Changes in systemic inflammation after pulmonary rehabilitation in patients with COPD and severe physical inactivity – an exploratory study. (28th June 2022)

• Record Type: Journal Article
• Authors: Thyregod, Mimi; Løkke, Anders; Skou, Søren T.; Larsen, Jacob; Bodtger, Uffe
• Is Part Of: Chronic respiratory disease. Volume 19(2022)
• Publication Date: 2022-06-28
• Subjects: Physical inactivity -- COPD -- inflammation -- nasal lavage -- physical activity monitoring -- motion sensor; Respiratory organs -- Diseases -- Periodicals; 616.2005
• DOI: 10.1177/14799731221112439
• Languages: English
• ISSNs: 1479-9723

Abstract

Background: Severe physical inactivity (SPI) in patients with COPD is associated with a poor prognosis. It is unknown whether there is a link between SPI and systemic inflammation, and if systemic inflammation in SPI changes following pulmonary rehabilitation (PR). Methods: A prospective, observational study of patients referred for at least 7 weeks of PR comprising 2 h of exercise therapy and education twice weekly. At baseline and after PR, daily physical activity level (PAL) was measured with a validated activity monitor, SenseWear ® as well as systemic inflammation: b-eosinophils, p-fibrinogen, p-CRP, s-IL-6 and s-CD 163. SPI was defined as PAL <1.4. Results: At baseline, SPI was present in 31 of the 57 patients included, and 23% (7/31) improved to non-SPI after PR. We observed no differences between patients with SPI and non-SPI, except baseline plasma fibrinogen level was slightly yet significantly higher in patients with SPI (median 13.3 [6.2–23.6] vs 11.2 [6.5–16.7] µmol/l) but change in fibrinogen levels differed insignificantly between patients who improved to non-SPI at follow-up compared to patients with persistent SPI (−0.6 [−16.9–9.9] vs −0.4 [−11.2–1.2] µmol/l). Conclusion: SPI in COPD appears not to be associated with a distinct inflammatory profile compared to less sedentary COPD patients attending pulmonary rehabilitation. Currently biomarkers have no role in the detection of SPI in COPD.