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Title: Measuring intensity during free-living physical activities in people with chronic obstructive pulmonary disease: a systematic literature review
Author: Rebelo, Patrícia
Brooks, Dina
Marques, Alda
Keywords: Chronic obstructive pulmonary disease
Activities of daily living
Issue Date: Mar-2022
Publisher: Elsevier
Abstract: Background and objective: Measuring intensity of physical activity (PA) is important to ensure safety and PA interventions’ effectiveness in chronic obstructive pulmonary disease (COPD). This systematic review identified which outcomes, outcome measures and instruments have been used to assess single free-living PAs-related intensity in people with COPD and compared the intensity level (light, moderate, vigorous) obtained by different outcome measures. Methods: PubMed, Scopus, Web of Science, Cochrane Library and EBSCO were searched. Original studies including COPD and assessing single free-living PAs-related intensity were included. Agreement was calculated as: number of agreements between two measures [same intensity level]/ number of comparisons using both measures*100. Results: Forty-three studies (1282 people with COPD- 66 years, 65% men, 49%FEV1%pred) were included. Thirteen outcomes, forty-six outcome measures and twenty-two instruments were identified. Dyspnoea with the Borg scale 0-10; cardiac function, via heart rate (HR) using HR monitors; and pulmonary gas exchange, namely oxygen consumption (VO2), using portable gas analysers were the most reported. The most frequently assessed PAs were walking and lifting, changing or moving weights/objects. Agreement between the outcome measures varied from 0 (%VO2peak vs. Metabolic equivalent tasks [METs]; %HRpeak vs. Fatigue Borg; METs vs. walking speed) to 100% (%HRreserve vs. dyspnoea Borg; fatigue and exertion Borg vs. walking speed). %VO2peak/reserve elicited the highest intensity, thus, it can be hypothesised that Borg scores, %HRreserve and METs may underestimate PA-related intensity. Conclusions: Various methodologies are used to assess single free-living PAs-related intensity, which yield different intensity levels for the same PA. Future studies, further exploring the agreement between the different outcome measures of PA-related intensity and discussing their advantages, disadvantages and applicability in real-world settings are pressingly warranted. These would guide future worldwide recommendations on how to assess single free-living PAs-related intensity in COPD, which are essential to optimise PA interventions and ensure patients’ safety.
Peer review: yes
DOI: 10.1016/
ISSN: 1877-0657
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