Profile and determinants of daily physical activity objectively assessed in university students.

BACKGROUND: The aim of this study was to quantify and compare physical activity (PA) levels of university students from different fields of study, and to investigate its correlates. METHODS: 221 students (111 female, 20 [18-23] years), from different study fields were cross-sectionally assessed for daily PA (pedometer), cardiorespiratory fitness (20 m Shuttle Run Test-20mSRT), health-related quality of life (HRQoL), anxiety and depression symptoms. RESULTS: In general, 60% of the students were physically active (>8000 steps/day), presented good HRQoL and cardiorespiratory fitness, minimal symptoms of depression and moderate of anxiety. The highest PA level was observed in students from physical education and sport sciences, and the lowest in those from social sciences (median [IQR]: 9882 [8435-13510] versus 7593 [6070-9753] steps/day, respectively; P<0.01). Male students were more active than female. Steps/day was moderately associated with VO2max (r=0.42), VO2%pred (r=0.41) and distance achieved in the 20mSRT (r=0.43) (P<0.0001 for all), and weakly associated with anxiety symptoms (r=-0.20; P=0.004) and HRQoL domains (0.15

Best Protocol for the Sit-to-Stand Test in Subjects With COPD.

BACKGROUND: Different protocols for the sit-to-stand test (STS) are available for assessing functional capacity in COPD. We sought to correlate each protocol of the STS (ie, the 5-repetition [5-rep STS], the 30-s STS, and the 1-min STS) with clinical outcomes in subjects with COPD. We also aimed to compare the 3 protocols of the STS, to verify their association and agreement, and to verify whether the 3 protocols are able to predict functional exercise capacity and physical activity in daily life (PADL). METHODS: 23 subjects with COPD (11 men; FEV1 53 ± 15% predicted) performed 3 protocols of the STS. Subjects also underwent the following assessments: incremental shuttle walking test, 6-min walk test (6MWT), 4-m gait speed test (4MGS), 1-repetition maximum of quadriceps muscle, assessment of PADL, and questionnaires on health-related quality of life and functional status. RESULTS: The 1-min STS showed significant correlations with the 6MWT (r = 0.40), 4MGS (r = 0.64), and PADL (0.40 ≤ r ≤ 0.52), and the 5-rep STS and 30-s STS were associated with the 4MGS (r = 0.54 and r = 0.52, respectively). The speed differed for each protocol (5-rep STS 0.53 ± 0.16 rep/s, 30-s STS 0.48 ± 0.13 rep/s, 1-min STS 0.45 ± 0.11 rep/s, P = .01). However, they presented good agreement (intraclass correlation coefficient ≥ 0.73 for all) and correlated well with each other (r ≥ 0.68 for all). More marked changes in peripheral oxygen saturation (P = .004), heart rate (P < .001), blood pressure (P < .001), dyspnea (P < .001), and leg fatigue (P < .001) were found after the 1-min STS protocol. Furthermore, the 3 protocols were equally able to identify subjects with low exercise capacity or preserved exercise capacity. CONCLUSIONS: The 1-min STS generated higher hemodynamic demands and correlated better with clinical outcomes in subjects with COPD. Despite the difference in speed performance and physiological demands between the 5-rep STS and 1-min STS, there was a good level of agreement among the 3 protocols. In addition, all 3 tests were able to identify subjects with low exercise capacity or preserved exercise capacity.

Heart Rate Recovery, Physical Activity Level, and Functional Status in Subjects With COPD.

BACKGROUND: A normal heart rate reflects the balance between the sympathetic and parasympathetic autonomic nervous system. When the difference between heart rate at the end of an exercise test and after 1 min of recovery, known as the 1-min heart rate recovery, is ≤ 12 beats/min, this may indicate an abnormal delay. We sought to compare physical activity patterns and subjects' functional status with COPD with or without delayed 1-min heart rate recovery after the 6-min walk test (6MWT). METHODS: 145 subjects with COPD (78 men, median [interquartile range (IQR)] age 65 [60-73] y, body mass index 25 [21-30] kg/m2, FEV1 45 ± 15% predicted) were underwent the following assessments: spirometry, 6MWT, functional status, and physical activity in daily life (PADL). A delayed heart rate recovery of 1 min was defined as ≤ 12 beats/min. RESULTS: Subjects with delayed 1-min heart rate recovery walked a shorter distance in the 6MWT compared to subjects without delayed heart rate recovery (median [IQR] 435 [390-507] m vs 477 [425-515] m, P = .01; 81 [71-87] vs 87 [79-98]% predicted, P = .002). Regarding PADL, subjects with delayed heart rate recovery spent less time in the standing position (mean ± SD 185 ± 89 min vs 250 ± 107 min, P = .002) and more time in sedentary positions (472 ± 110 min vs 394 ± 129 min, P = .002). Scores based on the self-care domain of the London Chest Activity of Daily Living questionnaire and the activity domain of the Pulmonary Functional Status and Dyspnea questionnaire were also worse in the group with delayed heart rate recovery (6 ± 2 points vs 5 ± 2 points; P = .039 and 29 ± 24 points vs 19 ± 17 points; P = .037, respectively). CONCLUSIONS: Individuals with COPD who exhibit delayed 1-min heart rate recovery after the 6MWT exhibited worse exercise capacity as well as a more pronounced sedentary lifestyle and worse functional status than those without delayed heart rate recovery. Despite its assessment simplicity, heart rate recovery after the 6MWT can be further explored as a promising outcome in COPD.

Peripheral muscle training in patients with chronic obstructive pulmonary disease: novel approaches and recent advances.

INTRODUCTION: Pulmonary rehabilitation is one of the most effective non-pharmacological management options for individuals with chronic obstructive pulmonary disease (COPD). Exercise training is the cornerstone of pulmonary rehabilitation, however considerable variability exists regarding the way it is delivered across the world. It is widely accepted that efforts should be made to tailor specific therapeutic approaches to individuals' needs. This applies as much to respiratory medicine as it does to respiratory rehabilitation. Areas covered: This narrative review examines the emerging literature evaluating advancements of exercise training modalities targeting peripheral muscle function in people with COPD. It aims to highlight practical considerations regarding the delivery key evidence regarding clinical effectiveness, as well as highlight some of the and evaluation of their effectiveness to inform clinical practice. Expert commentary: Although novel therapies may offer advantages over more 'traditional' training methods under specific circumstances, challenges regarding the potential impact upon clinical rehabilitation, the identification of the best candidates for such therapy and access to equipment may pose realistic barriers to their more widespread clinical implementation. Future directions regarding the ways in which these barriers could be overcome will be discussed, including identification of the key research priorities to optimize evidence-based practice in this area.

Step counting and energy expenditure estimation in patients with chronic obstructive pulmonary disease and healthy elderly: accuracy of 2 motion sensors.

OBJECTIVE: To compare the accuracy of 2 motion sensors (a pedometer and a multisensor) in terms of step counting and estimation of energy expenditure (EE) in patients with chronic obstructive pulmonary disease (COPD) and in healthy elderly. DESIGN: In this descriptive study, all participants wore both motion sensors while performing a treadmill walking protocol at 3 different speeds corresponding to 30%, 60%, and 100% of the average speed achieved during a six-minute walk test. As criterion methods, EE was estimated by indirect calorimetry, and steps were registered by videotape. SETTING: Research laboratory at a university hospital. PARTICIPANTS: Patients with COPD (n=30; 17 men; mean age +/- SD, 67+/-8 y; mean forced expiratory volume in the first second [FEV(1)] predicted +/- SD, 46%+/-17%; mean body mass index [BMI] +/- SD, 24+/-4 kg.m(2)) and matched healthy elderly (n=30; 15 men; mean age +/- SD, 68+/-7 y; mean FEV(1) predicted +/- SD, 104%+/-21%; mean BMI +/- SD, 25+/-3 kg.m(2)). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE: Step counting and EE estimation during a treadmill walking protocol. RESULTS: The pedometer was accurate for step counting and EE estimation in both patients with COPD and healthy elderly at the higher speed. However, it showed significant underestimation at the 2 slower speeds in both groups. The multisensor did not detect steps accurately at any speed, although it accurately estimated EE at all speeds in healthy elderly and at the intermediate and higher speeds in patients with COPD. CONCLUSIONS: In both patients with COPD and healthy elderly, the multisensor showed better EE estimates during most walking speeds than the pedometer. Conversely, for step counting, accuracy is observed only with the pedometer during the higher walking speed in both groups.