RT Journal Article
SR Electronic
T1 Determinants and outcomes of physical activity in patients with COPD: a systematic review
JF Thorax
JO Thorax
FD BMJ Publishing Group Ltd and British Thoracic Society
SP 731
OP 739
DO 10.1136/thoraxjnl-2013-204763
VO 69
IS 8
A1 Elena Gimeno-Santos
A1 Anja Frei
A1 Claudia Steurer-Stey
A1 Jordi de Batlle
A1 Roberto A Rabinovich
A1 Yogini Raste
A1 Nicholas S Hopkinson
A1 Michael I Polkey
A1 Hans van Remoortel
A1 Thierry Troosters
A1 Karoly Kulich
A1 Niklas Karlsson
A1 Milo A Puhan
A1 Judith Garcia-Aymerich
A1 on behalf of PROactive consortium
YR 2014
UL http://thorax.bmj.com/content/69/8/731.abstract
AB 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.