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Sedentary time in people with obstructive airway diseases

  • Laura Cordova-Rivera
    Affiliations
    National Health and Medical Research Council Centre of Excellence in Severe Asthma, Australia

    Priority Research Centre for Healthy Lungs, The University of Newcastle, Newcastle, Australia

    Hunter Medical Research Institute, Newcastle, Australia
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  • Paul A. Gardiner
    Affiliations
    Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia

    School of Kinesiology, Western University, London, Canada
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  • Peter G. Gibson
    Affiliations
    National Health and Medical Research Council Centre of Excellence in Severe Asthma, Australia

    Priority Research Centre for Healthy Lungs, The University of Newcastle, Newcastle, Australia

    Hunter Medical Research Institute, Newcastle, Australia

    Department of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle, Australia
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  • Elisabeth A.H. Winkler
    Affiliations
    School of Public Health, The University of Queensland, Brisbane, Australia
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  • Paola D. Urroz
    Affiliations
    National Health and Medical Research Council Centre of Excellence in Severe Asthma, Australia

    Priority Research Centre for Healthy Lungs, The University of Newcastle, Newcastle, Australia

    Hunter Medical Research Institute, Newcastle, Australia
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  • Vanessa M. McDonald
    Correspondence
    Corresponding author. Level 2 West Wing, 1 Kookaburra Circuit, New Lambton Heights, NSW, 2305, Australia.
    Affiliations
    National Health and Medical Research Council Centre of Excellence in Severe Asthma, Australia

    Priority Research Centre for Healthy Lungs, The University of Newcastle, Newcastle, Australia

    Hunter Medical Research Institute, Newcastle, Australia

    Department of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle, Australia

    School of Nursing and Midwifery, University of Newcastle, Australia
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Published:March 23, 2021DOI:https://doi.org/10.1016/j.rmed.2021.106367

      Highlights

      • ST level/patterns in COPD are worse than in bronchiectasis & severe asthma.
      • ST volume in severe asthma, bronchiectasis and non-respiratory controls are similar.
      • Lower volume/better ST accrual patterns are associated with key clinical outcomes.
      • The strength of the association between ST and clinical outcomes differs by disease.
      • ST volume & accrual patterns are important, different, and yet complementary metrics.

      Abstract

      Sedentary time (ST) and light-intensity physical activity (LIPA) are movement behaviours associated with important health outcomes, but are not widely explored in respiratory diseases. We aimed to describe their volume and/or accumulation patterns in moderate-severe COPD, bronchiectasis and severe asthma using the accurate postural-based accelerometer activPAL, contrasting these values with a non-respiratory population. We also sought to test the cross-sectional associations of these behaviours with disease characteristics by diagnostic group, and as a combined label-free disease group.

      Results

      Adults with COPD (n = 64), bronchiectasis (n = 61), severe asthma (n = 27), and controls (n = 61) underwent cross-sectional measurements of volume and/or accumulation patterns of ST and LIPA. The prevalence and characteristics, and associations with exercise capacity, health-status, airflow-limitation, dyspnoea, systemic inflammation and exacerbations were analysed.
      ST volumes in COPD were higher than that of bronchiectasis and severe asthma. Values in bronchiectasis and severe asthma were similar to each other and controls (≈8.9 h/day). Their accumulation patterns were also significantly better than in COPD, but similar if not worse compared to controls. LIPA volumes in bronchiectasis and severe asthma were also higher than those of COPD (p < 0.05) and controls. In bronchiectasis and COPD, lower levels/better patterns of ST accumulation, as well as higher LIPA volume were associated with better clinical characteristics. These associations may be mediated by airflow limitation.

      Conclusions

      The discordance between engagement in ST volume versus ST patterns highlights the importance of accounting for both these different yet complementary metrics. ST and LIPA are low-intensity activities associated with important clinical characteristics in people with chronic respiratory diseases.

      Trial registration

      Not applicable.

      Abbreviations:

      ST (sedentary time), LIPA (light-intensity physical activity), COPD (chronic obstructive pulmonary disease), MET (metabolic equivalent of task), MVPA (moderate to vigorous physical activity), FEV1 (forced expiratory volume in 1-s), FVC (forced vital capacity), 6MWT (6-min walk test), mMRC (modified Medical Research Dyspnoea Scale), SGRQ (St. George Respiratory Questionnaire), MCID (minimal clinically important difference), Hs-CRP (high sensitivity C- reactive protein), BMI (body mass index), CI (confidence interval), Coeff (coefficients), OR (odds ratio)
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