Physical inactivity and lung disease Flashcards
WHO recommend physical activity levels for 18-64
- 150-300 minutes of moderate-intensity aerobic physical activity
or - 75-150 minutes of vigorous-intensity aerobic physical activity
or - Equivalent combination of moderate and vigorous-intensity activity
what is COPD ?
- Chronic obstructive pulmonary disease
- is a treatable but not curable and largely preventable lung condition characterised by persistent respiratory symptoms (e.g. breathlessness) and air flow obstruction.
- airflow obstruction results from chronic inflammation caused by expires to noxious particles or gasses.
-“extra-pulmonary effects include skeletal muscle dysfunction/wasting and weight loss, leading to reductions in functional capacity and Pa…”
Global prevalence of respiratory diseases
- Almost 550 million people have chronic respiratory disease
-COPD- 384 million - Asthma- 339 million
What is the impact of COPD ?
- COPD affects approximately 1 in 10 adults over 40 years
- COPD is the third leading cause of death (behind CVD and cancer)
- Global cost of COPD is estimated to rise to $4.8 trillion by 2030
what are the risk factors for COPD?
- occupational hazards e.g. workplace
- Alpha 1-antitrypsin (AAT) is a protein produced in the liver that protects the body’s tissues from being damaged by infection-fighting agents released by its immune system.
- aging population- chronic nature of the disease - progressive over time
GOLD stages of COPD
- Stage I (Early) FEV1: >80% pred
- Stage II (Moderate) FEV1: 50-80% pred
- Stage III (Severe) FEV1: 30-50% pred
- Stage IV (Very Severe) FEV1: <30% pred
how can we assess Pa ?
-Questionnaire, log books, self-report dairies, interview
-Patients’ perspectives concerning ability to undertake daily activities.
-Simple and cost-effective
-Approach
-Patient characteristic (age, memory, cognitive capacity) may impact reliability.
-Disparity with objective assessment (over and underestimation
how can we assess Pa using technology ?
-Motion sensors (pedometers and accelerometers)
-Pedometers quantify step-count – may underestimate slow waling speeds/no information concerning pattern or duration of activity.
- Accelerometer – factor body posture and quantifies intensity and energy expenditure.
-High cost, patient acceptance/ compliance, sensitivity to artefacts
what is COPD biomarker qualification consortium (CBQC)?
- bi-or-tri axial accelerometers (2 or 3 directions)
- wrist worn monitors tend to have lower accuracy compared to monitors worn closer to the centre of man.
- 1-week duration for 4 days at least 8 hours wearing per day
what are levels of Pa like in COPD?
-A group of patients with normal lung function and symptoms of chronic bronchitis, who were matched for social and lifestyle-associated confounders of physical activity, served as a control.
-Pa is reduced in patients with chronic obstructive pulmonary disease.
what factors are associated with Pa in COPD?
- lung function - cannot accurately precept Pa from resting lung function parameters
- Exercise capacity- limited value to predict Pa
- self capacity- belief in ability to perform/task
-Co-morbidities – diabetes strongly associated with Physical inactivity in COPD.
-Sociodemographic factors – lower socio-economic status (high incidence of smoking/ education/ greater reliance on walking and public transport)
-Environmental factors – colder weather associated with reduced activity in some studies.
what is the cycle of inactivity ?
-you do less activity
-your muscle become weaker
-weak muscles yes more oxygen and are less efficient
-you feel breathless
-you become fearful of activity that makes you breathless
-you avoid those actives which make you breathlessness
How does Pa impact health-related quality of life (HRQoL)?
- if more pa is completed HRQoL is improved as some symptoms of the disease are mitigated.
why does exercise capacity matter ?
- increased quality of life and disease prognosis
- It doesn’t matter what disease you have – if you’re unfit- you have a higher risk of death
What is the impact of Pa on COPD?
- Subjects with COPD who perform some level, of regular Pa have a lower risk of both COPD admissions and mortality.
