PT  - JOURNAL ARTICLE
AU  - Ayedh AlAhmari
AU  - Anant Patel
AU  - Beverly Kowlessar
AU  - Alex Mackay
AU  - Richa Singh
AU  - James Allinson
AU  - Jadwiga Wedzicha
AU  - Gavin Donaldson
TI  - Time course of daily activity at COPD exacerbation
DP  - 2013 Sep 01
TA  - European Respiratory Journal
PG  - P3685
VI  - 42
IP  - Suppl 57
4099  - http://erj.ersjournals.com/content/42/Suppl_57/P3685.short
4100  - http://erj.ersjournals.com/content/42/Suppl_57/P3685.full
SO  - Eur Respir J2013 Sep 01; 42
AB  - COPD patients may have reduced daily physical activity (DPA), which worsens during acute exacerbations. Early pulmonary rehabilitation (EPR) post-exacerbation may not be feasible in more symptomatic patients. We investigated DPA alongside symptoms and airflow limitation during COPD exacerbations.Patients recorded any increase in respiratory symptoms, peak expiratory flow (PEF) every morning, hours spent outdoors and the number of steps walked daily using a pedometer (Yamax SW-200) on daily diary cards. Exacerbations were defined by our usual symptomatic criteria (Seemungal et al, AJRCCM 1998).37 COPD patients (28 male) had a mean (±SD) age of 70 (±7) years and FEV1 52 (±15)% predicted. 79 exacerbations were captured and data from repeat exacerbations were averaged. Pre, versus post-exacerbation data were analysed with paired t-tests. Mean daily steps in the first week post-exacerbation week was 480 (±1407) steps/day lower than over a week, starting two weeks earlier (p=0.045) and took one week to recover (fig.1A). Similarly, mean symptom count rose by 1.9 (±1.3) p<0.001 (fig.1B), but took longer to recover and PEF fell by 6.7 (±13.3) L/min (p=0.005) fig.1C. There was no significant difference in time outdoors (p=0.13) fig.1D.DPA measured by pedometry fell during COPD exacerbations, likely due to increased symptoms and airflow limitation – although no change in outdoors activity. One week post-exacerbation may be the optimal day for starting EPR.