Examinando por Autor "Hopkinson, Nicholas S."

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    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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    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.