The usefulness of pedometry in patients with chronic obstructive pulmonary disease

BACKGROUND: Effort tolerance and daily physical activity (DPA) are predictive of quality of life and survival in COPD patients, but still remain difficult to assess based on their daily life. The aim of this study was: how to relate pedometry to other classic parameters commonly used in pulmonary rehabilitation (PR). METHODS: DPA was evaluated through pedometry. 74 patients with COPD, aged 63.55 ± 8.73 (12 stage II, FEV(1) = 60.16 ± 7.78%), (29 stage III, FEV(1) = 39.07 ± 6.30%), (33 stage IV, FEV(1) = 23.1 ± 7.18%). The monitoring was conducted for a period of 7 days before and 6 months after a pulmonary rehabilitation program (PRP) of 3 weeks. A control group consisting of 21 patients with stable COPD was evaluated initially, but they did not undergo Pulmonary Rehabilitation Program (PRP). After 6 months the patients were re-evaluated using the same parameters. RESULTS AND DISCUSSION: The values are widely dispersed, with a maximum of 17,420 and minimum of 964 steps/24hrs. The average values acquired were: the lowest in COPD stage IV (2476→3112 steps/24 hrs, p < 0.0001), still with the highest increase over 6 months of PR + 636steps/24hrs; in COPD stage III the increase of DPA was + 597steps/24hrs over 6 months (5627→6224, p < 0.0001), COPD stage II registered the lowest increase + 540steps/24hrs (8724→9264, p < 0.13), probably because the subjects belonging to this stage had the best preserved DPA. The results show moderate correlation between pedometry and the 6MWT and the SGQ. (r = 0.5-0.7). However it demonstrated the positive effects of PRP, even after 6 months. CONCLUSIONS: DPA decreases with increasing COPD stage, it is fluctuant with every subject, dependent on clinical status, weather and daily schedule. Wearing pedometers is very easy and motivational, provided that patients realize that they are being “watched”.