Background
Moderate to vigorous physical activity ( MVPA) in patients with COPD affects their overall health outcomes, including symptom relief and improved quality of life. However, the magnitude of the effect of starting moderate-to-vigorous physical activity (MVPA) on real-world clinical outcomes has not been well investigated.
Research question
How does initiation of moderate-to-vigorous physical activity (MVPA) affect mortality and severe exacerbations in patients who have not participated in MVPA prior to COPD diagnosis?
Study design and methods
This study included COPD patients aged ≥ 40 years who were not engaging in moderate to vigorous physical activity (MVPA) before their COPD diagnosis and who had at least one health screening visit before and after their COPD diagnosis between January 1, 2010 and December 31, 2018.
The primary exposure was moderate-to-vigorous physical activity (MVPA), defined as vigorous aerobic exercise > 20 min per day ≥ 3 days per week or moderate aerobic exercise > 30 min per day ≥ 5 days per week.
The primary endpoint was all-cause mortality and the secondary endpoint was initial severe exacerbation as time to event after COPD diagnosis.
Results
In total, 110,097 personal trials were included (27,564 MVPA increases and 82,533 control groups). No differences were observed between covariates after matching. The adjusted hazard ratio for all-cause mortality for the MVPA group compared with the control group was 0.84 (95% CI, 0.79-0.89).
In subgroup analysis, patients > 65 years of age, women, never smokers, and patients with a higher Charlson Comorbidity Index score showed a stronger effect of moderate-to-vigorous physical activity (MVPA). ) in reduced mortality than younger male patients, those who had ever smoked, and patients with a lower Charlson Comorbidity Index score (Pinteraction < 0.05).
The fully adjusted hazard ratio for the risk of severe exacerbation (MVPA group versus control) was 0.90 (95% CI, 0.87-0.94).
Interpretation Initiating moderate-to-vigorous physical activity (MVPA) can potentially reduce mortality and severe exacerbations in patients with COPD, although personalized interventions and additional clinical trials are needed. |
