Physical Inactivity as a Missing Link in Understanding the Progression of Chronic Obstructive Pulmonary Disease

摘要

Physical activity (PA) is reduced in patients with chronic obstructive pulmonary disease (COPD), and physical inactivity has been shown to be associated with the development of morbidity in these patients. It is a feature of early COPD and may delay diagnosis, as COPD symptoms are particularly present during exercise and PA . Avoiding activities is a strategy to avoid symptoms, and may lead to a delay in diagnosis. Little is known on how inactivity evolves over time in subjects with COPD. In this issue of the Journal, Waschki and colleagues (pp. 295-306) describe the decline in PA over time in subjects with COPD . In absolute terms, this decline was not statistically different between patients in different severity stages, but given the lower starting points, patients with more severe disease lost proportionally more PA. The present study would suggest roughly 5-6% of annual decline for the total cohort. In Global Initiative for Chronic Obstructive Lung Disease stage IV, this increased to 15% per year. To the best of our knowledge, only four studies report to some extent on the longitudinal decline of objectively measured PA in patients with COPD (Table 1).