Association between morning symptoms and physical activity in COPD: a systematic review

摘要

Morning symptoms are common in chronic obstructive pulmonary disease (COPD). Many COPD patients consider the morning as the most troublesome part of the day; in which they experience more symptoms and physical activity limitations.To systematically report evidence of the association between morning symptoms and physical activity in COPD patients; a literature search was conducted using relevant MESH terms and text words in PubMed; Embase; Web of Science; COCHRANE; CINAHL and PsycINFO. Quality of the articles was assessed with validated checklists.Eight studies were included. Morning symptoms were present in 39.8xe2x80x9394.4%. In 37.0xe2x80x9390.6% of all COPD patients; there was an association between physical activity and morning symptoms. However; causality could not be proved. Morning symptoms were associated with a sedentary lifestyle (p<0.05). Treatment in line with the guidelines improved the degree of activity limitations due to morning symptoms (p<0.0001).Across all disease stages; COPD patients experience morning symptoms which are negatively associated with physical activity. Physicians should consider morning symptoms as a treatment goal. Pharmacotherapy may improve the degree of activity limitations due to morning symptoms. More objective research should focus on symptoms; activity limitations and physical inactivity of COPD patients; especially in the morning.