3 research outputs found
Patterns of Physical Activity Progression in Patients With COPD [Patrones de progresiĂłn de la actividad fĂsica en pacientes con EPOC]
Introduction: Although mean physical activity in COPD patients declines by 400â500 steps/day annually, it is unknown whether the natural progression is the same for all patients. We aimed to identify distinct physical activity progression patterns using a hypothesis-free approach and to assess their determinants. Methods: We pooled data from two cohorts (usual care arm of Urban Training [NCT01897298] and PROactive initial validation [NCT01388218] studies) measuring physical activity at baseline and 12 months (Dynaport MoveMonitor). We identified clusters (patterns) of physical activity progression (based on levels and changes of steps/day) using k-means, and compared baseline sociodemographic, interpersonal, environmental, clinical and psychological characteristics across patterns. Results: In 291 COPD patients (mean ± SD 68 ± 8 years, 81% male, FEV1 59 ± 19%pred) we identified three distinct physical activity progression patterns: Inactive (n = 173 [59%], baseline: 4621 ± 1757 steps/day, 12-month change (Î): â487 ± 1201 steps/day), Active Improvers (n = 49 [17%], baseline: 7727 ± 3275 steps/day, Î: + 3378 ± 2203 steps/day) and Active Decliners (n = 69 [24%], baseline: 11 267 ± 3009 steps/day, Î: â2217 ± 2085 steps/day). After adjustment in a mixed multinomial logistic regression model using Active Decliners as reference pattern, a lower 6-min walking distance (RRR [95% CI] 0.94 [0.90â0.98] per 10 m, P =.001) and a higher mMRC dyspnea score (1.71 [1.12â2.60] per 1 point, P =.012) were independently related with being Inactive. No baseline variable was independently associated with being an Active Improver. Conclusions: The natural progression in physical activity over time in COPD patients is heterogeneous. While Inactive patients relate to worse scores for clinical COPD characteristics, Active Improvers and Decliners cannot be predicted at baseline. © 2020 SEPA
Enoxaparin versus dalteparin or tinzaparin in patients with cancer and venous thromboembolism: The RIETECAT study.
Patrones de progresiĂłn de la actividad fĂsica en pacientes con EPOC
Data de publicaciĂł electrĂČnica: 09-10-2020Introduction: Although mean physical activity in COPD patients declines by 400-500steps/day annually, it is unknown whether the natural progression is the same for all patients. We aimed to identify distinct physical activity progression patterns using a hypothesis-free approach and to assess their determinants. Methods: We pooled data from two cohorts (usual care arm of Urban Training [NCT01897298] and PROactive initial validation [NCT01388218] studies) measuring physical activity at baseline and 12 months (Dynaport MoveMonitor). We identified clusters (patterns) of physical activity progression (based on levels and changes of steps/day) using k-means, and compared baseline sociodemographic, interpersonal, environmental, clinical and psychological characteristics across patterns. Results: In 291 COPD patients (mean±SD 68±8 years, 81% male, FEV1 59±19%pred) we identified three distinct physical activity progression patterns: Inactive (n=173 [59%], baseline: 4621±1757 steps/day, 12-month change (Î): -487±1201 steps/day), ActiveImprovers (n=49 [17%], baseline: 7727±3275 steps/day, Î:+3378±2203 steps/day) and ActiveDecliners (n=69 [24%], baseline: 11 267±3009 steps/day, Î: -2217±2085 steps/day). After adjustment in a mixed multinomial logistic regression model using Active Decliners as reference pattern, a lower 6-min walking distance (RRR [95% CI] 0.94 [0.90-0.98] per 10m, P=.001) and a higher mMRC dyspnea score (1.71 [1.12-2.60] per 1 point, P=.012) were independently related with being Inactive. No baseline variable was independently associated with being an Active Improver. Conclusions: The natural progression in physical activity over time in COPD patients is heterogeneous. While Inactive patients relate to worse scores for clinical COPD characteristics, Active Improvers and Decliners cannot be predicted at baseline.IntroducciĂłn: Aunque la actividad fĂsica en pacientes con EPOC declina una media anual de 400-500 pasos/dĂa, se desconoce si esta progresiĂłn es igual en todos los pacientes. Este estudio pretendiĂł identificar los patrones de progresiĂłn de la actividad fĂsica mediante mĂ©todos libres de hipĂłtesis y evaluar sus determinantes. MĂ©todos: Se estudiaron 291 pacientes con EPOC estable (media±DE: 68±8años, 81% hombres, VEMS 59±19%pred) de dos cohortes europeas con actividad fĂsica basal y a 12meses (acelerĂłmetro Dynaport MoveMonitor). Se identificaron conglomerados (patrones) de progresiĂłn de actividad fĂsica basados en los niveles y cambios de pasos/dĂa usando k-means, y se compararon entre patrones las caracterĂsticas sociodemogrĂĄficas, interpersonales, ambientales, clĂnicas y psicosociales basales. Resultados: Se identificaron tres patrones: inactivo (n=173 [59%], basal: 4.621±1.757 pasos/dĂa, cambio en 12meses (Î): â487±1.201 pasos/dĂa), activo que aumenta (n=49 [17%], basal: 7.727±3.275 pasos/dĂa, Î: +3.378±2.203 pasos/dĂa) y activo que reduce (n=69 [24%], basal: 11.267±3.009 pasos/dĂa, Î: â2.217±2.085 pasos/dĂa). La distancia en la prueba de la marcha de 6minutos (6MWD) y la disnea se asociaron independientemente con ser inactivo: RRR [IC95%] 0,94 [0,90-0,98] por cada 10m de 6MWD (p=0,001) y 1,71 [1,12-2,60] por cada punto en la escala mMRC (p=0,012), respectivamente, en comparaciĂłn con el patrĂłn activo que reduce. No se encontraron variables basales independientemente asociadas con ser activo que aumenta. Conclusiones: La progresiĂłn natural de la actividad fĂsica en pacientes con EPOC es heterogĂ©nea. Mientras que el patrĂłn de pacientes inactivo se relaciona con peores caracterĂsticas clĂnicas de EPOC, no se pudo predecir la evoluciĂłn de los activos a aumentar o reducir