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Article ; Online: The Association between Objectively Measured Physical Activity and the Prevalence of Comorbidities in Lung Transplant Recipients.

Breuls, Sofie / Blondeel, Astrid / Wuyts, Marieke / Verleden, Geert M / Vos, Robin / Janssens, Wim / Troosters, Thierry / Demeyer, Heleen

Respiration; international review of thoracic diseases

2024 Volume 103, Issue 5, Page(s) 251–256

Abstract: Introduction: Lung transplant recipients are often physically inactive and are at risk of developing comorbidities. We investigated whether objectively measured physical activity was associated with the prevalence of comorbidities.: Methods: Physical ...

Abstract	Introduction: Lung transplant recipients are often physically inactive and are at risk of developing comorbidities. We investigated whether objectively measured physical activity was associated with the prevalence of comorbidities. Methods: Physical activity (accelerometry) and the presence of cardiovascular disease, symptoms of depression and anxiety, diabetes, dyslipidaemia, hypertension, lower extremity artery disease, muscle weakness, obesity, and osteoporosis were assessed in 108 lung transplant recipients. Patients were divided into four groups based on daily step count. Results: A cohort of 108 patients (60 ± 7 years, 51% male, 20 ± 14 months since transplantation) was included. Active patients (>7,500 steps/day) had significantly fewer comorbidities (4 comorbidities) compared to severely inactive patients (<2,500 steps/day, 6 comorbidities), and muscle weakness and high symptoms of depression were less prevalent. Severely inactive patients had significantly more cardiovascular comorbidities compared to all other groups. No other significant differences were observed. Conclusion: Physically active lung transplant recipients have fewer comorbidities, lower prevalence of muscle weakness, and fewer symptoms of depression compared to very inactive patients.
MeSH term(s)	Humans ; Male ; Lung Transplantation ; Middle Aged ; Female ; Comorbidity ; Prevalence ; Aged ; Depression/epidemiology ; Exercise ; Cardiovascular Diseases/epidemiology ; Muscle Weakness/epidemiology ; Muscle Weakness/etiology ; Hypertension/epidemiology ; Diabetes Mellitus/epidemiology ; Osteoporosis/epidemiology ; Accelerometry ; Anxiety/epidemiology ; Dyslipidemias/epidemiology ; Obesity/epidemiology ; Obesity/complications ; Transplant Recipients/statistics & numerical data
Language	English
Publishing date	2024-03-08
Publishing country	Switzerland
Document type	Journal Article ; News
ZDB-ID	206674-9
ISSN	1423-0356 ; 0025-7931
ISSN (online)	1423-0356
ISSN	0025-7931
DOI	10.1159/000536607
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Article ; Online: Accuracy of consumer-based activity trackers as measuring tool and coaching device in patients with COPD and healthy controls.

Blondeel, Astrid / Demeyer, Heleen / Janssens, Wim / Troosters, Thierry

PloS one

2020 Volume 15, Issue 8, Page(s) e0236676

Abstract: Background: Consumer-based activity trackers are used to measure and improve physical activity. However, the accuracy of these devices as clinical endpoint or coaching tool is unclear. We investigated the use of two activity trackers as measuring and ... ...

Abstract	Background: Consumer-based activity trackers are used to measure and improve physical activity. However, the accuracy of these devices as clinical endpoint or coaching tool is unclear. We investigated the use of two activity trackers as measuring and coaching tool in patients with Chronic Obstructive Pulmonary Disease (COPD) and healthy age-matched controls. Methods: Daily steps were measured by two consumer-based activity trackers (Fitbit Zip, worn at the hip and Fitbit Alta, worn at the wrist) and a validated activity monitor (Dynaport Movemonitor) in 28 patients with COPD and 14 healthy age-matched controls for 14 consecutive days. To investigate the accuracy of the activity trackers as a clinical endpoint, mean step count per patient were compared with the reference activity monitor and agreement was investigated by Bland-Altman plots. To evaluate the accuracy of activity trackers as coaching tool, day-by-day differences within patients were calculated for all three devices. Additionally, consistency of ranking daily steps between the activity trackers and accelerometer was investigated by Kendall correlation coefficient. Results: As a measuring tool, the hip worn activity tracker significantly underestimates daily step count in patients with COPD as compared to DAM (mean±SD Δ-1112±872 steps/day; p<0.0001). This underestimation is less prominent in healthy subjects (p = 0.21). The wrist worn activity tracker showed a non-significant overestimation of step count (p = 0.13) in patients with COPD, and a significant overestimation of daily steps in healthy controls (mean±SD Δ+1907±2147 steps/day; p = 0.006). As a coaching tool, both hip and wrist worn activity tracker were able to pick up the day-by-day variability as measured by Dynaport (consistency of ranking resp. r = 0.80; r = 0.68 in COPD). Conclusion: Although the accuracy of hip worn consumer-based activity trackers in patients with COPD and wrist worn activity trackers in healthy subjects as clinical endpoints is unsatisfactory, these devices are valid to use as a coaching tool.
MeSH term(s)	Accelerometry/instrumentation ; Aged ; Case-Control Studies ; Data Collection/instrumentation ; Exercise ; Female ; Fitness Trackers ; Humans ; Male ; Mentoring ; Middle Aged ; Monitoring, Ambulatory/instrumentation ; Pulmonary Disease, Chronic Obstructive
Language	English
Publishing date	2020-08-04
Publishing country	United States
Document type	Evaluation Study ; Journal Article ; Research Support, Non-U.S. Gov't
ISSN	1932-6203
ISSN (online)	1932-6203
DOI	10.1371/journal.pone.0236676
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Article ; Online: Sustaining training effects through physical activity coaching (STEP): a randomized controlled trial.

Loeckx, Matthias / Rodrigues, Fernanda M / Blondeel, Astrid / Everaerts, Stephanie / Janssens, Wim / Demeyer, Heleen / Troosters, Thierry

The international journal of behavioral nutrition and physical activity

2023 Volume 20, Issue 1, Page(s) 121

Abstract: Background: Pulmonary rehabilitation (PR) programs improve physical fitness, symptoms and quality of life (QoL) of patients with COPD. However, improved physical activity (PA) is not guaranteed after PR and the clinical benefits fade off after PR ... ...

Abstract	Background: Pulmonary rehabilitation (PR) programs improve physical fitness, symptoms and quality of life (QoL) of patients with COPD. However, improved physical activity (PA) is not guaranteed after PR and the clinical benefits fade off after PR discharge. We aimed to investigate whether a 9 months PA-telecoaching program is able to improve PA of patients with COPD, after 3 months of PR and if this leads to maintenance of PR-acquired benefits. Methods: Patients with COPD enrolled in a 6-month PR program were randomized to a (semi-automated) PA-telecoaching program or usual care, 3 months after PR initiation. The intervention consisted of a smartphone application with individual targets and feedback (for 6 months) and self-monitoring with a step counter (for 9 months). Patients were followed up for 9 months after randomization. Primary outcome was PA (daily step count by accelerometery), secondary outcomes were exercise tolerance, quadriceps force, dyspnea and QoL. Results: Seventy-three patients were included (mean ± SD: 65 ± 7 years, FEV Conclusion: The semi-automated PA-telecoaching program implemented after 3 months of PR was effective to improve the amount of PA (steps/day) during PR and after follow-up. However, this was not accompanied by the maintenance of other PR-acquired benefits. Trial registration: ClinicalTrials.gov. Identifier: NCT02702791. Retrospectively registered on March 9, 2016. Start study October 2015. https://clinicaltrials.gov/ct2/show/NCT02702791?term=NCT02702791&draw=2&rank=1 .
MeSH term(s)	Humans ; Quality of Life ; Mentoring ; Exercise ; Exercise Therapy ; Pulmonary Disease, Chronic Obstructive/therapy
Language	English
Publishing date	2023-10-10
Publishing country	England
Document type	Randomized Controlled Trial ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2134691-4
ISSN	1479-5868 ; 1479-5868
ISSN (online)	1479-5868
ISSN	1479-5868
DOI	10.1186/s12966-023-01519-w
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Article ; Online: Validation of Commercial Activity Trackers in Everyday Life of People with Parkinson's Disease.

Ginis, Pieter / Goris, Maaike / De Groef, An / Blondeel, Astrid / Gilat, Moran / Demeyer, Heleen / Troosters, Thierry / Nieuwboer, Alice

Sensors (Basel, Switzerland)

2023 Volume 23, Issue 8

Abstract: Maintaining physical activity is an important clinical goal for people with Parkinson's disease (PwPD). We investigated the validity of two commercial activity trackers (ATs) to measure daily step counts. We compared a wrist- and a hip-worn commercial AT ...

Abstract	Maintaining physical activity is an important clinical goal for people with Parkinson's disease (PwPD). We investigated the validity of two commercial activity trackers (ATs) to measure daily step counts. We compared a wrist- and a hip-worn commercial AT against the research-grade Dynaport Movemonitor (DAM) during 14 days of daily use. Criterion validity was assessed in 28 PwPD and 30 healthy controls (HCs) by a 2 × 3 ANOVA and intraclass correlation coefficients (ICC
MeSH term(s)	Humans ; Fitness Trackers ; Parkinson Disease ; Accelerometry ; Reproducibility of Results ; Exercise
Language	English
Publishing date	2023-04-21
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2052857-7
ISSN	1424-8220 ; 1424-8220
ISSN (online)	1424-8220
ISSN	1424-8220
DOI	10.3390/s23084156
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Article ; Online: The role of physical activity in the context of pulmonary rehabilitation.

Blondeel, Astrid / Demeyer, Heleen / Janssens, Wim / Troosters, Thierry

COPD

2019 Volume 15, Issue 6, Page(s) 632–639

Abstract: Pulmonary rehabilitation is an important treatment for patients with chronic obstructive pulmonary disease (COPD). Although this intervention leads to large and clinically meaningful improvements in exercise capacity and quality of life, the effect of ... ...

Abstract	Pulmonary rehabilitation is an important treatment for patients with chronic obstructive pulmonary disease (COPD). Although this intervention leads to large and clinically meaningful improvements in exercise capacity and quality of life, the effect of pulmonary rehabilitation on physical activity is controversial. Physical activity is lower in patients with COPD as compared to healthy age-matched controls and it is related to important health outcomes (e.g. increased risk of mortality and hospitalization). It is an important goal for rehabilitation programs to enhance physical activity to more normal levels in order to achieve the ultimate goal of rehabilitation 'to improve adherence to health enhancing behaviors'. This review discusses the role of physical activity in the context of pulmonary rehabilitation and possible ways to embed interventions geared to behavior change (i.e. to enhance physical activity) and exercise training (i.e. to enhance physical fitness) into comprehensive rehabilitation programs for patients with COPD.
MeSH term(s)	Behavior Therapy ; Breathing Exercises ; Exercise/physiology ; Exercise Therapy/methods ; Exercise Tolerance ; Health Behavior ; Humans ; Physical Fitness ; Pulmonary Disease, Chronic Obstructive/physiopathology ; Pulmonary Disease, Chronic Obstructive/rehabilitation
Language	English
Publishing date	2019-02-04
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	2171107-0
ISSN	1541-2563 ; 1541-2555
ISSN (online)	1541-2563
ISSN	1541-2555
DOI	10.1080/15412555.2018.1563060
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Article ; Online: The past, present and future of pulmonary rehabilitation.

Troosters, Thierry / Blondeel, Astrid / Janssens, Wim / Demeyer, Heleen

Respirology (Carlton, Vic.)

2019 Volume 24, Issue 9, Page(s) 830–837

Abstract: Abundant evidence supports the use of pulmonary rehabilitation as a treatment for stable and exacerbated chronic obstructive pulmonary disease. Several questions around the science base of rehabilitation in other patient groups as well as the role of ... ...

Abstract	Abundant evidence supports the use of pulmonary rehabilitation as a treatment for stable and exacerbated chronic obstructive pulmonary disease. Several questions around the science base of rehabilitation in other patient groups as well as the role of rehabilitation as a component in other comprehensive care trajectories remain to be addressed. The impact of a rehabilitation programme could also perhaps be enhanced if clear guidance would be available on how to individualize the components of a rehabilitation programme in individual patients. The rehabilitation community, in an attempt to increase access to programmes, has developed less rigorous interventions. These may serve specific patients (e.g. less severe patients or may be used as a maintenance programme), but in order to have conceptual clarity they should not be called substitutes for rehabilitation if they do not meet the definition of rehabilitation. Reaching clarity on the best format for maintenance programmes in order to achieve long-lasting health benefits for patients is another challenge. Furthermore, as many patients as possible should be referred to adequate rehabilitation programmes within their reach with fair reimbursement. Programmes should take into account the burden of the disease of a patient, the required components to tackle the problems, adequate assessment to document the outcome and the patient's preference. In summary, pulmonary rehabilitation is one of the most potent evidence-based therapies for patients with respiratory diseases. Researchers should continue to fine tune the interventions, get clarity on terminology as well as the ultimate outcomes for rehabilitation to ensure sustainable health effects.
MeSH term(s)	Humans ; Physical Therapy Modalities ; Respiratory Tract Diseases/rehabilitation
Language	English
Publishing date	2019-03-13
Publishing country	Australia
Document type	Journal Article ; Review
ZDB-ID	1435849-9
ISSN	1440-1843 ; 1323-7799
ISSN (online)	1440-1843
ISSN	1323-7799
DOI	10.1111/resp.13517
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Article ; Online: Physical activity pattern of patients with interstitial lung disease compared to patients with COPD: A propensity-matched study.

Breuls, Sofie / Pereira de Araujo, Cintia / Blondeel, Astrid / Yserbyt, Jonas / Janssens, Wim / Wuyts, Wim / Troosters, Thierry / Demeyer, Heleen

PloS one

2022 Volume 17, Issue 11, Page(s) e0277973

Abstract: Introduction: Physical activity (PA) is reduced in patients with interstitial lung disease (ILD) and chronic obstructive pulmonary disease (COPD). Evidence about the PA pattern of patients with ILD is scarce. If PA of patients with ILD would be ... ...

Abstract	Introduction: Physical activity (PA) is reduced in patients with interstitial lung disease (ILD) and chronic obstructive pulmonary disease (COPD). Evidence about the PA pattern of patients with ILD is scarce. If PA of patients with ILD would be comparable to COPD, it is tempting to speculate that existing interventions focusing on enhancing PA could be as effective in ILD as already shown in COPD. Therefore, we aimed to compare PA and the correlates with PA in matched patients with ILD, COPD, and healthy subjects. Materials and methods: Patients with ILD (n = 45), COPD (n = 45) and healthy subjects (n = 30) were propensity matched. PA level, pattern, and PA correlations with lung function and physical performance (6-minute walking distance and quadriceps force) were compared between groups. Results: Daily number of steps was similar in both patient groups (mean±SE: 5631±459 for ILD, 5544±547 for COPD, p = 0.900), but significantly lower compared to healthy subjects (10031±536, p<0.001 for both). Mean intensity of PA tended to be lower in the ILD group (mean±SE metabolic equivalents of task per day: 1.41±0.04) compared to COPD (1.52±0.05, p = 0.074) and healthy individuals (1.67±0.04, p<0.001). The pattern of PA over one day was found to be similar between the three groups. Lastly, the correlation between PA and 6-minute walking distance was significantly weaker in patients with ILD compared to patients with COPD (respectively r = 0.348 and r = 0.739; p<0.05 for both). Conclusions: For a given functional reserve, patients with ILD perform an equal amount of steps but perform PA at lower intensity compared to patients with COPD. Both groups are less active compared to healthy control subjects. Functional exercise capacity was shown to be only moderately related to PA. This can potentially influence the effectiveness of PA interventions that can be expected.
MeSH term(s)	Humans ; Pulmonary Disease, Chronic Obstructive ; Lung Diseases, Interstitial ; Exercise ; Health Status
Language	English
Publishing date	2022-11-21
Publishing country	United States
Document type	Journal Article
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0277973
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Article ; Online: Can COPD Exacerbations Be Picked Up Early

Blondeel, Astrid / Demeyer, Heleen / Breuls, Sofie / Wuyts, Marieke / Glorie, Lies / De Maeyer, Nikolaas / Janssens, Wim / Troosters, Thierry

Frontiers in rehabilitation sciences

2022 Volume 2, Page(s) 814704

Abstract: Background: Exacerbations affect the disease trajectory of patients with COPD and result in an acute drop of functional status and physical activity. Timely detection of exacerbations by non-medical healthcare professionals is needed to counteract this ... ...

Abstract	Background: Exacerbations affect the disease trajectory of patients with COPD and result in an acute drop of functional status and physical activity. Timely detection of exacerbations by non-medical healthcare professionals is needed to counteract this decline. The use of digital health applications in patient interaction allows embedded detection of exacerbations. However, it is unknown if this is an effective way to pick up exacerbations. Method: We investigated the detection of exacerbations in patients with COPD enrolled in a physical activity coaching program, by prompting a weekly question on changes in medication via the smartphone application. Data on response rate and occurrence of exacerbations were collected. Results: Response rate to the medication question, evaluated in 42 patients, was 72% ( Conclusion: Electronic interaction through a weekly medication question, embedded in a smartphone application, is feasible to support the detection of the occurrence of COPD exacerbations and can be used complementary to regular forms of detecting exacerbations. Compliance and smartphone literacy should be optimized when further using this method to report on COPD exacerbations.
Language	English
Publishing date	2022-01-26
Publishing country	Switzerland
Document type	Journal Article
ISSN	2673-6861
ISSN (online)	2673-6861
DOI	10.3389/fresc.2021.814704
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Article: The association of weather conditions with day-to-day variability in physical activity in patients with COPD.

Blondeel, Astrid / Hermans, Fien / Breuls, Sofie / Wuyts, Marieke / De Maeyer, Nikolaas / Verniest, Thessa / Derom, Eric / Van Calster, Ben / Janssens, Wim / Troosters, Thierry / Demeyer, Heleen

ERJ open research

2023 Volume 9, Issue 6

Abstract: Background: While patients with COPD often cite weather conditions as a reason for inactivity, little is known about the relationship between physical activity (PA) and weather conditions. The present study investigated the association of day-to-day ... ...

Abstract	Background: While patients with COPD often cite weather conditions as a reason for inactivity, little is known about the relationship between physical activity (PA) and weather conditions. The present study investigated the association of day-to-day weather changes on PA in patients with COPD and investigated patient characteristics related to being more or less influenced by weather conditions. Methods: In this longitudinal analysis, device-based day-by-day step counts were objectively measured in COPD patients for up to 12 months. Daily meteorological data (temperature, precipitation, wind speed, hours of sunlight and daylight) were linked to the daily step count and individual and multivariable relationships were investigated using mixed-model effects. Individual R Results: We included 50 patients with a mean±sd follow-up time of 282±93 days, totalling 14 117 patient-days. Daily temperature showed a positive linear pattern up until an inflexion point, after which a negative association with increasing temperature was observed (p<0.0001). Sunshine and daylight time had a positive association with PA (p<0.0001). Precipitation and wind speed were negatively associated with PA (p<0.0001). The median per-patient R Conclusion: Weather conditions are partly associated with PA in patients with COPD, yet the overall explained variance of PA due to weather conditions is rather low and varied strongly between individuals.
Language	English
Publishing date	2023-11-13
Publishing country	England
Document type	Journal Article
ZDB-ID	2827830-6
ISSN	2312-0541
ISSN	2312-0541
DOI	10.1183/23120541.00314-2023
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Article ; Online: Factors associated to physical activity in patients with COPD: An ecological approach.

Blondeel, Astrid / Hermans, Fien / Breuls, Sofie / Wuyts, Marieke / Everaerts, Stephanie / Gyselinck, Iwein / De Maeyer, Nikolaas / Verniest, Thessa / Derom, Eric / Janssens, Wim / Troosters, Thierry / Demeyer, Heleen

Respiratory medicine

2023 Volume 219, Page(s) 107424

Abstract: Background: Physical activity (PA) is low in patients with Chronic Obstructive Pulmonary Disease (COPD). Identifying modifiable and non-modifiable correlates of PA give understanding of the individual behavior and provide future directions for PA ... ...

Abstract	Background: Physical activity (PA) is low in patients with Chronic Obstructive Pulmonary Disease (COPD). Identifying modifiable and non-modifiable correlates of PA give understanding of the individual behavior and provide future directions for PA enhancing interventions. As PA is complex and multidimensional, it should be embedded within a thorough framework. Objective: To identify correlates of PA in a comprehensive COPD population based on a broad ecological model, including physiological, psychological, socio-demographic and environmental dimensions. Methods: PA was objectively measured using the Dynaport Movemonitor and a comprehensive data collection of physiological, psychological, socio-demographic and environmental factors were collected. Bivariable and multivariable regression analyses (including principle component analysis) were executed. Results: For this cross-sectional analysis, we included 148 patients with COPD and valid PA data (mean (SD) age 68 (7) years, FEV1 57 (17) % predicted, 5613 (3596) steps per day). Significant bivariable associations were found for physiological (exercise capacity, muscle force, lung function, symptoms, comorbidities), psychological (e.g. fatigue, motivation, perceived difficulty with PA), socio-demographic (dog owning, use of activity tracker) and environmental (season, daylight, temperature) factors. Based on the multivariable regression model, exercise capacity, beliefs on motivation, importance and self-confidence regarding PA and weather conditions were independent correlates of mean steps per day (R Conclusion: Although a wide range of potential influence factors were evaluated, variance in PA was only partly explained, supporting that PA is a complex behavior which is difficult to predict.
MeSH term(s)	Humans ; Animals ; Dogs ; Aged ; Cross-Sectional Studies ; Pulmonary Disease, Chronic Obstructive ; Walking/physiology ; Comorbidity ; Regression Analysis
Language	English
Publishing date	2023-10-10
Publishing country	England
Document type	Journal Article
ZDB-ID	1003348-8
ISSN	1532-3064 ; 0954-6111
ISSN (online)	1532-3064
ISSN	0954-6111
DOI	10.1016/j.rmed.2023.107424
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