168 Real-world walking of people with the chronic lung disease COPD

TL;DR

People with COPD walk less and differently than healthy adults, and these differences worsen as the disease progresses.

Contribution

Identified six distinct domains of real-world walking in COPD using wearable devices.

Findings

Most walking activity and gait parameters were reduced in COPD patients compared to healthy adults.

Differences remained significant after adjusting for age, sex, height, and comorbidities.

Factor analysis revealed six walking domains: amount, patterns, pace, rhythm, and their variability.

Abstract

Walking is crucial for active and healthy ageing, but it changes with age and in the presence of diverse health conditions, such as non-communicable diseases. In the field of the chronic lung disease COPD (chronic obstructive pulmonary disease), extensive research has been done on physical activity limitation, but little is known about the patterns of walking during daily life (i.e., real-world). We aimed to assess the levels and distribution of real-world walking (walking activity and gait parameters) in people with COPD compared with healthy adults, and across disease severity; and to identify domains of walking in COPD, using a single wearable device.

In a cross-sectional study, 550 people with COPD (37% women, with a mean (SD) age of 68 (8) years, postbronchodilator FEV1 54 (21) %) and 19 age-matched healthy adults were recruited in ten cities across eight countries. Subjects were given a single wearable device to wear at their lower back for one week. Twenty-five walking activity and gait parameters (e.g., number of steps, number of walking bouts (WB)>30s, walking speed in WB > 30s, cadence in WB > 30s, walking speed and cadence variability) were derived from the device outputs.

Most walking activity and gait parameters were reduced in people with COPD compared to healthy adults, and according to COPD severity. Differences remained statistically significant after adjusting for age, sex, height and comorbidities in multivariable analyses. Factor analysis identified six distinct walking domains: Amount of walking, Patterns of walking, Pace, Rhythm, Pace variability and Rhythm variability.

Real-world walking in people with COPD is a multi-dimensional behaviour that is impaired as the disease progresses. These results may be used to set priorities and improve patient centricity in clinical practice, research and public health initiatives.

This work was supported by the Mobilise-D project that has received funding from the Innovative Medicines Initiative 2 Joint Undertaking (JU) under grant agreement No. 820820. This JU receives support from the European Union’s Horizon 2020 research and innovation programme and the European Federation of Pharmaceutical Industries and Associations (EFPIA).