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Factors associated with low physical activity in patients with Chronic Obstructive Pulmonary Disease: A cross-sectional study
Linköpings universitet, Avdelningen för fysioterapi.ORCID iD: 0000-0001-7922-4258
Linköpings universitet, Avdelningen för fysioterapi.
Linköpings universitet, Avdelningen för kardiovaskulär medicin.
Karlstad University, Sweden .
Show others and affiliations
2015 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 29, no 4, p. 697-707Article in journal (Refereed) Published
Abstract [en]

Objectives

Low physical activity (PA) in chronic obstructive pulmonary disease (COPD) is associated with poor prognosis. In addition physical activity seems to be low early in the disease. The aim in this study was to describe the level of PA in patients with stable COPD, and to explore factors associated with low PA, with a focus on fatigue, symptom burden and body composition.

Methods

In a cross-sectional study 101 patients (52 women) with COPD  were classified having low, moderate or high PA according to the International Physical Activity Questionnaire – Short. Fatigue, dyspnoea, depression and anxiety, symptom burden, body composition, physical capacity (lung function, exercise capacity, muscle strength), exacerbation rate and systemic inflammation were assessed. A multiple logistic regression was used to identify independent associations with low PA.

Results

Mean age was 68 (+/- 7) years and mean percentage of predicted forced expiratory volume in one second was 50 (+/-16.5). Forty-two patients reported a low PA level, while 34 moderate and 25 reported high levels. Factors independently associated with low PA, presented as odds ratio (95% confidence interval), were severe fatigue 5.87 (1.23 – 28.12), exercise capacity 0.99 (0.99 – 1.0) and the number of pack years 1.04 (1.01 – 1.07). No relationship was found between depression, anxiety, body composition, exacerbation rate or systemic inflammation and PA.

Conclusions

Severe fatigue, worse exercise capacity and a higher amount of smoking were independently associated with low PA. Promoting physical activity is important in all patients with COPD. Our result suggests that patients with severe fatigue might need specific strategies to become more physically active.

Place, publisher, year, edition, pages
Wiley-Blackwell , 2015. Vol. 29, no 4, p. 697-707
National Category
Health Sciences
Identifiers
URN: urn:nbn:se:hig:diva-40228DOI: 10.1111/scs.12200ISI: 000368345900010OAI: oai:DiVA.org:hig-40228DiVA, id: diva2:1702393
Note

Available from: 2014-03-12 Created: 2022-10-10 Last updated: 2024-02-13Bibliographically approved
In thesis
1. Fatigue in long-term illness: Influencing factors and functional performance in chronic obstructive pulmonary disease and in cancer
Open this publication in new window or tab >>Fatigue in long-term illness: Influencing factors and functional performance in chronic obstructive pulmonary disease and in cancer
2024 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [sv]

Syfte: Avhandlingen studerade sambandet mellan fatigue (trötthet) och valda inverkande faktorer, funktionsförmåga (fysisk och daglig aktivitet och arbetsförmåga) samt med hälsorelaterad livskvalitet (HRQL) vid kroniskt obstruktiv lungsjukdom (KOL) och vid cancer. 

Metod: Patienter med KOL (n=121, delarbete I-II) och patienter med cancer under pågående strålbehandling (n=457, delarbete III) studerades i tvärsnittsstudier. Canceröverlevare följdes longitudinellt upp sju år efter strålbehandling (n=215, jämfört med 172 matchade icke-cancerreferenter, delarbete IV). Data samlades in genom frågeformulär och kliniska bedömningar. Beskrivande och inferentiell statistik användes.

Resultat: Fatigue förekom hos 74% av patienterna med KOL, 72% hos patienterna under cancerbehandling, 58% hos långtids-canceröverlevarna samt 41% av referenterna. Svårare sjukdom och sämre ansträngningsförmåga vid KOL, och samsjuklighet och nedstämdhet vid cancer under strålbehandling var associerat med större sannolikheten för fatigue. Fatigue under tidigare strålbehandling, och nuvarande nedstämdhet, smärta och antal symptom var associerat med fatigue vid uppföljningen. Svår fatigue hade samband med låg fysisk aktivitet vid KOL och fatigue vid strålbehandling med mindre fysisk och daglig aktivitet och sämre HRQL. Under strålbehandling rapporterade patienter med fatigue 60% sjukfrånvaro gentemot 40% utan. Fatigue hade minskat vid uppföljning men var värre än hos referenterna. Fysisk och daglig aktivitet hade förbättrats och var inte sämre än referenternas. Självskattad arbetsförmåga och arbetsprocent var dock lägre. Fatigue och tilltron till sin arbetsförmåga var associerat med självskattad arbetsförmåga hos canceröverlevare som arbetade.

 Konklusion: Att uppmärksamma fatigue kan underlätta för hälso och sjukvårdspersonal att identifiera och ge stöd till patienter med nedsatt funktionsförmåga samt till canceröverlevare med risk för långvarig fatigue och påverkad arbetsförmåga.

Abstract [en]

Aim: The overall aim was to study the relationship between fatigue and selected influencing factors, functional performance (physical activity [PA], daily activity and work ability) and health-related quality of life (HRQL) in two long-term illnesses: chronic obstructive pulmonary disease (COPD) and cancer. 

Method: Patients with COPD (n=121, Paper I-II), and with cancer undergoing radiotherapy (n=457, Paper III) were cross-sectionally studied. Cancer survivors were longitudinally followed up seven years post-radiotherapy (n=215, compared to 172 matched non-cancer referents, Paper IV). Data were collected using questionnaires and clinical assessments. Descriptive and inferential statistics were applied. 

Results: Fatigue was present in 74% of patients with COPD, 72% of patients during radiotherapy, 58% of cancer survivors at follow-up and 41% of referents. Greater disease severity and poorer exercise capacity in COPD, and comorbidity and depressed mood during radiotherapy, were associated with a greater likelihood of fatigue. Fatigue during previous radiotherapy and current depressed mood, pain and number of concurrent symptoms were associated with fatigue at follow-up. Severe fatigue was associated with low PA in COPD and fatigue during radiotherapy with less PA and daily activity and worse HRQL. Patients with fatigue reported 60% sickness absence during radiotherapy, whereas those without reported 40%. Fatigue had decreased at follow-up but was worse compared to referents. PA and daily activity had improved and were not inferior to referents. Self-perceived work ability and working percentage were lower, however. Fatigue and confidence in their work ability were associated with self-perceived work ability among working cancer survivors. 

Conclusion: Paying attention to fatigue may aid healthcare professionals identify and provide support to patients with impaired functional performance, and to cancer survivors at risk of long-term fatigue and impaired work ability.

Place, publisher, year, edition, pages
Gävle: Gävle University Press, 2024. p. 71
Series
Doctoral thesis ; 44
Keywords
fatigue, chronic obstructive pulmonary disease, cancer, daily activity, health-related quality of life, mental health, physical capacity, physical activity, radiotherapy, work ability, fatigue, kroniskt obstruktiv lungsjukdom, cancer, daglig aktivitet, hälsorelaterad livskvalitet, oro och nedstämdhet, fysisk kapacitet, fysisk aktivitet, strålbehandling, arbetsförmåga
National Category
Health Sciences
Identifiers
urn:nbn:se:hig:diva-43802 (URN)978-91-89593-28-2 (ISBN)978-91-89593-29-9 (ISBN)
Public defence
2024-04-19, Krusenstjernasalen, Högskolan i Gävle, Kungsbäcksvägen 47, Gävle, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2024-03-27 Created: 2024-02-13 Last updated: 2024-03-27

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Tödt, KristinaSkargren, ElisabethJakobsson, PerUnosson, Mitra

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