Urban environment and physical activity and capacity in patients with chronic obstructive pulmonary disease

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dc.contributor.authorKoreny, Maria
dc.contributor.authorArbillaga Etxarri, Ane
dc.contributor.authorBosch de Basea, Magda
dc.contributor.authorForaster, María
dc.contributor.authorCarsin, Anne-Elie
dc.contributor.authorCirach, Marta
dc.contributor.authorGimeno-Santos, Elena
dc.contributor.authorBarberan-Garcia, Anael
dc.contributor.authorNieuwenhuijsen, Mark
dc.contributor.authorVall-Casas, Pere
dc.contributor.authorRodríguez-Roisin, Robert
dc.contributor.authorGarcia-Aymerich, Judith
dc.date.accessioned2024-11-11T10:49:55Z
dc.date.available2024-11-11T10:49:55Z
dc.date.issued2022-11
dc.date.updated2024-11-11T10:49:55Z
dc.description.abstractBackground: Physical activity and exercise capacity are key prognostic factors in chronic obstructive pulmonary disease (COPD) but their environmental determinants are unknown. Objectives: To test the association between urban environment and objective physical activity, physical activity experience and exercise capacity in COPD. Methods: We studied 404 patients with mild-to-very severe COPD from a multi-city study in Catalonia, Spain. We measured objective physical activity (step count and sedentary time) by the Dynaport MoveMonitor, physical activity experience (difficulty with physical activity) by the Clinical visit-PROactive (C-PPAC) instrument, and exercise capacity by the 6-min walk distance (6MWD). We estimated individually (geocoded to the residential address) population density, pedestrian street length, slope of terrain, and long-term (i.e., annual) exposure to road traffic noise, nitrogen dioxide (NO2) and particulate matter (PM2.5). We built single- and multi-exposure mixed-effects linear regressions with a random intercept for city, adjusting for confounders. Results: Patients were 85% male, had mean (SD) age 69 (9) years and walked 7524 (4045) steps/day. In multi-exposure models, higher population density was associated with fewer steps, more sedentary time and worse exercise capacity (−507 [95% CI: 1135, 121] steps, +0.2 [0.0, 0.4] h/day and −13 [-25, 0] m per IQR). Pedestrian street length related with more steps and less sedentary time (156 [9, 304] steps and −0.1 [-0.1, 0.0] h/day per IQR). Steeper slope was associated with better exercise capacity (15 [3, 27] m per IQR). Higher NO2 levels related with more sedentary time and more difficulty in physical activity. PM2.5 and noise were not associated with physical activity or exercise capacity. Discussion: Population density, pedestrian street length, slope and NO2 exposure relate to physical activity and capacity of COPD patients living in highly populated areas. These findings support the consideration of neighbourhood environmental factors during COPD management and the attention to patients with chronic diseases when developing urban and transport planning policies.en
dc.description.sponsorshipThe Urban Training study was funded by grants from Fondo de Investigación Sanitaria, Instituto de Salud Carlos III (ISCIII, PI11/01283 and PI14/0419), integrated into Plan Estatal I + D + I 2013–2016 and co-funded by ISCIII-Subdirección General de Evaluación y Fomento de la Investigación and Fondo Europeo de Desarrollo Regional (FEDER); Sociedad Española de Neumología y Cirugía Torácica (SEPAR, 147/2011 and 201/2011), Societat Catalana de Pneumologia (Ajuts al millor projecte en fisioteràpia respiratòria 2013). We acknowledge support from the Spanish Ministry of Science and Innovation through the “Centro de Excelencia Severo Ochoa 2019–2023” Program (CEX 2018-000806-S), and support from the Generalitat de Catalunya through the CERCA Program. MF is beneficiary of an AXA Research Fund granten
dc.identifier.citationKoreny, M., Arbillaga-Etxarri, A., Bosch de Basea, M., Foraster, M., Carsin, A.-E., Cirach, M., Gimeno-Santos, E., Barberan-Garcia, A., Nieuwenhuijsen, M., Vall-Casas, P., Rodriguez-Roisín, R., & Garcia-Aymerich, J. (2022). Urban environment and physical activity and capacity in patients with chronic obstructive pulmonary disease. Environmental Research, 214. https://doi.org/10.1016/J.ENVRES.2022.113956
dc.identifier.doi10.1016/J.ENVRES.2022.113956
dc.identifier.issn1096-0953
dc.identifier.urihttp://hdl.handle.net/20.500.14454/1735
dc.language.isoeng
dc.publisherAcademic Press Inc.
dc.rights© 2022 The Authors
dc.subject.otherAir pollution
dc.subject.otherChronic obstructive pulmonary disease
dc.subject.otherExercise capacity
dc.subject.otherNoise
dc.subject.otherPhysical activity
dc.subject.otherUrban environment
dc.titleUrban environment and physical activity and capacity in patients with chronic obstructive pulmonary diseaseen
dc.typejournal article
dcterms.accessRightsopen access
oaire.citation.titleEnvironmental Research
oaire.citation.volume214
oaire.licenseConditionhttps://creativecommons.org/licenses/by-nc-nd/4.0/
oaire.versionVoR
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