horas e por periodo de tempo acordado. Concluiu-se, afinal, que o uso do monitor de atividade fisica durante o tempo acordado e o desfecho mais indicado para monitoracao acurada e completa de sedentarismo e atividade fisica em pacientes com DPOC.Study presented as a poster in the XVIII International Symposium of Cardiorespiratory Physical Therapy and Intensive Care Physical Therapy, from June 8th to 10th, 2016, Belo Horizonte (MG), Brazil. 1 Laboratório de Pesquisa em Fisioterapia Pulmonar (LFIP), Department of Physical Therapy, Universidade Estadual de Londrina (UEL) – Londrina (PR), Brazil. 2 Centro de Pesquisa em Ciências da Saúde, Universidade Norte do Paraná (Unopar) – Londrina (PR), Brazil. 43 Does the wearing time of motion sensor interfere with the choice of physical activity in daily life outcomes of COPD patients? O tempo de uso do sensor de movimento interfere na escolha do desfecho de atividade física na vida diária em pacientes com DPOC? El tiempo de uso del sensor de movimiento interfiere en la escoja del resultado de actividad física en la vida diaria en pacientes con EPOC? Lorena Paltanin Schneider1, Karina Couto Furlanetto1,2, Nidia Aparecida Hernandes1, Fabio Pitta1

El tiempo de uso del sensor de movimiento interfiere en la escoja del resultado de actividad física en la vida diaria en pacientes con EPOC

Este estudo analisa a atividade fisica na vida diaria (AFVD) de pacientes com doenca pulmonar obstrutiva cronica (DPOC), quantificada em tres diferentes periodos de uso diario do sensor de movimento: 8 horas, 12 horas e periodo de tempo acordado, a fim de identificar se os desfechos de AFVD diferem entre si. Trata-se de um estudo transversal com 45 pacientes (66±8 anos) classificados com DPOC de moderada a grave. A AFVD foi avaliada utilizando-se o monitor de atividade fisica SenseWear Armband (SAB) durante 7 dias consecutivos, 24 horas por dia. Compararam-se os resultados de AFVD fornecidos pelo monitor nos tres periodos de avaliacao dentro das 24 horas de uso. Os desfechos de sedentarismo e de atividade fisica (numero de passos e gasto energetico total) foram diferentes nos tres periodos de utilizacao do SAB, com maiores valores na avaliacao por periodo de tempo acordado. Quanto aos desfechos de atividade fisica estratificados por idade - 3 ou 2 equivalentes metabolicos (MET) -, os resultados foram similares na avaliacao por 12 horas e por periodo de tempo acordado. Concluiu-se, afinal, que o uso do monitor de atividade fisica durante o tempo acordado e o desfecho mais indicado para monitoracao acurada e completa de sedentarismo e atividade fisica em pacientes com DPOC.Study presented as a poster in the XVIII International Symposium of Cardiorespiratory Physical Therapy and Intensive Care Physical Therapy, from June 8th to 10th, 2016, Belo Horizonte (MG), Brazil. 1 Laboratório de Pesquisa em Fisioterapia Pulmonar (LFIP), Department of Physical Therapy, Universidade Estadual de Londrina (UEL) – Londrina (PR), Brazil. 2 Centro de Pesquisa em Ciências da Saúde, Universidade Norte do Paraná (Unopar) – Londrina (PR), Brazil. 43 Does the wearing time of motion sensor interfere with the choice of physical activity in daily life outcomes of COPD patients? O tempo de uso do sensor de movimento interfere na escolha do desfecho de atividade física na vida diária em pacientes com DPOC? El tiempo de uso del sensor de movimiento interfiere en la escoja del resultado de actividad física en la vida diaria en pacientes con EPOC? Lorena Paltanin Schneider1, Karina Couto Furlanetto1,2, Nidia Aparecida Hernandes1, Fabio Pitta1

O tempo de uso do sensor de movimento interfere na escolha do desfecho de atividade física na vida diária em pacientes com DPOC

Este estudo analisa a atividade fisica na vida diaria (AFVD) de pacientes com doenca pulmonar obstrutiva cronica (DPOC), quantificada em tres diferentes periodos de uso diario do sensor de movimento: 8 horas, 12 horas e periodo de tempo acordado, a fim de identificar se os desfechos de AFVD diferem entre si. Trata-se de um estudo transversal com 45 pacientes (66±8 anos) classificados com DPOC de moderada a grave. A AFVD foi avaliada utilizando-se o monitor de atividade fisica SenseWear Armband (SAB) durante 7 dias consecutivos, 24 horas por dia. Compararam-se os resultados de AFVD fornecidos pelo monitor nos tres periodos de avaliacao dentro das 24 horas de uso. Os desfechos de sedentarismo e de atividade fisica (numero de passos e gasto energetico total) foram diferentes nos tres periodos de utilizacao do SAB, com maiores valores na avaliacao por periodo de tempo acordado. Quanto aos desfechos de atividade fisica estratificados por idade - 3 ou 2 equivalentes metabolicos (MET) -, os resultados foram similares na avaliacao por 12 horas e por periodo de tempo acordado. Concluiu-se, afinal, que o uso do monitor de atividade fisica durante o tempo acordado e o desfecho mais indicado para monitoracao acurada e completa de sedentarismo e atividade fisica em pacientes com DPOC.Study presented as a poster in the XVIII International Symposium of Cardiorespiratory Physical Therapy and Intensive Care Physical Therapy, from June 8th to 10th, 2016, Belo Horizonte (MG), Brazil. 1 Laboratório de Pesquisa em Fisioterapia Pulmonar (LFIP), Department of Physical Therapy, Universidade Estadual de Londrina (UEL) – Londrina (PR), Brazil. 2 Centro de Pesquisa em Ciências da Saúde, Universidade Norte do Paraná (Unopar) – Londrina (PR), Brazil. 43 Does the wearing time of motion sensor interfere with the choice of physical activity in daily life outcomes of COPD patients? O tempo de uso do sensor de movimento interfere na escolha do desfecho de atividade física na vida diária em pacientes com DPOC? El tiempo de uso del sensor de movimiento interfiere en la escoja del resultado de actividad física en la vida diaria en pacientes con EPOC? Lorena Paltanin Schneider1, Karina Couto Furlanetto1,2, Nidia Aparecida Hernandes1, Fabio Pitta1

Maximal Exercise capacity as discriminatory factor to identify subjects with COPD as physical active\inactive: Preliminary results

Introduction: Physical activity in daily life (PADL) has been widely studied in subjects with chronic obstructive pulmonary disease (COPD). However, relationship of PADL with variables from maximal exercise tests still lacks attention in the literature. Aim: To identify whether maximal exercise capacity presents discriminative capacity to identify physical activity/inactivity in subjects with COPD. Methods: Fourteen subjects with COPD (9 men) were assessed regarding lung function, PADL (SenseWear® ArmBand during seven days) and maximal exercise capacity (incremental shuttle waking test, ISWT). Furthermore, subjects wore the PADL monitor during the ISWT in order to determine maximal METs achieved. Results: The 3-METs threshold represented 57(35–73)% of the maximum (%max). The intensity of 48%max was identified as point of better discriminative capacity to identify inactive subjects (area under the curve [AUC] 0.64[95%CI 0.27–0.99]; sensitivity 1; specificity 0.36). However lower values were found for the discrimination of active subjects (AUC 0,36[95%CI 0.001–0.73]). Additionally, for 3-METs, 79% of subjects were classified as active and 21% as inactive, whereas for the %max, 86% of subjects were classified as active and 14% inactive (P>0.05). Among subjects in which 3 METs represented lower than 48%max, there was no subject classified as inactive. However, among subjects in which 3METs represented higher than 48%max, 30% of subjects were classified as inactive and 70% as active (P>0.05). Conclusion: These preliminary results show that maximal exercise intensity had good discriminative capacity to identify physical inactivity in subjects with COPD.

Sedentary behavior and physical inactivity in patients with COPD: two sides of the same coin?

Background: It is possible for an individual to accumulate long amounts of both moderate-vigorous physical activity (MVPA) and sedentary behaviour (SB) throughout the same day. Deleterious effects of this combination in patients with chronic obstructive pulmonary disease (COPD) were not yet investigated. Aims: To investigate the relationship between MVPA and SB in patients with COPD and to identify the profile of physically (in)active and (not) sedentary patients. Methods: MVPA and SB (time spent/day in activities requiring >3 METs and Results: MVPA and SB were correlated in the total sample (n=136; r=-0.74) and in active patients (n=76; r=-0.53), but not in sedentary patients (n=42; r=-0.25). Four groups of patients were compared: Active+Non-Sedentary (Act_NS; n=68); Active+Sedentary (Act_S; n=8); Inactive+Non-Sedentary (Inact_NS; n=26), and Inactive+Sedentary (Inact_S; n=34). Inact_S had worse 6MWT and FEV1 and higher age, BMI and MRC than Act_NS (P Conclusion: SB is negatively related with MVPA in physically active patients, but not in sedentary. Despite better clinical conditions in patients who reach MVPA recommendations combined with a non-sedentary lifestyle, there are no differences between patients presenting only one of these positive behaviours.