Short- and long-term effects of a physical activity counselling programme in COPD:A randomized controlled trial

SummaryBackgroundWe were interested in the effects of a physical activity (PA) counselling programme in three groups of COPD patients from general practice (primary care), outpatient clinic (secondary care) and pulmonary rehabilitation (PR).MethodsIn this randomized controlled trial 155 COPD patients, 102 males, median (IQR) age 62 (54–69) y, FEV1predicted 60 (40–75) % were assigned to a 12-weeks' physical activity counselling programme or usual care. Physical activity (pedometer (Yamax SW200) and metabolic equivalents), exercise capacity (6-min walking distance) and quality of life (Chronic Respiratory Questionnaire and Clinical COPD Questionnaire) were assessed at baseline, after three and 15 months.ResultsA significant difference between the counselling and usual care group in daily steps (803 steps, p = 0.001) and daily physical activity (2214 steps + equivalents, p = 0.001)) from 0 to 3 months was found in the total group, as well as in the outpatient (1816 steps, 2616 steps + equivalents, both p = 0.007) and PR (758 steps, 2151 steps + equivalents, both p = 0.03) subgroups. From 0 to 15 months no differences were found in physical activity. However, when patients with baseline physical activity>10,000 steps per day (n = 8), who are already sufficiently active, were excluded, a significant long-term effect of the counselling programme on daily physical activity existed in the total group (p = 0.02). Differences in exercise capacity and quality of life were found only from 0 to 3 months, in the outpatient subgroup.ConclusionOur PA counselling programme effectively enhances PA level in COPD patients after three months. Sedentary patients at baseline still benefit after 15 months.ClinicalTrials.gov: registration number NCT00614796

Trends in International Cancer Research Investment 2006-2018.

The International Cancer Research Partnership (ICRP) is an active network of cancer research funding organizations, sharing information about funded research projects in a common database. Data are publicly available to enable the cancer research community to find potential collaborators and avoid duplication. This study presents an aggregated analysis of projects funded by 120 partner organizations and institutes in 2006-2018, to highlight trends in cancer research funding. Overall, the partners' funding for cancer research increased from $5.562 billion (bn) US dollars (USD) in 2006 to$8.511bn USD in 2018, an above-inflation increase in funding. Analysis by the main research focus of projects using Common Scientific Outline categories showed that Treatment was the largest investment category in 2018, followed by Early Detection, Diagnosis, and Prognosis; Cancer Biology; Etiology; Control, Survivorship, and Outcomes; and Prevention. Over the 13 years covered by this analysis, research funding into Treatment and Early Detection, Diagnosis, and Prognosis had increased in terms of absolute investment and as a proportion of the portfolio. Research funding in Cancer Biology and Etiology declined as a percentage of the portfolio, and funding for Prevention and Control, Survivorship and Outcomes remained static. In terms of cancer site-specific research, funding for breast cancer and colorectal cancer had increased in absolute terms but declined as a percentage of the portfolio. By contrast, investment for brain cancer, lung cancer, leukemia, melanoma, and pancreatic cancer increased both in absolute terms and as a percentage of the portfolio

Daily physical activity in patients with a pulmonary disease

Dit proefschrift gaat over dagelijkse fysieke activiteiten bij mensen met een chronische longafwijking, voornamelijk mensen met COPD. Ondanks dat COPD veel voor komt, is er weinig bekend over het dagelijkse fysieke activiteitenniveau van mensen met COPD. Nog minder is bekend over de mogelijke factoren die bijdragen aan het dagelijkse fysieke activiteitenniveau, en de gevolgen voor de kwaliteit van leven. In dit proefschrift laten we zien dat het dagelijkse fysieke activiteitenniveau van mensen met COPD laag is. We laten zien dat we dagelijkse fysieke activiteiten kunnen stimuleren door middel van een combinatie van individuele coaching op activiteiten en het gebruik van een stappenteller, en dat deze stimulatie een positief effect heeft. Na een longtransplantatie kan het dagelijkse fysieke activiteitenniveau zelfs toenemen tot weer het niveau van gezonden mensen. Het blijft onduidelijk waarom iemand wel of niet fysiek actief is. Het lagere dagelijkse fysieke activiteitenniveau van mensen met COPD is met name geassocieerd met een sterkere mate van luchtwegvernauwing en een lager niveau van fysieke fitheid. De associatie met de kwaliteit van leven is minder duidelijk. Samengevat is aandacht voor dagelijkse fysieke activiteiten belangrijk bij mensen met COPD. Door onze kennis over dagelijkse fysieke activiteiten en de factoren die hieraan bijdragen kunnen we mensen met COPD veel beter helpen de neerwaartse spiraal van inactiviteit bij te buigen

Validation of the Dynaport Minimod during sleep: A pilot study

To measure activity during sleep, polysomnography and actigraphy are often used. The DynaPort MiniMod measures movement intensity and body position day and night. The goal was to examine the validity of the DynaPort MiniMod in assessing physical activity and body posture during sleep. In Study A, 10 healthy participants slept with the DynaPort MiniMod and the Actiwatch for one night. In Study B, 8 participants suspected of having Obstructive Sleep Apnoea Syndrome slept for one night with the DynaPort MiniMod and underwent complete polysomnography as part of the typical care protocol. In Study A, there was a significant moderate correlation (r=.70) between the movement scores of the Actiwatch and the DynaPort MiniMod. In Study B, a high intraclass correlation (r=.84) between body posture scores of the DynaPort MiniMod and the polysomnography position sensor was observed. The DynaPort MiniMod is a valid measurement device for physical activity during sleep

Enhancement of daily physical activity increases physical fitness of outclinic COPD patients:Results of an exercise counseling program

Objective: To investigate whether a 12-week pedometer-based exercise counseling strategy is feasible and effectively enhances daily physical activity in outclinic Chronic Obstructive Pulmonary Disease (COPD) patients who do not participate in a rehabilitation program in a controlled way. Methods: 35 outclinic COPI) patients (21 males. mean age 62 years, GOLD I-III, mean FEV(1)% predicted 64.7) were randomized for a 12-week individual pedometer-based exercise counseling program promoting daily physical activities or usual care. Daily physical activity (DigiWalker SW-200), physical fitness, health-related quality of life, self-efficacy, fatigue, depression and motivation to be physically active were assessed before and after the intervention. Results: After the intervention, COPD patients in the exercise counseling group showed a significant increase in their mean number of steps/day (from 7087 to 7872), whereas the usual care group showed a decrease (from 7539 to 6172). Significant differences favoring the exercise counseling group were demonstrated in arm strength, leg strength, health-related quality of life and intrinsic motivation to be physically active. Conclusion: Our study shows that a 12-week pedometer-based exercise counseling strategy is feasible and effectively enhances daily physical activity, physical fitness, health-related quality of life and intrinsic motivation in outclinic COPD patients who do not participate in a rehabilitation program. Practice implications: The feasibility of our exercise counseling strategy is good and patients were motivated to participate. (C) 2008 Elsevier Ireland Ltd. All rights reserved

Daily physical activity in patients with chronic obstructive pulmonary disease: a systematic review.

Patients with chronic obstructive pulmonary disease (COPD) are often limited in their daily physical activity. However, the level, type and intensity of daily physical activity are not known, nor there is a clear insight in the contributing factors. The aim of this review is to describe daily physical activity of COPD patients, and to examine its relationship with demographic factors, pulmonary function, physical fitness, systemic inflammation and quality of life. A systematic literature search was conducted, including studies assessing daily physical activity in all stages of COPD by various different types of measurement techniques. In total, 47 studies were selected; 17 performance-, 20 questionnaire-, and 12 interview-based. Two studies used both a performance- and questionnaire-based method. Overall, COPD patients have a lower level and intensity of daily physical activity compared to healthy controls. This was reported by performance- as well as questionnaire-based studies, yet with a large variation (42-86% and 28-97%, respectively). Reduced daily physical activity is associated with higher levels of airway obstruction, higher levels of systemic inflammation, and lower levels of physical fitness. The association between daily physical activity and quality of life is less clear. In conclusion, this is the first review that examined the level, type and determinants of daily physical activity in COPD. It demonstrates that reduced daily physical activity frequently occurs in COPD patients, yet with a large variation. Methods of measuring and reporting daily physical activity should be more standardized

Consequences of physical inactivity in chronic obstructive pulmonary disease

The many health benefits of regular physical activity underline the importance of this topic, especially in this period of time when the prevalence of a sedentary lifestyle in the population is increasing. Physical activity levels are especially low in patients with chronic obstructive pulmonary disease (COPD). Regular physical activity and an active lifestyle has shown to be positively associated with outcomes such as exercise capacity and health-related quality of life, and therefore could be beneficial for the individual COPD patient. An adequate level of physical activity needs to be integrated into daily life, and stimulation of physical activity when absent is important. This article aims to discuss in more detail the possible role of regular physical activity for a number of well-known outcome parameters in COPD