Physical and Psychosocial Factors Associated With Physical Activity in Patients With Chronic Obstructive Pulmonary Disease

The aim of this study cross-sectional study was to assess physical activity and sitting time in patients with chronic obstructive pulmonary disease (COPD) and to examine which physical and psychosocial factors are linked to physical activity and sitting time. Patients (N=113) with mild to very severe COPD were recruited at outpatient clinics of general hospitals and from general practitioners. Physical activity and sitting time were measured with a triaxial accelerometer (24h/d). Mean locomotion time per 24 hours was 6.8% (range, 0.7%–20.4%). Increased physical activity was independently associated with higher self-efficacy, higher functional exercise capacity, and lower lung hyperinflation. Decreased physical activity was strongest in more severe stages of COPD, in which the patients were primarily limited by physical disease-specific factors (higher lung hyperinflation, worse dyspnea severity, worse leg muscle function, and oxygen use). In less severe patients, physical activity was independently associated with more generic factors (higher self-efficacy and the spring/summer season). Sitting time didn’t vary between severity stages, and longer sitting time in the total group was independently associated with more positive perception of treatment control, less autonomous motivation to exercise, not using sleep medication, and oxygen use.

The study found that  physical as well as psychosocial factors were associated with physical activity in patients with COPD. The factors associated with physical activity differed between disease severity stages, raising the question of whether physical activity enhancement programs should differ as well. They added that sitting time ought to be investigated further.

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