Gimeno-Santos, E, Frei, A, Steurer-Stey, C, de, BJ, Rabinovich, RA, Raste, Y, Hopkinson, NS, Polkey, MI, van, RH, Troosters, T, Kulich, K, Karlsson, N, Puhan, MA and Garcia-Aymerich, J (2014) Determinants and outcomes of physical activity in patients with COPD: a systematic review. Thorax. pp. 731-739.

Abstract

BACKGROUND: The relationship between physical activity, disease severity, health status and prognosis in patients with COPD has not been systematically assessed. Our aim was to identify and summarise studies assessing associations between physical activity and its determinants and/or outcomes in patients with COPD and to develop a conceptual model for physical activity in COPD. METHODS: We conducted a systematic search of four databases (Medline, Embase, CINAHL and Psychinfo) prior to November 2012. Teams of two reviewers independently selected articles, extracted data and used the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) to assess quality of evidence. RESULTS: 86 studies were included: 59 were focused on determinants, 23 on outcomes and 4 on both. Hyperinflation, exercise capacity, dyspnoea, previous exacerbations, gas exchange, systemic inflammation, quality of life and self-efficacy were consistently related to physical activity, but often based on cross-sectional studies and low-quality evidence. Results from studies of pharmacological and non-pharmacological treatments were inconsistent and the quality of evidence was low to very low. As outcomes, COPD exacerbations and mortality were consistently associated with low levels of physical activity based on moderate quality evidence. Physical activity was associated with other outcomes such as dyspnoea, health-related quality of life, exercise capacity and FEV1 but based on cross-sectional studies and low to very low quality evidence. CONCLUSIONS: Physical activity level in COPD is consistently associated with mortality and exacerbations, but there is poor evidence about determinants of physical activity, including the impact of treatment

Item Type:	Article
Additional Information:	NIBR author: institute: NIBR contributor address: Center for Research in Environmental Epidemiology (CREAL), Barcelona, Spain CIBER Epidemiologia y Salud Publica (CIBERESP), Barcelona, Spain Universitat Pompeu Fabra (UPF), Barcelona, Spain FCS Blanquerna, Research Group in Physiotherapy (GReFis), Universitat Ramon Llull, Barcelona, SpainInstitute of Social and Preventive Medicine, University of Zurich, Zurich, Switzerland Institute of General Practice and Health Services Research, University of Zurich, Zurich, SwitzerlandInstitute of General Practice and Health Services Research, University of Zurich, Zurich, SwitzerlandCenter for Research in Environmental Epidemiology (CREAL), Barcelona, Spain CIBER Epidemiologia y Salud Publica (CIBERESP), Barcelona, Spain Section of Nutrition and Metabolism, International Agency for Research on Cancer, Lyon, FranceELEGI/Colt Laboratory, UoE/MRC Centre for Inflammation Research, University of Edinburgh, Edinburgh, UKNIHR Respiratory Biomedical Research Unit of the Royal Brompton and Harefield NHS Foundation Trust and Imperial College London, London, UKNIHR Respiratory Biomedical Research Unit of the Royal Brompton and Harefield NHS Foundation Trust and Imperial College London, London, UKNIHR Respiratory Biomedical Research Unit of the Royal Brompton and Harefield NHS Foundation Trust and Imperial College London, London, UKRespiratory Division, Katholieke University of Leuven, Leuven, BelgiumRespiratory Division, Katholieke University of Leuven, Leuven, BelgiumRespiratory Department, Novartis, Basel, SwitzerlandR&D, AstraZeneca, Sodertalje, SwedenInstitute of Social and Preventive Medicine, University of Zurich, Zurich, Switzerland Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USACenter for Research in Environmental Epidemiology (CREAL), Barcelona, Spain CIBER Epidemiologia y Salud Publica (CIBERESP), Barcelona, Spain Universitat Pompeu Fabra (UPF), Barcelona, Spain
Date Deposited:	13 Oct 2015 13:12
Last Modified:	13 Oct 2015 13:12
URI:	https://oak.novartis.com/id/eprint/23422