Protocol for a systematic review of the associations between inflammatory markers and lung function, muscle force and exercise capacity in people with COPD.

INTRODUCTION: The prevalence of chronic obstructive pulmonary disease (COPD) has been on the rise, with acute exacerbation of COPD associated with the highest burden and multiple pulmonary and systemic consequences. People with COPD have been found to have an abnormal response of systemic inflammation. To date, although limited, there are studies that suggest negative associations between inflammatory markers and important clinical outcomes such as exercise capacity and muscle force. This protocol aims to systematically review the evidence for (i) the associations between inflammatory markers and lung function, muscle force and exercise capacity and (ii) the influence of other factors (eg, hospitalisation, exercise programme) on the level of inflammatory markers in people with COPD. METHODS AND ANALYSIS: Scopus, PubMed, Cochrane, Web of Science and ProQuest will be searched from database inception to February 2023 using PEO search strategy (Population: adults with COPD; Exposure: inflammatory markers; Outcomes: lung function, muscle force and exercise capacity). Four reviewers working in pairs will independently screen articles for eligibility and extract data that fulfilled the inclusion criteria. Depending on the design of the included studies, either Cochrane risk-of-bias version 2 or the Newcastle-Ottawa Scale tools will be used to rate the methodological quality of the included studies. Effect sizes reported in each individual study will be standardised to Cohen's d and a random effects model will be used to calculate the pooled effect size for the association. ETHICS AND DISSEMINATION: Ethical approval is unnecessary as this study will only use publicly available data. The findings will be disseminated through publication in peer-reviewed journals and conferences. PROSPERO REGISTRATION NUMBER: CRD42022284446.

Effects of Ongoing Feedback During a 12-Month Maintenance Walking Program on Daily Physical Activity in People with COPD.

This multi-centred, randomised controlled trial explored the effects of adding ongoing feedback to a 12-month unsupervised maintenance walking program, on daily physical activity (PA) in people with chronic obstructive pulmonary disease. Participants were randomised to either an intervention group (IG) or a usual care group (UCG). During the maintenance program, the IG received ongoing feedback (telephone calls, biofeedback provided via pedometer and progressive goal setting) and the UCG received no feedback. The SenseWear® Pro3 Armband was used to measure PA. Of the 86 participants {IG = 42, (mean [SD]: age 70 [7] years; FEV1 43 [16] % predicted); UCG = 44, (age 69 [9] years; FEV1 44 [15] % predicted)} included at baseline, 43 had sufficient data to be included in the final analysis. There were no between-group differences in any of the PA variables from baseline to completion of the program (all p > 0.05). Ongoing feedback was no more effective than no feedback in improving PA during a 12-month unsupervised walking program.Trial Registration: The trial was registered in the Australia and New Zealand Clinical Trials Registry (ACTRN12609000472279).

Effects of ground-based walking training on daily physical activity in people with COPD: A randomised controlled trial.

This study explored the effects of ground-based walking training on physical activity (PA) and sedentary time (ST) in people with chronic obstructive pulmonary disease (COPD). Participants were randomised to a walk group (WG) [supervised, ground-based walking training, two or three times per week for 8-10 weeks] or a control group (CG) [usual medical care]. Before and after the intervention period, PA and ST were measured using the SenseWear® Pro3 Armband. Of the 143 participants randomised, 101 (71%) had sufficient data for the primary analysis; 62 were from the WG (mean [SD] age 69 [8] years, FEV1 42 [15] % predicted) and 39 were from the CG (age 68 [9] years, FEV1 43 [15] % predicted). No between-group differences were demonstrated in any measure of PA or ST (all p > 0.05). Secondary analyses (n = 44) revealed that, compared to the CG, the proportion of waking hours spent in moderate intensity PA accumulated in uninterrupted bouts of between 30 and 60 min, increased in the WG by 0.8% (95% CI = 0.4 to 1.3). This study demonstrated that, in people with COPD, ground-based walking training alone had little, if any clinically important effect on daily PA and no effect on ST.

Perceived barriers to and ideas for weight control interventions in Malay homemakers: results from focus groups.

OBJECTIVE: To develop a better understanding of perceived barriers to and ideas for weight loss and maintenance among Malay homemakers in Singapore. METHODS: Interventions for weight management were reviewed, and 5 focus groups were conducted among overweight and obese Malay homemakers (n = 24) to explore barriers to and concepts and ideas pertaining to weight loss and maintenance. RESULTS: Barriers identified included the lack of time, finances, and motivation. Ideas that were most appealing included free health screening, workshops on how best to manage children and family, regular fun group activities, monetary incentives for participation in activities for healthy living, and flexible part-time jobs. CONCLUSION: The focus groups provided useful insights pointing toward possible interventions that could appeal to Malay homemakers in Singapore. The most appealing approaches were those that were time flexible and had the least financial burden or had a financial benefit.