TY - JOUR AU - Palmen, Banchia AU - Ebadi, Zjala AU - van Herck, Maarten AU - Goërtz, Yvonne M J AU - Deng, Qichen AU - Thong, Melissa AU - Burtin, Chris AU - Peters, Jeannette B AU - Sprooten, Roy T M AU - Bischoff, Erik W M A AU - Wouters, Emiel F M AU - Sprangers, Mirjam A G AU - Vercoulen, Jan H AU - Houben-Wilke, Sarah AU - Vaes, Anouk W AU - Janssen, Daisy J A AU - Spruit, Martijn A TI - Bidirectional Associations Between Physical Activity, Sedentary Behavior, and Daily Symptoms in Patients With Chronic Obstructive Pulmonary Disease: Longitudinal Observational Study. JO - JMIR mhealth and uhealth VL - 13 SN - 2291-5222 CY - Toronto PB - JMIR Publications M1 - DKFZ-2025-02194 SP - e65653 - e65653 PY - 2025 AB - Questionnaire-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 KW - Humans KW - Pulmonary Disease, Chronic Obstructive: psychology KW - Pulmonary Disease, Chronic Obstructive: complications KW - Male KW - Female KW - Sedentary Behavior KW - Aged KW - Longitudinal Studies KW - Exercise: psychology KW - Exercise: physiology KW - Middle Aged KW - Surveys and Questionnaires KW - Accelerometry: methods KW - Accelerometry: instrumentation KW - Ecological Momentary Assessment: statistics & numerical data KW - Quality of Life: psychology KW - COPD (Other) KW - accelerometry (Other) KW - chronic obstructive pulmonary disease (Other) KW - ecological momentary assessment (Other) KW - physical activity (Other) KW - sedentary behavior (Other) KW - symptom assessment (Other) LB - PUB:(DE-HGF)16 C6 - pmid:41124569 C2 - pmc:PMC12543037 DO - DOI:10.2196/65653 UR - https://inrepo02.dkfz.de/record/305510 ER -