Display options
Share it on

J Clin Med. 2016 Aug 18;5(8). doi: 10.3390/jcm5080073.

Physical Activity and Exertional Desaturation Are Associated with Mortality in Idiopathic Pulmonary Fibrosis.

Journal of clinical medicine

Baruch Vainshelboim, Mordechai Reuven Kramer, Shimon Izhakian, Ricardo M Lima, Jose Oliveira

Affiliations

  1. Pulmonary Institute, Rabin Medical Center, Beilinson Hospital, Petach Tikva 4941492, Israel. [email protected].
  2. Research Center in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto, Porto 4200-450, Portugal. [email protected].
  3. Cardiology Division, Veterans Affairs Palo Alto Health Care System/Stanford University, Palo Alto, CA 94304, USA. [email protected].
  4. Pulmonary Institute, Rabin Medical Center, Beilinson Hospital, Petach Tikva 4941492, Israel. [email protected].
  5. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel. [email protected].
  6. Pulmonary Institute, Rabin Medical Center, Beilinson Hospital, Petach Tikva 4941492, Israel. [email protected].
  7. Cardiology Division, Veterans Affairs Palo Alto Health Care System/Stanford University, Palo Alto, CA 94304, USA. [email protected].
  8. Faculty of Physical Education, University of Brasília, Brasília 70910-900, Brazil. [email protected].
  9. Research Center in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto, Porto 4200-450, Portugal. [email protected].

PMID: 27548238 PMCID: PMC4999793 DOI: 10.3390/jcm5080073

Abstract

Idiopathic pulmonary fibrosis (IPF) is a chronic lung disease that manifests in hypoxemia, inactivity, and poor prognosis. This study aimed to assess the prognostic role of physical activity (PA) and exertional desaturation (ED) with mortality in IPF. At baseline, 34 IPF patients (68 (50-81) years) were interviewed using the International Physical Activity Questionnaire (IPAQ), and SpO₂ was assessed pre to post 6-min walking test (∆SpO₂). Patients were prospectively followed up for 40 months. Receiver operating characteristics curve analysis determined cut-off points associated with mortality, and Cox proportional hazard ratio (HR) were conducted. Thresholds for increased mortality risk in IPF patients were determined as IPAQ ≤ 417 metabolic equivalent task (METS)-min/week, p = 0.004 (HR; 9.7, CI 95% (1.3-71.9), p = 0.027), and ∆SpO₂ ≥ 10%, p = 0.002, (HR; 23.3, CI 95% (1.5-365), p = 0.025). This study demonstrated a significant association of PA and ED with mortality in IPF patients. The findings emphasize the clinical importance of PA and ED assessments to aid in IPF risk stratification, prognosis prediction, and in providing early appropriate treatments, such as pulmonary rehabilitation, PA consultation, oxygen supplementation, and lung transplantation referral. These results underscore that even low levels of PA corresponding to 100-105 min/week were associated with a reduced mortality risk and better survival in IPF.

Keywords: exercise; inactivity; international physical activity questionnaire; interstitial lung disease; pulmonary rehabilitation

References

  1. Eur Respir J. 2012 Jul;40(1):101-9 - PubMed
  2. Mayo Clin Proc. 2015 Nov;90(11):1533-40 - PubMed
  3. Rev Mal Respir. 2011 Mar;28(3):290-6 - PubMed
  4. Am J Respir Crit Care Med. 2013 Oct 15;188(8):e13-64 - PubMed
  5. Respiration. 2015;90(6):460-7 - PubMed
  6. J Cardiopulm Rehabil Prev. 2016 Jul-Aug;36(4):270-8 - PubMed
  7. Eur Respir J. 2014 Dec;44(6):1521-37 - PubMed
  8. Eur Respir J. 2014 May;43(5):1421-9 - PubMed
  9. Int J Behav Nutr Phys Act. 2012 Aug 31;9:103 - PubMed
  10. Am J Respir Crit Care Med. 2007 Aug 1;176(3):277-84 - PubMed
  11. Respirology. 2015 May;20(4):640-6 - PubMed
  12. Thorax. 2006 Sep;61(9):772-8 - PubMed
  13. Lancet. 2012 Jul 21;380(9838):219-29 - PubMed
  14. Med Sci Sports Exerc. 2011 Jul;43(7):1334-59 - PubMed
  15. Med Sci Sports Exerc. 2009 Jul;41(7):1510-30 - PubMed
  16. Am J Respir Crit Care Med. 2002 Jul 1;166(1):111-7 - PubMed
  17. Br J Sports Med. 2015 Oct;49(19):1262-7 - PubMed
  18. Chest. 2011 Aug;140(2):331-42 - PubMed
  19. Circulation. 2007 Aug 28;116(9):1094-105 - PubMed
  20. J Am Coll Cardiol. 2014 Aug 5;64(5):472-81 - PubMed
  21. Respir Care. 2014 Dec;59(12):1872-9 - PubMed
  22. Chest. 2013 Nov;144(5):1652-8 - PubMed
  23. Lung. 2015 Jun;193(3):345-54 - PubMed
  24. Lancet. 2012 Jul 21;380(9838):247-57 - PubMed
  25. Circulation. 2007 Aug 28;116(9):1081-93 - PubMed
  26. Am J Respir Crit Care Med. 2003 Nov 1;168(9):1084-90 - PubMed
  27. Eur Respir J. 2005 Oct;26(4):720-35 - PubMed
  28. Respir Care. 2016 Aug;61(8):1100-9 - PubMed
  29. BMJ. 1993 May 1;306(6886):1181-4 - PubMed
  30. Int J Behav Nutr Phys Act. 2011 Jul 28;8:80 - PubMed
  31. Thorax. 2008 Jun;63(6):549-54 - PubMed
  32. Am J Respir Crit Care Med. 2006 Oct 1;174(7):803-9 - PubMed
  33. Res Q Exerc Sport. 2000 Jun;71(2 Suppl):S114-20 - PubMed
  34. Eur Respir J. 2005 Sep;26(3):511-22 - PubMed
  35. Respir Med. 2005 Jun;99(6):755-61 - PubMed
  36. Am J Respir Crit Care Med. 2011 Mar 15;183(6):788-824 - PubMed
  37. Arch Phys Med Rehabil. 2016 May;97(5):788-97 - PubMed
  38. Malawi Med J. 2012 Sep;24(3):69-71 - PubMed
  39. Eur Respir J Suppl. 1993 Mar;16:5-40 - PubMed
  40. Respir Med. 2009 Jan;103(1):117-23 - PubMed
  41. Am J Respir Crit Care Med. 2006 Sep 15;174(6):659-64 - PubMed
  42. Lancet. 2011 Oct 1;378(9798):1244-53 - PubMed
  43. Respir Med. 2008 Dec;102(12):1675-80 - PubMed
  44. Sarcoidosis Vasc Diffuse Lung Dis. 2011 Oct;28(2):102-12 - PubMed
  45. Chest. 1988 Mar;93(3):580-6 - PubMed
  46. Respiration. 2014;88(5):378-88 - PubMed
  47. JAMA. 1995 Feb 1;273(5):402-7 - PubMed
  48. Orphanet J Rare Dis. 2008 Mar 26;3:8 - PubMed
  49. Med Sci Sports Exerc. 2003 Aug;35(8):1381-95 - PubMed
  50. Int J Behav Nutr Phys Act. 2011 Oct 21;8:115 - PubMed
  51. Eur Respir J. 2005 Jul;26(1):153-61 - PubMed
  52. CMAJ. 2006 Mar 14;174(6):801-9 - PubMed

Publication Types