Determinant factors of sedentary time in individuals with COPD.

Background: The factors influencing sedentary time (ST) of individuals with chronic obstructive pulmonary disease (COPD) have not been thoroughly explored.

Aim: To identify determinant factors of ST in individuals with stable COPD.

Methods: Individuals with COPD had their ST and variables of physical activity (PA) cross-sectionally assessed during seven days with an activity monitor.

Comparison of Physical Activity Patterns among Three Major Chronic Respiratory Diseases.

Although the level of physical activity in daily life (PADL) plays a vital role concerning the health of subjects with chronic lung diseases, it remains uncertain how PADL patterns compare among different conditions. This study's objective was to compare the PADL levels of subjects with COPD, asthma and idiopathic pulmonary fibrosis (IPF); and to investigate PADL behaviour in different diseases' severity. Stable subjects who had not undergone pulmonary rehabilitation in the previous year were included.

The Brazilian-Portuguese version of the Upper Extremity Functional Index (UEFI): Translation, cross-cultural adaptation and measurement properties for Brazilian adults after a burn injury.

Objectives: To translate, cross-culturally adapt, validate, verify the reliability and estimate the minimal detectable change (MDC) of the UEFI to Brazilian Portuguese (UEFI-Br) for burns.

Methods: The study was carried out with 131 Brazilian burn cases at two time points, at discharge and at the first outpatient follow-up (15-21 days after discharge) in a Burn Treatment Center. The adaptation process of the UEFI was based on international recommendations.

Assessment of sedentary behaviour in individuals with COPD: how many days are necessary?

Objective: The objective of the present study was to define the minimum number of monitoring days required for the adequate cross-sectional assessment of sedentary behaviour in individuals with chronic obstructive pulmonary disease (COPD).

Methods: In this cross-sectional study, the sedentary behaviour of individuals with COPD was assessed using two physical activity monitors during awake time for seven consecutive days. Time spent per day in activities requiring ≤1.

Cultural adaptation and validation of the Brazilian Portuguese version of the PROactive Physical Activity in COPD-clinical visit instrument for individuals with COPD.

Objective: To adapt the PROactive Physical Activity in COPD-clinical visit (C-PPAC) instrument to the cultural setting in Brazil and to determine the criterion validity, test-retest reliability agreement, and internal consistency of this version.

Methods: A protocol for cultural adaptation and validation was provided by the authors of the original instrument and, together with another guideline, was applied in a Portuguese-language version developed by a partner research group from Portugal. The adapted Brazilian Portuguese version was then cross-sectionally administered twice within a seven-day interval to 30 individuals with COPD (57% were men; mean age was 69 ± 6 years; and mean FEV1 was 53 ± 18% of predicted) to evaluate internal consistency and test-retest reliability.

Use of different reference values for handgrip strength in individuals with COPD: analysis of agreement, discriminative capacity, and main clinical implications.

Objective: To identify reference values for handgrip strength through a literature search and compare the agreement of reference values from Brazil with others for handgrip strength in a sample of COPD patients in Brazil, as well as to determine which set of reference values is more discriminative regarding differences in clinical characteristics between individuals with low handgrip strength and normal handgrip strength.

Methods: To identify reference values for handgrip strength, a literature search was performed; a retrospective cross-sectional analysis of baseline-only data from two unrelated studies was then performed. Individuals were evaluated for handgrip strength, peripheral muscle strength, respiratory muscle strength, pulmonary function, body composition, exercise capacity, dyspnea, and functional status.

Minimal important difference of two methods for assessment of quadriceps femoris strength post exercise program in individuals with COPD.

Background: The assessment of quadriceps femoris (QF) strength is recommended by international guidelines as an outcome of exercise training (ET) programs in patients with chronic obstructive pulmonary disease (COPD).

Objectives: To identify the minimal important difference (MID) of two methods for the assessment of improvement of QF strength after a high-intensity ET program in individuals with COPD: 1-repetition maximum (1RM) and maximal voluntary contraction (MVC).

Methods: Individuals with moderate to very-severe stable COPD were submitted to high-intensity ET (3 days/week, 36 sessions).

Energy expenditure per minute in different activities and body positions and its association with the classification as physically active or inactive in daily life in individuals with COPD.

To describe and compare energy expenditure (EE)/minute walking and in different body postures in individuals with COPD; and to investigate if EE/minute walking is a predictor of their classification as physically active or inactive. Physical activity (PA) in daily life was objectively assessed using two PA monitors for 7 days and data were analyzed on a minute-by-minute basis. Predominant minutes were separated into walking, standing, sitting, and reclined, and EE/minute (a reflection of PA intensity) was then calculated in each of these four activities and postures.

Handgrip Strength as a Reflection of General Muscle Strength in Chronic Obstructive Pulmonary Disease.

Muscle dysfunction is one of the main features in individuals with chronic obstructive pulmonary disease (COPD). Handgrip strength (HS) has been used as a representation of general muscle strength in various populations, and a few studies found correlation between HS and other measures of upper and lower limbs' muscle strength in the general population, although this was not yet studied in depth in COPD. The aims of this study were to verify if HS is cross-sectionally well correlated with upper and lower limbs' muscle strength in individuals with COPD, and to identify a new cutoff for handgrip weakness in this population.

Instruments to assess function or functionality in adults after a burn injury: A systematic review.

Introduction: Assessment of functionality or function, through valid and reliable instruments, is essential during rehabilitation of adults after a burn injury. Currently, there is no consensus in the literature regarding the most appropriate tool that should be used to assess function or functionality; there is also no synthesis of the current studies published in this area.

Objectives: To investigate and report the instruments used to assess function or functionality in adults after a burn injury; to identify the characteristics and evidence on their measurement properties; and to evaluate their clinical utility.

Nighttime features derived from topic models for classification of patients with COPD.

Nighttime symptoms are important indicators of impairment for many diseases and particularly for respiratory diseases such as chronic obstructive pulmonary disease (COPD). The use of wearable sensors to assess sleep in COPD has mainly been limited to the monitoring of limb motions or the duration and continuity of sleep. In this paper we present an approach to concisely describe sleep patterns in subjects with and without COPD.

Frequency and functional translation of low muscle mass in overweight and obese patients with COPD.

Background: Cut offs for fat-free mass index (FFMI) and appendicular skeletal muscle mass index (ASMI) are available for diagnosing low muscle mass in patients with COPD. This study aimed to investigate: (1) the frequency of low muscle mass (FFMI and ASMI) applying different cut-offs and (2) the functional translation (clinical impact) of low muscle mass, in patients with COPD stratified into BMI categories.

Methods: Patients with COPD were assessed regarding body composition, exercise capacity, quadriceps muscle strength, symptoms of anxiety and depression, dyspnea and quality of life upon referral to pulmonary rehabilitation.

Tossing and turning: association of sleep quantity-quality with physical activity in COPD.

The association between characteristics of sleep and physical activity in daily life (PADL) has not yet been investigated in depth in subjects with COPD. This study evaluated whether time spent per day in physical activity (PA) and sedentary behaviour are associated with sleep quantity and quality in this population. Sleep and PADL were objectively assessed by an activity monitor for 7 days and analysed on a minute-by-minute basis.

The Gini Coefficient: A New Approach to Assess Physical Activity Inequality in COPD.

Increasing physical activity (PA) is a complex and challenging task in patients with chronic obstructive pulmonary disease (COPD). However, some questions are raised regarding the evaluation of PA in these patients: Have all aspects of PA evaluation in patients with COPD already been explored in the scientific literature and clinical practice? What is the clinical importance of assessing PA inequality? PA inequality is defined as the Gini coefficient (Gini) of the PA distribution of a population and is already shown to have implications for public health in the general population. It is a simple tool that might allow a better understanding of PA disparities among different COPD populations, although to our knowledge there is no previous investigation of PA inequality in patients with COPD using the Gini.

Maximum Voluntary Ventilation and Its Relationship With Clinical Outcomes in Subjects With COPD.

Background: Previous studies have reported that maximum voluntary ventilation (MVV) may be better associated with commonly used outcomes in COPD than FEV and may provide information on respiratory mechanics. In this study, we aimed to investigate the relationship between MVV and clinical outcomes in COPD and to verify whether MVV predicts these outcomes better than FEV.

Methods: We conducted a cross-sectional study involving individuals with COPD.

Six-minute walk test in burned subjects: Applicability, reproducibility and performance at hospital discharge.

Introduction: Despite its clinical relevance in several populations, there is no evidence on applicability of the 6-min walk test (6MWT) in burned subjects.

Objectives: To verify the applicability and reproducibility of the 6MWT in burned individuals and to analyze patients' performance in this test at hospital discharge.

Methods: In a cross-sectional study, burned individuals performed two 6MWT at hospital discharge, according to international standardization.

Physical activity and inactivity among different body composition phenotypes in individuals with moderate to very severe chronic obstructive pulmonary disease.

Background: The phenotype profiling of individuals with chronic obstructive pulmonary disease (COPD) according to impairments in body composition and level of physical activity in daily life (PADL) needs to be determined.

Objective: To verify if individuals with COPD classified as physically active/inactive present different characteristics within different body composition phenotypes.

Methods: Individuals with COPD were cross-sectionally stratified into four groups according to fat-free and fat mass indexes: Normal Body Composition (NBC), Obese (Ob), Sarcopenic (Sarc), and Sarcopenic/Obese (Sarc/Ob).

Which is the best protocol and cut-off point in the 4-metre gait speed test to discriminate exercise capacity in COPD?

Objective To determine the discriminative capacity and cut-off point of different 4-metre gait speed test (4MGS) protocols in identifying preserved or reduced exercise capacity using the six-minute walk test (6MWT) in patients with Chronic Obstructive Pulmonary Disease (COPD); also, to compare 4MGS protocols and characteristics of individuals according to the best cut-off point. Methods We evaluated fifty-six patients with COPD, all of which were submitted to the assessment of anthropometric characteristics, pulmonary function (spirometry) and functional exercise capacity (6MWT and four protocols of the 4MGS). In the 4MGS test, patients were instructed to walk at normal pace and at maximum speed in a 4 meters course (4MGS 4m - usual pace and at maximum) and 8 meters course (4MGS 8m - usual pace and at maximum).

Are the Effects of High-Intensity Exercise Training Different in Patients with COPD Versus COPD+Asthma Overlap?

Purpose: This study aimed to investigate whether patients with chronic obstructive pulmonary disease (COPD) presenting asthma overlap (ACO) benefit similarly in comparison to patients with only COPD after a 12-week high-intensity exercise training (ET) program.

Methods: Subjects with a diagnosis of COPD alone or ACO were evaluated and compared before and after a high-intensity ET program composed of walking and cycling plus strengthening exercises of the upper and lower limbs (3 days/week, 3 months, 36 sessions). Assessments included spirometry, bioelectrical impedance, 6-min walk test (6MWT), London Chest Activity of Daily Living Scale (LCADL), Hospital anxiety and depression Scale, modified Medical Research Council Scale (mMRC), Saint George Respiratory Questionnaire (SGRQ), and respiratory and peripheral muscle strength [manovacuometry and 1-repetition maximum test (quadriceps femoris, biceps and triceps brachialis), respectively].

Functional Status of Patients with COPD Assessed by London Chest Activity of Daily Living Scale: Gender Association and Validity of a Cutoff Point.

Purpose: Whether the difference in the impact of chronic obstructive pulmonary disease (COPD) on the functional status of men and women stems from clinical distinctions or to the measuring instrument used is unclear. Like most instruments for assessing functional limitation in COPD, the interpretation of the results of the London Chest Activity of Daily Living (LCADL) scale is limited because a lack of a valid cutoff point to this scale. For that, this study sought to compare the functional status between men and women with COPD; and propose a cutoff point for LCADL capable of discriminating the prognosis of these individuals.

A breath of fresh air: Validity and reliability of a Portuguese version of the Multidimensional Dyspnea Profile for patients with COPD.

Aim: To provide a Portuguese version of the Multidimensional Dyspnea Profile (MDP), investigating its validity and reliability in Brazilian patients with COPD.

Methods: This was a cross-sectional study for translation and linguist validation of the Portuguese MDP version for patients with COPD. The process occurred according to the protocol of Mapi Research Trust, Lyon, France.

Sedentary Behaviour and Physical Inactivity in Patients with Chronic Obstructive Pulmonary Disease: Two Sides of the Same Coin?

Despite the growing interest in sedentarism, there is no available information on the profile of patients with COPD according to sedentary behaviour (SB) and with a detailed analysis of minute-by-minute bouts. Hence, the aims of this study were to quantify the time spent in SB, light activities and moderate-to-vigorous physical activities (MVPA) and to verify the relationship of MVPA and SB in individuals with COPD, as well as to identify the profile of those physically (in)active and (non)-sedentary. A cross-sectional study in which physical activity in daily life was objectively assessed through the use of SenseWear Pro 2 Armband (BodyMedia) during 2 consecutive weekdays, 12 h/day.

Clinical impact of body composition phenotypes in patients with COPD: a retrospective analysis.

Background/objectives: Abnormal body composition is an independent determinant of COPD outcomes. To date, it is already known that patient stratification into body composition phenotypes are associated with important outcomes, such as exercise capacity and inflammation, but there are no data comparing physical activity and muscle strength among these phenotypes. Thus, the aim of this study was to compare clinical characteristics and physical function in patients with COPD stratified into body composition phenotypes.