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María Hernández, Fabrício Zambom-Ferraresi, Pilar Cebollero, Javier Hueto, José Antonio Cascante and María M. Antón

Recently, several studies have observed that reduced levels of physical activity are associated with an increased risk of mortality in patients with chronic obstructive pulmonary disease (COPD) ( García-Aymerich, Lange, Benet, Schnohr, & Antó, 2006 ; Pitta et al., 2005 ; Troosters et al., 2010

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Cristina Jácome, Joana Cruz, Raquel Gabriel, Daniela Figueiredo and Alda Marques

This study assessed functional balance among older adults at all grades of chronic obstructive pulmonary disease (COPD) and explored balance impairment predictors. A cross-sectional study with outpatients with COPD (N = 160; M = 72.2 years, SD = 7.9; mean forced expiratory volume in 1 s = 63.8% predicted, SD = 23.7) was conducted. The Timed Up and Go (TUG) test was used to assess functional balance. Functional balance impairment was defined as a TUG score exceeding the upper limit of the confidence intervals of normative values for healthy older adults. Participants performed the TUG test in 11.0 s (SD = 4.8 s). Functional balance impairment was present in 44.4% of the participants and was significantly more frequent in severe to very severe COPD (62.5%). Body mass index (odds ratio [OR] = 1.12), number of medications (OR = 1.20), restriction in recreational activities (OR = 1.66), and depression score (OR = 1.14) were multivariate predictors of functional balance impairment. Functional balance impairment is present in early COPD, although more evident at advanced grades. These findings highlight the importance of balance assessment in older patients at all COPD grades.

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Amelia Guadalupe-Grau, Susana Aznar-Laín, Asier Mañas, Juan Castellanos, Julián Alcázar, Ignacio Ara, Esmeralda Mata, Rosa Daimiel and Francisco José García-García

To investigate the short- and long-term effects of concurrent strength and high-intensity interval training (HIIT) on octogenarian COPD patients, nine males (age = 84.2 ± 2.8 years, BMI = 29.3 ± 2.3) with low to severe COPD levels (2.1 ± 1.5 BODE index) underwent a supervised 9-week strength and HIIT exercise program. Training had a significant (p < .05) impact on senior fitness test scores (23–45%), 30-m walking speed (from 1.29 ± 0.29–1.62 ± 0.33 m/s), leg and chest press 1RM (38% and 45% respectively), maximal isometric strength (30–35%), and 6-min walking test (from 286.1 ± 107.2–396.2 ± 106.5 m), and tended to increase predicted forced vital capacity by 14% (p = .07). One year after the intervention all training-induced gains returned to their preintervention values except for the chest press 1RM (p <.05). Short-term concurrent strength and HIIT training increases physical fitness in the oldest-old COPD patients, and has potential long-term benefits.

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Fumi Hirayama, Andy H. Lee and Tetsuo Hiramatsu

Background:

Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide. Because only 20% of cigarette smokers develop COPD, certain environmental and lifestyle factors may protect against the disease development.

Methods:

To investigate the relationship between life-long physical activity involvement and the COPD risk, a case-control study was conducted in central Japan. A total of 278 eligible patients (244 men and 34 women) age 50 to 75 years were referred by respiratory physicians, while 335 controls (267 men and 68 women) were recruited from the community. All participants underwent spirometric measurements of lung function. Information on demographic and lifestyle characteristics was obtained by face-to-face interview using a structured questionnaire.

Results:

Older adults who remained physically active had better lung function than others inactive over the life course. The COPD patients were found to be less active than their healthy counterparts. Significant reductions in risk of COPD and breathlessness were evident by being active life-long, with adjusted odds ratio 0.59 (95% CI 0.36−0.97) and 0.56 (95% CI 0.36−0.88), respectively.

Conclusions:

The study suggested an inverse association between life-long physical activity and the risk of COPD and breathlessness. Promotion of physical activity to prevent this major disease should be encouraged.

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Travis Saunders, Nerissa Campbell, Timothy Jason, Gail Dechman, Paul Hernandez, Kara Thompson and Chris M. Blanchard

Background:

Although individual studies have reported on the number of steps/day taken by individuals with chronic obstructive pulmonary disease (COPD), this evidence has not been systematically reviewed or synthesized.

Methods:

MEDLINE and PsycINFO were searched for studies reporting objectively-measured steps/day and percent predicted forced expiratory volume in 1 second (FEV1%) in patients with COPD. Meta-analyses were used to estimate steps/day across studies, while metaregression was used to estimate between-study variance based on clinical and demographic factors (year and location of study, activity monitor brand, number of days wearing the monitor, whether participants were about to enter pulmonary rehabilitation, 6-minute walk distance (6MWD), FEV1%, age, and sex).

Results:

38 studies including 2621 participants met inclusion criteria. The pooled mean estimate was 4579 steps/day (95% CI:4310 to 5208) for individuals with COPD. Only 6MWD, FEV1% and whether patients were about to undergo pulmonary rehabilitation explained a significant portion of the variance (P < 0.1) in univariate meta-regression. In a multivariate model including the above risk factors, only FEV1% was associated with steps/day after adjustment for other covariates.

Conclusions:

These results indicate that patients with COPD achieve extremely low levels of physical activity as assessed by steps/day, and that severity of airflow obstruction is associated with activity level.

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Athina Liacos, Angela T. Burge, Narelle S. Cox and Anne E. Holland

People with chronic obstructive pulmonary disease (COPD) and bronchiectasis exhibit lower levels of participation in physical activity than the general population ( Bradley et al., 2015 ; Vorrink, Kort, Troosters, & Lammers, 2011 ; Watz, Waschki, Meyer, & Magnussen, 2009 ), and this has been

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Xiao Bao, Jie-Wen Tan, Ying Long, Howe Liu and Hui-Yu Liu

different functional classes of stable angina . Hyp Med J . 1993 ; 1 : 12 – 15 . 25. Burtscher M , Haider T , Domej W , et al . Intermittent hypoxia increases exercise tolerance in patients at risk for or with mild COPD . Respir Physiol Neurobiol . 2009 ; 165 ( 1 ): 97 – 103 . PubMed ID

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Joshua T. Slysz and Jamie F. Burr

, et al . Functional and muscular effects of neuromuscular electrical stimulation in patients with severe COPD: a randomized clinical trial . Chest . 2012 ; 141 ( 3 ): 716 – 725 . PubMed doi:10.1378/chest.11-0839 22116795 10.1378/chest.11-0839 10. Natsume T , Ozaki H , Saito AI , Abe T

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Steriani Elavsky, Lenka Knapova, Adam Klocek and David Smahel

.35 ). 6. Barberan-Garcia et al. ( 2014 ) RCT 2.0 (19.0–24.0) 173 (27:96) IG: 64 ± 6 CG: 66 ± 9 S—COPD Hybrid (SMS + Web + App): IG: rehabilitation, self-management supported by online Personal Health Folder (questionnaires, remote monitoring, summaries, educational information, information sharing), and

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Mary O. Whipple, Erica N. Schorr, Kristine M.C. Talley, Ruth Lindquist, Ulf G. Bronas and Diane Treat-Jacobson

–65 years) Sex: 43.2% female Families, healthy, sedentary Supervised stationary cycling VO 2max Mentz et al., 2013 (HF-ACTION) To investigate the clinical characteristics, exercise training response, and outcomes in patients with heart failure and COPD. Two-arm RCT (exercise, control), 2,331 (2,311 with