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Physical Activity and Respiratory Conditions
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Physical Activity and Respiratory Conditions

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Sports Medicine".

Deadline for manuscript submissions: closed (15 June 2023) | Viewed by 9682

Special Issue Editor

Dr. Christian Osadnik

E-Mail Website
Guest Editor
School of Primary and Allied Health Care, Monash University, Melbourne, Australia
Interests: physical activity; pulmonary rehabilitation; cardiopulmonary physiotherapy; lung diseases; chronic obstructive pulmonary disease; respiration disorders; rehabilitation; physiotherapy; rehabilitation medicine

Special Issue Information

Dear Colleagues,

People living with chronic lung disease are known to experience problematic symptoms of a respiratory nature such as breathlessness, cough and sputum production. The impact of these symptoms on non-respiratory aspects of daily life is, however, less obvious. Avoidance of exertion (including habitual physical activity levels as well as exercise) due to concerns regarding worsening symptoms can lead to subsequent muscle wasting, exercise intolerance, poor quality of life and social isolation. It is therefore essential that effective comprehensive management for people living with chronic lung diseases includes the optimisation of physical activity levels. There remains much to learn about the best ways to achieve this for people with differing lung conditions and differing needs.

We invite contributors to submit original research and review articles to this Special Issue in order to contribute new knowledge to the field and stimulate discussion of the importance of targeting physical activity in people living with lung disease. Contributions may relate to various areas for such patients including (but not limited to):

  • Strategies to measure physical activity levels;
  • Technical methods to evaluate physical activity data;
  • Lived experiences of patients regarding physical activity
  • Health impacts of physical activity;
  • Interventions to promote physical activity;
  • Reviews of best practices in healthcare targeting physical activity.

Your research may span a range of research methodologies and study designs, including experimental and observational research, qualitative research, data syntheses and perspective pieces.

Dr. Christian Osadnik
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • respiratory diseases
  • physical activity
  • rehabilitation
  • comprehensive care
  • sedentary behavior
  • self management
  • behaviour change

Published Papers (7 papers)

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Research

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12 pages, 1368 KiB  
Article
Association between Physical Activity and Reduced Mortality in Inoperable Lung Cancer
by Vinicius Cavalheri, Isis Grigoletto, Joanne McVeigh, David Manners, Terry Boyle, Carolyn J. Peddle-McIntyre, Rajesh Thomas, Jeanie Leong, Samantha Bowyer, Kirsten Mooney, Leon Straker and Daniel A. Galvão
J. Clin. Med. 2023, 12(23), 7346; https://doi.org/10.3390/jcm12237346 - 27 Nov 2023
Viewed by 2081
Abstract
We examined device-measured physical activity (PA) and sedentary behaviour at the time of diagnosis in people with inoperable lung cancer and investigated their associations with 12-month mortality. The people with inoperable lung cancer wore an accelerometer for seven days prior to the treatment [...] Read more.
We examined device-measured physical activity (PA) and sedentary behaviour at the time of diagnosis in people with inoperable lung cancer and investigated their associations with 12-month mortality. The people with inoperable lung cancer wore an accelerometer for seven days prior to the treatment commencement. The analysed PA/sedentary behaviour variables included light-intensity PA, moderate-to-vigorous-intensity PA (MVPA), step count, the total time spent sedentary, and the usual sedentary bout duration. The data on the disease stage, clinical covariates and 12-month mortality were extracted from medical records. Cox regression models were used to estimate the association between the PA measures and 12-month mortality, and the sedentary behaviour measures and 12-month mortality. The models were adjusted for the stage and neutrophil-to-lymphocyte ratio. All the PA and sedentary behaviour variables were dichotomised at their medians for analysis. Eighty-nine participants (70 ± 10 years; 55 [62%] males) contributed valid data. The twelve-month mortality was 30% (n = 27). Compared to the participants who spent ≤4.6 min/day in MVPA (n = 45), those who spent >4.6 min/day (n = 44) had a relative risk of 12-month mortality reduced by 60% (hazard ratio, 0.40; 95% CI, 0.16 to 0.96; 18 versus nine deaths, respectively). The other variables of PA/sedentary behaviour were not associated with 12-month mortality. Higher device-measured MVPA was associated with reduced 12-month mortality in people who were newly diagnosed with inoperable lung cancer. Full article
(This article belongs to the Special Issue Physical Activity and Respiratory Conditions)
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12 pages, 640 KiB  
Article
Comparison of Physical Activity Patterns among Three Major Chronic Respiratory Diseases
by Leandro Cruz Mantoani, Karina Couto Furlanetto, Carlos Augusto Camillo, Joice Mara de Oliveira, Cláudia Polastri, Lorena Paltanin Schneider, Camile Ludovico Zamboti, Nidia Aparecida Hernandes and Fabio Pitta
J. Clin. Med. 2023, 12(21), 6832; https://doi.org/10.3390/jcm12216832 - 29 Oct 2023
Viewed by 775
Abstract
Although the level of physical activity in daily life (PADL) plays a vital role concerning the health of subjects with chronic lung diseases, it remains uncertain how PADL patterns compare among different conditions. This study’s objective was to compare the PADL levels of [...] Read more.
Although the level of physical activity in daily life (PADL) plays a vital role concerning the health of subjects with chronic lung diseases, it remains uncertain how PADL patterns compare among different conditions. This study’s objective was to compare the PADL levels of subjects with COPD, asthma and idiopathic pulmonary fibrosis (IPF); and to investigate PADL behaviour in different diseases’ severity. Stable subjects who had not undergone pulmonary rehabilitation in the previous year were included. Subjects were divided into two subgroups according to disease severity: mild/moderate and severe/very severe. The primary outcome was time spent in moderate-to-vigorous physical activities (MVPA) (Actigraph GT3x) measured during one week over 12 h/day; other assessments included pulmonary function, peripheral muscle strength and exercise capacity. Comparisons among subgroups were corrected for age, BMI and sex. The analysis involved 119 subjects (47 asthma, 48 COPD and 24 IPF). Subjects with asthma had higher PADL levels than those with COPD and IPF (MVPA 18(14–22) vs. 8(4–12) vs. 7(1–12) min/day, respectively; p ancova = 0.002). Subjects with severe/very severe IPF had the lowest PADL level among all subgroups. Adult subjects with asthma have higher PADL levels than those with COPD and IPF, whereas patients with severe and very severe IPF are the most physically inactive subjects. Full article
(This article belongs to the Special Issue Physical Activity and Respiratory Conditions)
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22 pages, 1554 KiB  
Article
Stakeholder Perceptions of a Web-Based Physical Activity Intervention for COPD: A Mixed-Methods Study
by Stephanie A. Robinson, Stephanie L. Shimada, Samantha K. Sliwinski, Renda S. Wiener and Marilyn L. Moy
J. Clin. Med. 2023, 12(19), 6296; https://doi.org/10.3390/jcm12196296 - 29 Sep 2023
Viewed by 755
Abstract
Technology-based physical activity interventions have been shown to be efficacious in chronic obstructive pulmonary disease (COPD), though their potential impact has not been fully realized due to ineffective implementation. We used a convergent, parallel mixed-methods design to identify patient- and provider-facing barriers and [...] Read more.
Technology-based physical activity interventions have been shown to be efficacious in chronic obstructive pulmonary disease (COPD), though their potential impact has not been fully realized due to ineffective implementation. We used a convergent, parallel mixed-methods design to identify patient- and provider-facing barriers and facilitators to implementing a rigorously studied web-based physical activity intervention for COPD. Quantitative surveys (based on the unified theory of acceptance and use of technology; range 1 (poor usability)—5 (high usability)) and semi-structured interviews (guided by the practical robust implementation and sustainability model) assessed the perspectives of 15 patients and 15 health care providers. The patients and providers rated the usability of the intervention as high (median = 5.0, IQR = 1.0). For both patients and providers, the main facilitators included: the potential high impact of the intervention on patient health, the usefulness of the intervention for unmet clinical needs, and the perceived ease of use of the intervention. The main barriers identified were digital literacy and its fit with current clinical workflows. Implementation efforts may benefit from supporting patients’ use of the website and developing strategies to integrate referrals to the intervention and the monitoring of patients into current clinical infrastructures. Full article
(This article belongs to the Special Issue Physical Activity and Respiratory Conditions)
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14 pages, 2714 KiB  
Article
Effect of Data Reduction Techniques on Daily Moderate to Vigorous Physical Activity Collected with ActiGraph® in People with COPD
by Patrícia Rebelo, Joana Antão, Dina Brooks and Alda Marques
J. Clin. Med. 2023, 12(16), 5340; https://doi.org/10.3390/jcm12165340 - 16 Aug 2023
Cited by 1 | Viewed by 788
Abstract
ActiGraph® is a valid, frequently used, accelerometer to quantify moderate to vigorous physical activities (MVPA) in people with COPD. The impact of ActiGraph processing techniques on this population is unknown. This study aimed to explore the effect of data reduction techniques on [...] Read more.
ActiGraph® is a valid, frequently used, accelerometer to quantify moderate to vigorous physical activities (MVPA) in people with COPD. The impact of ActiGraph processing techniques on this population is unknown. This study aimed to explore the effect of data reduction techniques on MVPA in people with COPD. MVPA/day, through ActiGraph GT3X+, was estimated using: Troiano, Freedson 98 and FreedsonVM3 cutoffs, 15-s and 60-s epochs, and normal and low-frequency extension (LFE) filters. Cutoff, epoch, and filter effects were explored with Aligned Rank Transform-ANOVA. Lin’s concordance correlation coefficients and Bland–Altman plots were used to evaluate agreement and bias between different techniques. The analysis included 136 people with COPD (79% male; 68 ± 8 years; FEV1 51 ± 17% predicted). MVPA/day differed according to cutoff, filter, and epoch selection (p-value < 0.001). FreedsonVM3 cutoff, 15-s epochs, and LFE yielded the highest MVPA (45 min/day, 68% of physically active participants). Troiano cutoff, 60-s epochs, and normal filter yielded the lowest MVPA (8 min/day, 20% of physically active participants). Only comparisons between Troiano and Freedson98 cutoffs presented an almost perfect agreement. ActiGraph data reduction techniques affected MVPA/day estimates and their interpretation at the individual and group level. Studies using different processing criteria should not be compared in people with COPD. Future studies with a gold standard are required to ascertain which processing technique produces the most accurate MVPA estimates in COPD. Meanwhile, future trials employing the ActiGraph GT3X+ may consider estimating MVPA based on Freedson VM3 cutofffs, 60-s epochs, and normal filter. Full article
(This article belongs to the Special Issue Physical Activity and Respiratory Conditions)
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13 pages, 3702 KiB  
Article
Physical Activity Profiles among Patients Admitted with Acute Exacerbations of Chronic Obstructive Pulmonary Disease
by Christopher Byron and Christian R. Osadnik
J. Clin. Med. 2023, 12(15), 4914; https://doi.org/10.3390/jcm12154914 - 26 Jul 2023
Viewed by 871
Abstract
People with hospitalised acute exacerbations of chronic obstructive pulmonary disease (AECOPD) exhibit low levels of physical activity (PA) and increased risks of future exacerbations. While methods to objectively measure and express PA are established for people with stable COPD, less clarity exists for [...] Read more.
People with hospitalised acute exacerbations of chronic obstructive pulmonary disease (AECOPD) exhibit low levels of physical activity (PA) and increased risks of future exacerbations. While methods to objectively measure and express PA are established for people with stable COPD, less clarity exists for people during AECOPD. Further, the relationship between PA during AECOPD and clinically relevant outcomes remains uncertain. The purpose of the study was to evaluate how much PA (step count and intensity) people accumulate during hospitalised AECOPDs, and the effect of accumulated inpatient PA (expressed via differing metrics) on length of stay (LOS), PA recovery, and readmission risk. This study was a secondary analysis of prospective observational cohort data collected with Actigraph wActiSleep-BT devices from patients with AECOPD in a Melbourne hospital from 2016 to 2018. Step counts and PA intensity throughout the hospital admission and at one-month follow-up were collected and analysed. Sixty-eight participants were recruited for inpatient measurement, and 51 were retained for follow-up. There were no significant changes in step count or intensity across the inpatient days, but 33/51 (65%) of participants demonstrated a clinically meaningful improvement in steps per day from 3817.0 to 6173.7 at follow-up. Participants spent most time sedentary and in light PA, with both PA metrics demonstrating significant influences on LOS and follow-up PA intensity, but with generally low explanatory power (R2 value range 7–22%). Those who had LOS < 5 days spent significantly less time sedentary and more time in light PA than those with LOS ≥ 5 days (p < 0.001 for both). Time spent sedentary or in light PA appears to be the most promising metric to associate with clinically relevant outcomes related to recovery following AECOPD. These findings can inform future clinical practice for the evaluation of inpatient PA to better establish its role in the clinical management of patients with AECOPD. Full article
(This article belongs to the Special Issue Physical Activity and Respiratory Conditions)
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19 pages, 3645 KiB  
Article
Home-Based Preoperative Exercise Training for Lung Cancer Patients Undergoing Surgery: A Feasibility Trial
by Pedro Machado, Sara Pimenta, Ana Luís Garcia, Tiago Nogueira, Sónia Silva, Bárbara Oliveiros, Raul A. Martins and Joana Cruz
J. Clin. Med. 2023, 12(8), 2971; https://doi.org/10.3390/jcm12082971 - 19 Apr 2023
Cited by 2 | Viewed by 2387
Abstract
Background: Clinical guidelines recommend prehabilitation with exercise training to optimize recovery after lung cancer surgery. However, the lack of access to facility-based exercise programs is a major barrier to routine participation. This study aimed to assess the feasibility of a home-based exercise intervention [...] Read more.
Background: Clinical guidelines recommend prehabilitation with exercise training to optimize recovery after lung cancer surgery. However, the lack of access to facility-based exercise programs is a major barrier to routine participation. This study aimed to assess the feasibility of a home-based exercise intervention before lung cancer resection. Methods: We conducted a prospective, two-site feasibility study, including patients scheduled for lung cancer surgery. Exercise prescription involved aerobic and resistance training with telephone-based supervision. The primary endpoint was overall feasibility (recruitment rate, retention rate, intervention adherence and acceptability). Secondary endpoints included safety and effects on health-related quality of life (HRQOL) and physical performance, evaluated at baseline, after the exercise intervention and 4–5 weeks after surgery. Results: Over three months, 15 patients were eligible, and all agreed to participate (recruitment rate: 100%). A total of 14 patients completed the exercise intervention, and 12 patients were evaluated postoperatively (retention rate: 80%). The median length of the exercise intervention was 3 weeks. Patients performed an aerobic and resistance training volume higher than prescribed (median adherence rates of 104% and 111%, respectively). A total of nine adverse events occurred during the intervention (Grade 1, n = 8; Grade 2, n = 1), the most common being shoulder pain. After the exercise intervention, significant improvements were observed in the HRQOL summary score (mean difference, 2.9; 95% confidence interval [CI], from 0.9 to 4.8; p = 0.049) and the five-times sit-to-stand test score (median difference, −1.5; 95% CI, from −2.1 to −0.9; p = 0.001). After surgery, no significant effects on HRQOL and physical performance were observed. Conclusion: A short-term preoperative home-based exercise intervention is feasible before lung cancer resection and may enhance accessibility to prehabilitation. Clinical effectiveness should be investigated in future studies. Full article
(This article belongs to the Special Issue Physical Activity and Respiratory Conditions)
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Review

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19 pages, 1617 KiB  
Review
Key Considerations When Addressing Physical Inactivity and Sedentary Behaviour in People with Asthma
by Paola D. Urroz Guerrero, Joice M. Oliveira, Hayley Lewthwaite, Peter G. Gibson and Vanessa M. McDonald
J. Clin. Med. 2023, 12(18), 5998; https://doi.org/10.3390/jcm12185998 - 15 Sep 2023
Viewed by 1557
Abstract
People with asthma tend to be less physically active and more sedentary than people without asthma. This narrative review aimed to present key considerations when addressing physical inactivity and sedentary behaviour in people with asthma by identifying barriers and facilitators, determinants and correlates, [...] Read more.
People with asthma tend to be less physically active and more sedentary than people without asthma. This narrative review aimed to present key considerations when addressing physical inactivity and sedentary behaviour in people with asthma by identifying barriers and facilitators, determinants and correlates, and intervention approaches. Using a search strategy, electronic databases were searched for relevant studies. Data extracted from studies were qualitatively synthesised. A total of 26 studies were included in the review. Six studies reported asthma symptoms as a barrier to physical activity, while four studies reported having a supportive network as a physical activity facilitator. Across studies, physical activity correlates/determinants were pulmonary function, exercise capacity, body mass index, dyspnoea, psychological health, and asthma control. Interventions that effectively improved physical activity in the short term were a step-based prescription programme, a weight loss programme incorporating aerobic and resistance training, and a weight loss lifestyle intervention, while a high-intensity interval training pulmonary rehabilitation program was effective in the long term. The collective findings suggest that a personalised physical activity programme incorporating different strategies is needed. There was minimal evidence to provide recommendations to optimise sedentary behaviour in asthma, and more research is needed on the topic. Full article
(This article belongs to the Special Issue Physical Activity and Respiratory Conditions)
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