Examinando por Autor "Balcells, Eva"

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    Ítem
    Determinants of study completion and response to a 12-month behavioral physical activity intervention in chronic obstructive pulmonary disease: a cohort study
    (Public Library of Science, 2019-05-20) Koreny, Maria; Demeyer, Heleen; Arbillaga Etxarri, Ane; Gimeno Santos, Elena; Barberán García, Anael; Benet, Marta; Balcells, Eva; Borrell, Eulàlia; Marín, Alicia; Rodríguez Chiaradía, Diego A.; Vall Casas, Pere; Vilaró, Jordi; Rodríguez Roisin, Robert; García Aymerich, Judith
    Objectives Physical activity is key to improve the prognosis of chronic obstructive pulmonary disease (COPD). To help to tailor future interventions we aimed to identify the baseline characteristics of COPD patients which predict 12-month completion and response to a behavioral physical activity intervention. Methods This is a 12-month cohort study of the intervention arm of the Urban Training randomized controlled trial (NCT01897298), an intervention proven to be efficacious to increase physical activity. We considered baseline sociodemographic, interpersonal, environmental, clinical and psychological characteristics as potential determinants of completion and response. We defined completion as attending the 12-month study visit. Among completers, we defined response as increasing physical activity ≥1100 steps/day from baseline to 12 months, measured by accelerometer. We estimated the factors independently for completion and response using multivariable logistic regression models. Results Of a total of 202 patients (m (SD) 69 (9) years, 84% male), 132 (65%) completed the study. Among those, 37 (28%) qualified as responders. Higher numbers of baseline steps/day (OR [95% CI] 1.11 [1.02-1.21] per increase of 1000 steps, p<0.05) and living with a partner (2.77 [1.41-5.48], p<0.01) were related to a higher probability of completion while more neighborhood vulnerability (0.70 [0.57-0.86] per increase of 0.1 units in urban vulnerability index, p<0.01) was related to a lower probability. Among the completers, working (3.14 [1.05-9.33], p<0.05) and having an endocrino-metabolic disease (4.36 [1.49-12.80], p<0.01) were related to a higher probability of response while unwillingness to follow the intervention (0.21 [0.05-0.98], p<0.05) was related to a lower probability. Conclusions This study found that 12-month completion of a behavioral physical activity intervention was generally determined by previous physical activity habits as well as interpersonal and environmental physical activity facilitators while response was related to diverse factors thought to modify the individual motivation to change to an active lifestyle.
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    Ítem
    Patterns of physical activity progression in patients with COPD
    (Elsevier Doyma, 2021-03) Koreny, Maria; Demeyer, Heleen; Benet, Marta; Arbillaga Etxarri, Ane; Balcells, Eva; Barberán García, Anael; Gimeno Santos, Elena; Hopkinson, Nicholas S.; Jong, Corina de; Karlsson, Niklas; Louvaris, Zafeiris; Polkey, Michael I.; Puhan, Milo A.; Rabinovich, Roberto A.; Rodríguez Roisin, Robert; Vall Casas, Pere; Vogiatzis, Ioannis; Troosters, Thierry; García Aymerich, Judith
    Introduction: Although mean physical activity in COPD patients declines by 400–500 steps/day annually, it is unknown whether the natural progression is the same for all patients. We aimed to identify distinct physical activity progression patterns using a hypothesis-free approach and to assess their determinants. Methods: We pooled data from two cohorts (usual care arm of Urban Training [NCT01897298] and PROactive initial validation [NCT01388218] studies) measuring physical activity at baseline and 12 months (Dynaport MoveMonitor). We identified clusters (patterns) of physical activity progression (based on levels and changes of steps/day) using k-means, and compared baseline sociodemographic, interpersonal, environmental, clinical and psychological characteristics across patterns. Results: In 291 COPD patients (mean ± SD 68 ± 8 years, 81% male, FEV1 59 ± 19%pred) we identified three distinct physical activity progression patterns: Inactive (n = 173 [59%], baseline: 4621 ± 1757 steps/day, 12-month change (Δ): −487 ± 1201 steps/day), Active Improvers (n = 49 [17%], baseline: 7727 ± 3275 steps/day, Δ: + 3378 ± 2203 steps/day) and Active Decliners (n = 69 [24%], baseline: 11 267 ± 3009 steps/day, Δ: −2217 ± 2085 steps/day). After adjustment in a mixed multinomial logistic regression model using Active Decliners as reference pattern, a lower 6-min walking distance (RRR [95% CI] 0.94 [0.90–0.98] per 10 m, P =.001) and a higher mMRC dyspnea score (1.71 [1.12–2.60] per 1 point, P =.012) were independently related with being Inactive. No baseline variable was independently associated with being an Active Improver. Conclusions: The natural progression in physical activity over time in COPD patients is heterogeneous. While Inactive patients relate to worse scores for clinical COPD characteristics, Active Improvers and Decliners cannot be predicted at baseline.
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    Ítem
    Physical activity and cardiac autonomic dysfunction in patients with chronic obstructive pulmonary disease: a cross-sectional analysis
    (Elsevier Masson s.r.l., 2022-05) Delgado Ortiz, Laura; Arbillaga Etxarri, Ane; Rodríguez Chiaradia, Diego A.; Gimeno Santos, Elena; Barberán García, Anael; Balcells, Eva; Rodríguez Roisin, Robert; García Aymerich, Judith
    Background: The cardiac autonomic function in patients with chronic obstructive pulmonary disease (COPD) has been poorly studied. Objectives: We aimed to 1) describe the cardiac autonomic function assessed by heart rate recovery (HRR) and chronotropic response (CR) during a 6-min walk test (6MWT) and afterward and 2) estimate the association of physical activity with HRR and CR in COPD patients. Methods: This cross-sectional analysis included 320 patients with mild to very severe COPD. Physical activity (steps, time in any/moderate-to-vigorous/vigorous physical activity, intensity and sedentary time) was measured during 1 week by accelerometer. CR and HRR were measured during a 6MWT and 5 min after, respectively, and their association with physical activity parameters was estimated by multivariable linear regression models. Results: Patients were 82% male and had a mean (SD) age 68 (8) years, post-bronchodilator FEV1 57 (18) % predicted, and walked a mean of 7716 (4139) steps/day. HRR was slow until 5 min after the 6MWT; the mean (SD) HRR was 15 (10), 22 (11), 25 (12), 25 (12) and 27 (12) bpm after 1, 2, 3, 4 and 5 min, respectively. The mean (SD) CR was 35% (16). After adjusting for relevant confounders, time in vigorous physical activity was significantly associated with a fast decrease in HRR (p = 0.044) and an increase in CR (p = 0.021). We found no independent association for other physical activity parameters. Conclusion: A cardiac autonomic dysfunction is present in patients with mild to very severe COPD and is inversely related to the practice of vigorous physical activity. Trial registration ClinicalTrials.gov NCT01897298.
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    Real-world walking cadence in people with COPD
    (European Respiratory Society, 2024-03) Delgado Ortiz, Laura; Ranciati, Saverio; Arbillaga Etxarri, Ane; Balcells, Eva; Buekers, Joren; Demeyer, Heleen; Frei, Anja; Gimeno Santos, Elena; Hopkinson, Nicholas S.; Jong, Corina de; Karlsson, Niklas; Louvaris, Zafeiris; Palmerini, Luca; Polkey, Michael I.; Puhan, Milo A.; Rabinovich, Roberto A.; Rodríguez Chiaradía, Diego A.; Rodríguez Roisin, Robert; Torán, Pere; Vogiatzis, Ioannis; Watz, Henrik; Troosters, Thierry; García Aymerich, Judith
    Introduction The clinical validity of real-world walking cadence in people with COPD is unsettled. Our objective was to assess the levels, variability and association with clinically relevant COPD characteristics and outcomes of real-world walking cadence. Methods We assessed walking cadence (steps per minute during walking bouts longer than 10 s) from 7days’ accelerometer data in 593 individuals with COPD from five European countries, and clinical and functional characteristics from validated questionnaires and standardised tests. Severe exacerbations during a 12-month follow-up were recorded from patient reports and medical registries. Results Participants were mostly male (80%) and had mean±SD age of 68±8 years, post-bronchodilator forced expiratory volume in 1 s (FEV1) of 57±19% predicted and walked 6880±3926 steps·day−1. Mean walking cadence was 88±9 steps·min−1, followed a normal distribution and was highly stable within-person (intraclass correlation coefficient 0.92, 95% CI 0.90–0.93). After adjusting for age, sex, height and number of walking bouts in fractional polynomial or linear regressions, walking cadence was positively associated with FEV1, 6-min walk distance, physical activity (steps·day−1, time in moderate-to-vigorous physical activity, vector magnitude units, walking time, intensity during locomotion), physical activity experience and health-related quality of life and negatively associated with breathlessness and depression (all p<0.05). These associations remained after further adjustment for daily steps. In negative binomial regression adjusted for multiple confounders, walking cadence related to lower number of severe exacerbations during follow-up (incidence rate ratio 0.94 per step·min−1, 95% CI 0.91–0.99, p=0.009). Conclusions Higher real-world walking cadence is associated with better COPD status and lower severe exacerbations risk, which makes it attractive as a future prognostic marker and clinical outcome.
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    Roles of the physical environment in health-related quality of life in patients with chronic obstructive pulmonary disease
    (Academic Press Inc., 2022-01) Moitra, Subhabrata; Foraster, María; Arbillaga Etxarri, Ane; Marín, Alicia; Barberán García, Anael; Rodríguez Chiaradia, Diego A.; Balcells, Eva; Koreny, Maria; Torán, Pere; Vall Casas, Pere; Rodríguez Roisin, Robert; García Aymerich, Judith
    Rationale: Many clinical and psychological factors are known to influence the health-related quality of life (HRQL) in chronic obstructive pulmonary disease (COPD). However, research on whether environmental factors, such as air pollution, noise, temperature, and blue/green spaces also influence HRQL in COPD has not been systematically investigated. Objective: To assess the relationship between air pollution, road traffic noise, temperature, and distance to blue/green spaces and respiratory-specific HRQL in COPD. Methods: We used cross-sectional data from a multicenter study in 407 stable mild-to-very severe COPD patients from Barcelona (Catalonia). Patients answered the COPD Assessment Test (CAT) and Clinical COPD Questionnaire (CCQ). Individual residential exposure to air pollutants (nitrogen dioxide [NO2] and particulate matters of varying aerodynamic diameters [PM2.5, PM10, and PM2.5absorbance]), road traffic noise (Lden), and land surface temperature were estimated using long-term averages from land-use regression models, 24-h noise maps, and land surface temperature maps, respectively. We measured residential distances to blue/green spaces from the Urban Atlas. We used mixed-effect negative binomial (for CAT) and linear (for CCQ) regression models, adjusted for potential confounders, with a random effect by center. Results: Of those patients, 85 % were male and had a mean (SD) age of 69 (9) years, CAT score of 12 (7), CCQ-total score of 1.4 (1.0), and post-bronchodilator forced expiratory volume in 1 s (FEV1) of 57 (18) %predicted. We found that NO2 and PM2.5absorbance were associated with worsened CAT and CCQ-mental scores, e.g., 0.15-unit change in CAT score [regression coefficient (β) = 0.15; 95 % confidence interval (CI) = 0.03, 0.26] per interquartile range in NO2 [13.7 μg/m3]. Greater distances to blue/green spaces were associated with worsened CCQ-mental scores [0.08; 0.002, 0.15]. Conclusions: Our study showed that increased air pollution, particularly NO2 and PM2.5absorbance and greater distances to blue/green spaces negatively influence HRQL in COPD patients. These findings have important implications for the WHO promotion to develop healthy cities for our future.
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    Short-term effects of air pollution and weather on physical activity in patients with chronic obstructive pulmonary disease (COPD)
    (Academic Press Inc., 2024-04-15) Josa-Culleré, Alícia; Basagaña, Xavier; Koch, Sarah; Arbillaga Etxarri, Ane; Balcells, Eva; Bosch de Basea, Magda; Celorrio, Nuria; Foraster, María; Rodríguez-Roisin, Robert; Marín, Alicia; Peralta, Gabriela P.; Rodríguez-Chiaradia, Diego A.; Simonet, Pere; Torán, Pere; Vall-Casas, Pere; Garcia-Aymerich, Judith
    Introduction: Patients with chronic obstructive pulmonary disease (COPD) accumulate low levels of physical activity. How environmental factors affect their physical activity in the short-term is uncertain. Aim: to assess the short-term effects of air pollution and weather on physical activity levels in COPD patients. Methods: This multi-center panel study assessed 408 COPD patients from Catalonia (Spain). Daily physical activity (i.e., steps, time in moderate-to-vigorous physical activity (MVPA), locomotion intensity, and sedentary time) was recorded in two 7-day periods, one year apart, using the Dynaport MoveMonitor. Air pollution (nitrogen dioxide (NO2), particulate matter below 10 μm (PM10) and a marker of black carbon (absorbance of PM2.5: PM2.5ABS), and weather (average and maximum temperature, and rainfall) were estimated the same day (lag zero) and up to 5 days prior to each assessment (lags 1–5). Mixed-effect distributed lag linear regression models were adjusted for age, sex, weekday, public holidays, greenness, season, and social class, with patient and city as random effects. Results: Patients (85% male) were on average (mean ± SD) 68 ± 9 years old with a post-bronchodilator forced expiratory volume in 1 s (FEV1) of 57 ± 18% predicted. Higher NO2, PM10 and PM2.5ABS levels at lag four were associated with fewer steps, less time in MVPA, reduced locomotion intensity, and longer sedentary time (e.g., coefficient (95% CI) of −60 (−105, −15) steps per 10 μg/m3 increase in NO2). Higher average and maximum temperatures at lag zero were related to more steps and time in MVPA, and less sedentary time (e.g., +85 (15, 154) steps per degree Celsius). Higher rainfall at lag zero was related to fewer steps and more sedentary time. Conclusion: Air pollution affects the amount and intensity of physical activity performed on the following days in COPD patients, whereas weather affects the amount of physical activity performed on the same day