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Identification of Phenotypes in People with COPD: Influence of Physical Activity, Sedentary Behaviour, Body Composition and Skeletal Muscle Strength

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Abstract

Introduction

People with chronic obstructive pulmonary disease (COPD) present high prevalence of physical inactivity that leads to a negative effect on health-related quality of life (HRQoL). The present study investigated COPD phenotypes according to their levels of physical activity and sedentary behaviour, as well as body composition and skeletal muscle strength.

Methods

This is an observational and cross-sectional study. Anthropometric data and COPD clinical control were collected and all participants underwent assessments of lung function, HRQoL, dyspnoea, levels of physical activity and sedentary behaviour, body composition and skeletal muscle strength. Participants were classified using hierarchical cluster analysis. Age, dyspnoea and obstruction (ADO) index was used to determine prognosis and calculated for each cluster.

Results

One hundred and fifty-two participants were included. Three distinct phenotypes were identified. Participants in phenotype 1 were more physically active, less sedentary and had better body composition and lower ADO index (p < 0.0001 for all variables). Overall, participants in phenotypes 2 and 3 were less physically active, more sedentary having a higher ADO index. However, participants in phenotype 2 were older, whereas participants in phenotype 3 had worse HRQoL, clinical control and body composition. Lung function did not differ across the three phenotypes.

Conclusions

Our results show that physical activity, sedentary behaviour and body composition should be considered to determine phenotypes in people with COPD and are involved in the prognosis of the disease. Less sedentary patients have better prognosis while age, body composition and clinical control seems to differentiate physically inactive patients.

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Funding

Funding was provided by Fundação de Amparo à Pesquisa do Estado de São Paulo with Grant No. 2013/20676-9.

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Authors and Affiliations

  1. Department of Physical Therapy, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil

    Rafaella F. Xavier, Ana Carolina A. C. Pereira, Aline C. Lopes & Celso R. F. Carvalho

  2. School of Physiotherapy and Exercise Science, Curtin University, Perth, WA, Australia

    Vinícius Cavalheri

  3. Institute for Respiratory Health, Sir Charles Gairdner Hospital, Nedlands, WA, Australia

    Vinícius Cavalheri

  4. Pulmonary Division, Heart Institute (InCor), Clinics Hospital, Medical School, University of Sao Paulo, Sao Paulo, Brazil

    Regina M. C. Pinto & Alberto Cukier

  5. Department of Physical Therapy, State University of Sao Paulo, Sao Paulo, Brazil

    Ercy M. C. Ramos

  6. Department of Medicine, School of Medicine, University of Sao Paulo, Av. Dr. Arnaldo 455, Room 1210, Sao Paulo, SP, 01246-903, Brazil

    Celso R. F. Carvalho

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  1. Rafaella F. Xavier
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  2. Ana Carolina A. C. Pereira
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  3. Aline C. Lopes
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  4. Vinícius Cavalheri
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  6. Alberto Cukier
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  7. Ercy M. C. Ramos
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  8. Celso R. F. Carvalho
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Correspondence to Celso R. F. Carvalho.

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Xavier, R.F., Pereira, A.C.A.C., Lopes, A.C. et al. Identification of Phenotypes in People with COPD: Influence of Physical Activity, Sedentary Behaviour, Body Composition and Skeletal Muscle Strength. Lung 197, 37–45 (2019). https://doi.org/10.1007/s00408-018-0177-8

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  • DOI: https://doi.org/10.1007/s00408-018-0177-8

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