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000305510 1001_ $$00009-0002-3023-8223$$aPalmen, Banchia$$b0
000305510 245__ $$aBidirectional Associations Between Physical Activity, Sedentary Behavior, and Daily Symptoms in Patients With Chronic Obstructive Pulmonary Disease: Longitudinal Observational Study.
000305510 260__ $$aToronto$$bJMIR Publications$$c2025
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000305510 520__ $$aQuestionnaire-based symptom assessment may introduce recall bias and lacks bidirectional exploration. This is particularly relevant, given the unclear direction of the associations between physical activity (PA), sedentary time (ST), and symptoms in patients with chronic obstructive pulmonary disease (COPD). Understanding these associations could inform symptom management strategies and improve patient quality of life.This study aimed to investigate the direction of the association between PA, ST, and symptoms in patients with COPD using accelerometry and ecological momentary assessment (EMA).A subsample from the FAntasTIGUE study answered 8 randomly timed EMA questionnaires daily for 5 days. Ten symptoms were rated on a 7-point Likert scale: 'I feel relaxed, short of breath, energetic, cheerful, insecure, irritated, satisfied, anxious, tired, and mentally fit.' Concurrently, step count and ST were measured using the ActiGraph GT9X Link placed on the right hip. Step count and ST 15 and 30 minutes pre- and post-EMA were used in multilevel models, controlled for pre-EMA steps and ST, and the previous EMA score. Significant confounders were used as covariates, and patient ID was used as random intercept.Thirty-four patients (19/34, 56% men, mean age 66, SD 7 years; forced expiratory volume in 1 second 52±20% predicted; 1035 EMA responses) were included. Feeling more relaxed was associated with a higher step count 15 minutes post-EMA (β=5.1; 95% CI 0.9 to 10.1; P=.046). Conversely, higher step count 15 and 30 minutes pre-EMA was associated with feeling less relaxed (β=-5.2×10-4; 95% CI -9.7×10-4 to -7.0×10-5; P=.02; and β=-3.2×10-4; 95% CI -5.6×10-4 to -7.9×10-5; P=.009), more short of breath (β=8.5×10-4; 95% CI 4.7×10-4 to 1.2×10-3; P<.001; and β=4.6×10-4; 95% CI 2.6×10-4 to 6.6×10-4; P<.001), and tired (β=5.1×10-4; 95% CI 7.2×10-5 to 9.4×10-4; P=.02; and β=2.9×10-4; 95% CI 5.3×10-5 to 5.2×10-4; P=.02). Higher ST 15 and 30 minutes pre-EMA was associated with feeling more anxious (β=1.7×10-4; 95% CI 1.7×10-5 to 3.2×10-4; P=.03; and β=8.5×10-5; 95% CI 2.5×10-6 to 1.7×10-4; P=.04).A bidirectional association of feeling relaxed with PA was found in patients with COPD. Higher step count was related to feeling more short of breath and tired, whereas higher ST was associated with heightened anxiety.
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000305510 650_7 $$2Other$$aCOPD
000305510 650_7 $$2Other$$aaccelerometry
000305510 650_7 $$2Other$$achronic obstructive pulmonary disease
000305510 650_7 $$2Other$$aecological momentary assessment
000305510 650_7 $$2Other$$aphysical activity
000305510 650_7 $$2Other$$asedentary behavior
000305510 650_7 $$2Other$$asymptom assessment
000305510 650_2 $$2MeSH$$aHumans
000305510 650_2 $$2MeSH$$aPulmonary Disease, Chronic Obstructive: psychology
000305510 650_2 $$2MeSH$$aPulmonary Disease, Chronic Obstructive: complications
000305510 650_2 $$2MeSH$$aMale
000305510 650_2 $$2MeSH$$aFemale
000305510 650_2 $$2MeSH$$aSedentary Behavior
000305510 650_2 $$2MeSH$$aAged
000305510 650_2 $$2MeSH$$aLongitudinal Studies
000305510 650_2 $$2MeSH$$aExercise: psychology
000305510 650_2 $$2MeSH$$aExercise: physiology
000305510 650_2 $$2MeSH$$aMiddle Aged
000305510 650_2 $$2MeSH$$aSurveys and Questionnaires
000305510 650_2 $$2MeSH$$aAccelerometry: methods
000305510 650_2 $$2MeSH$$aAccelerometry: instrumentation
000305510 650_2 $$2MeSH$$aEcological Momentary Assessment: statistics & numerical data
000305510 650_2 $$2MeSH$$aQuality of Life: psychology
000305510 7001_ $$00000-0002-8194-3945$$aEbadi, Zjala$$b1
000305510 7001_ $$00000-0002-3333-6964$$avan Herck, Maarten$$b2
000305510 7001_ $$00000-0003-4674-9562$$aGoërtz, Yvonne M J$$b3
000305510 7001_ $$00000-0003-3835-9142$$aDeng, Qichen$$b4
000305510 7001_ $$0P:(DE-He78)24fe6057396bec79d2638615b12eb989$$aThong, Melissa$$b5$$udkfz
000305510 7001_ $$00000-0002-1342-8554$$aBurtin, Chris$$b6
000305510 7001_ $$00000-0003-4592-7275$$aPeters, Jeannette B$$b7
000305510 7001_ $$00000-0003-2844-3500$$aSprooten, Roy T M$$b8
000305510 7001_ $$00000-0002-3323-8475$$aBischoff, Erik W M A$$b9
000305510 7001_ $$00000-0002-9186-575X$$aWouters, Emiel F M$$b10
000305510 7001_ $$00000-0002-3728-6933$$aSprangers, Mirjam A G$$b11
000305510 7001_ $$00000-0001-7300-9725$$aVercoulen, Jan H$$b12
000305510 7001_ $$00000-0001-6214-0365$$aHouben-Wilke, Sarah$$b13
000305510 7001_ $$00000-0002-4136-1553$$aVaes, Anouk W$$b14
000305510 7001_ $$00000-0002-1827-9869$$aJanssen, Daisy J A$$b15
000305510 7001_ $$00000-0003-3822-7430$$aSpruit, Martijn A$$b16
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