COPD patients benefit from physical activity

COPD patients who engage in regular physical activity, even a relatively small amount, may lower their risk not only of being hospitalized but also of dying, a new study shows.

COPD—short for chronic obstructive pulmonary disease—is a progressive lung illness caused by smoking that includes emphysema and chronic bronchitis. It is characterized by airflow limitation that is not completely reversible.

At present, only oxygen therapy, the use of certain drugs like bronchodilators, and flu shots are thought to be effective in altering the course of COPD.

In contrast to studies of other chronic diseases, such as cancer and diabetes, few COPD studies have looked at the impact of regular physical activity on disease outcomes, particularly death. With the exception of guidelines issued by the British Thoracic Society in 1997, which were not evidence-based, no current, internationally recognized guidelines advocate regular physical activity for COPD patients.

In a study reported in 2003, Dr. J. Garcia-Aymerich, from the Institut Municipal d’Investigacio Medica in Barcelona, Spain, and colleagues had shown that physical activity equivalent to walking 1 hour/day cut the risk of hospital admission for COPD compared with activity equivalent to 20 minutes/day or less of walking.

To delve further into the effects of regular physical activity in COPD patients, Garcia-Aymerich’s team included death as a disease outcome. The subjects included 2386 COPD patients who were part of a population-based sample recruited in Copenhagen in the early 1980s and 1990s. Self-reported physical activity was recorded at baseline and the subjects were followed until 2000.

Physical activity was divided into four categories: 1) very low: virtually no physical activity; 2) low: light physical activity, such as biking or walking, for less than 2 hours/week; 3) moderate: same as low, but for 2 to 4 hours/week; and 4) high: same as low, but for greater than 4 hours/week or in more vigorous activity for any duration.

Patients in the three upper categories of physical activity were 28 percent less likely to be admitted to the hospital for COPD than patients with very low activity. Similarly, the upper categories of physical activity was associated with a 24 percent reduction in death from all causes and a 30 percent reduction in respiratory-related deaths.

The effects of physical activity were not modified by gender, age group, COPD severity, or a history of heart disease, the report indicates.

“This is the first population-based cohort study showing that a relatively small amount of physical activity may have important beneficial effects on the course of COPD,” the researchers conclude.

SOURCE: Thorax September, 2006.

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