000305510 001__ 305510 000305510 005__ 20251026023429.0 000305510 0247_ $$2doi$$a10.2196/65653 000305510 0247_ $$2pmid$$apmid:41124569 000305510 0247_ $$2pmc$$apmc:PMC12543037 000305510 0247_ $$2altmetric$$aaltmetric:182800592 000305510 037__ $$aDKFZ-2025-02194 000305510 041__ $$aEnglish 000305510 082__ $$a610 000305510 1001_ $$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 000305510 3367_ $$2DRIVER$$aarticle 000305510 3367_ $$2DataCite$$aOutput Types/Journal article 000305510 3367_ $$0PUB:(DE-HGF)16$$2PUB:(DE-HGF)$$aJournal Article$$bjournal$$mjournal$$s1761299205_2721447 000305510 3367_ $$2BibTeX$$aARTICLE 000305510 3367_ $$2ORCID$$aJOURNAL_ARTICLE 000305510 3367_ $$00$$2EndNote$$aJournal Article 000305510 520__ $$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. 000305510 536__ $$0G:(DE-HGF)POF4-313$$a313 - Krebsrisikofaktoren und Prävention (POF4-313)$$cPOF4-313$$fPOF IV$$x0 000305510 588__ $$aDataset connected to CrossRef, PubMed, , Journals: inrepo02.dkfz.de 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$$b16 000305510 773__ $$0PERI:(DE-600)2719220-9$$a10.2196/65653$$gVol. 13, p. e65653 - e65653$$pe65653 - e65653$$tJMIR mhealth and uhealth$$v13$$x2291-5222$$y2025 000305510 909CO $$ooai:inrepo02.dkfz.de:305510$$pVDB 000305510 9101_ $$0I:(DE-588b)2036810-0$$6P:(DE-He78)24fe6057396bec79d2638615b12eb989$$aDeutsches Krebsforschungszentrum$$b5$$kDKFZ 000305510 9131_ $$0G:(DE-HGF)POF4-313$$1G:(DE-HGF)POF4-310$$2G:(DE-HGF)POF4-300$$3G:(DE-HGF)POF4$$4G:(DE-HGF)POF$$aDE-HGF$$bGesundheit$$lKrebsforschung$$vKrebsrisikofaktoren und Prävention$$x0 000305510 9141_ $$y2025 000305510 915__ $$0StatID:(DE-HGF)0100$$2StatID$$aJCR$$bJMIR MHEALTH UHEALTH : 2022$$d2024-12-12 000305510 915__ $$0StatID:(DE-HGF)0200$$2StatID$$aDBCoverage$$bSCOPUS$$d2024-12-12 000305510 915__ $$0StatID:(DE-HGF)0300$$2StatID$$aDBCoverage$$bMedline$$d2024-12-12 000305510 915__ $$0StatID:(DE-HGF)0501$$2StatID$$aDBCoverage$$bDOAJ Seal$$d2023-04-12T14:53:44Z 000305510 915__ $$0StatID:(DE-HGF)0500$$2StatID$$aDBCoverage$$bDOAJ$$d2023-04-12T14:53:44Z 000305510 915__ $$0StatID:(DE-HGF)0030$$2StatID$$aPeer Review$$bDOAJ : Peer review$$d2023-04-12T14:53:44Z 000305510 915__ $$0LIC:(DE-HGF)CCBYNV$$2V:(DE-HGF)$$aCreative Commons Attribution CC BY (No Version)$$bDOAJ$$d2023-04-12T14:53:44Z 000305510 915__ $$0StatID:(DE-HGF)0199$$2StatID$$aDBCoverage$$bClarivate Analytics Master Journal List$$d2024-12-12 000305510 915__ $$0StatID:(DE-HGF)0160$$2StatID$$aDBCoverage$$bEssential Science Indicators$$d2024-12-12 000305510 915__ $$0StatID:(DE-HGF)1110$$2StatID$$aDBCoverage$$bCurrent Contents - Clinical Medicine$$d2024-12-12 000305510 915__ $$0StatID:(DE-HGF)0113$$2StatID$$aWoS$$bScience Citation Index Expanded$$d2024-12-12 000305510 915__ $$0StatID:(DE-HGF)0150$$2StatID$$aDBCoverage$$bWeb of Science Core Collection$$d2024-12-12 000305510 915__ $$0StatID:(DE-HGF)9905$$2StatID$$aIF >= 5$$bJMIR MHEALTH UHEALTH : 2022$$d2024-12-12 000305510 915__ $$0StatID:(DE-HGF)0561$$2StatID$$aArticle Processing Charges$$d2024-12-12 000305510 915__ $$0StatID:(DE-HGF)0700$$2StatID$$aFees$$d2024-12-12 000305510 9201_ $$0I:(DE-He78)C071-20160331$$kC071$$lCancer Survivorship$$x0 000305510 980__ $$ajournal 000305510 980__ $$aVDB 000305510 980__ $$aI:(DE-He78)C071-20160331 000305510 980__ $$aUNRESTRICTED