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Physical activity low among emphysema patients

Respiratory ProblemsApr 04, 06

People with chronic obstructive lung disease, commonly emphysema, have low levels of physical activity during and after being hospitalized for an acute flare-up of their condition, researchers report. This in turn can lead to further worsening of their condition.

“Acute exacerbations have a negative impact on various aspects of the progression of COPD,” write Dr. Rik Gosselink, of University Hospitals, Leuven, Belgium and colleagues in the medical journal Chest, “but objective and detailed data on the impact of hospitalizations for an acute exacerbation on physical activity are not available.”

To investigate, the researchers used an activity monitor to assess physical activity in 17 COPD patients while they were in the hospital for an acute exacerbation and after they were discharged.

The average time spent on weight-bearing activities, such as walking and standing, while in the hospital was “markedly low,” at 7 percent.

There are several possible reasons for the inactivity, the researchers note. Because patients are so ill and are likely to have worsening of symptoms, they may be fearful of becoming breathless and therefore try to limit activity.

Also, the hospital environment itself may contribute to inactivity, the researchers point out. Other factors, such as depression and muscle weakness itself, may also contribute to inactivity during an acute exacerbation.

Among the study group, weight-bearing activity increased to 19 percent one month after discharge.

The team found that patients hospitalized for an acute exacerbation spent less time walking after discharge compared with patients without an acute exacerbation in the previous year. In addition, patients with lower physical activity levels one month after discharge were more likely to be readmitted the following year for another acute flare-up.

The investigators therefore suggest that the treatment of patients with COPD should put more emphasis on increased physical activity.

SOURCE: Chest, March 2006.

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