Associação do conhecimento e automanejo da doença no tempo sedentário e inatividade física em indivíduos com DPOC
Association of disease knowledge and management on sedentary time and physical inactivity in individuals with COPD
Heloisa Krokoch, Thais Moçatto Tofoli, Laís Santin, Franciele Del Nobile, Amanda Pucca, Gustavo Pakuszewski, Fabio Pitta
Resumo
Introdução: A doença pulmonar obstrutiva crônica (DPOC) é caracterizada por obstrução persistente das vias aéreas e manifestações sistêmicas, gerando sintomas como dispneia e fadiga, que contribuem para um comportamento de inatividade física e alto tempo sedentário na vida diária. Ainda não está claro, porém, se o conhecimento sobre a doença tem alguma correlação com esse comportamento. Objetivo: Identificar se o nível de conhecimento e o automanejo da doença em indivíduos com DPOC se correlacionam com piores níveis de sedentarismo, inatividade física ou ambos. Métodos: Trata-se de um estudo transversal que incluiu pacientes com DPOC submetidos à avaliação da atividade física na vida diária durante sete dias consecutivos por meio do uso de um acelerômetro. Adicionalmente, foi realizada a avaliação da função pulmonar por meio de espirometria e avaliação do conhecimento da doença por meio do uso dos questionários Understanding COPD (UCOPD) e Pulmonary Rehabilitation Adapted Index of Self-Efficacy (PRAISE). Resultados: 34 indivíduos com DPOC foram analisados (17 homens, 69±6 anos, VEF1 48±19%pred). Observou-se correlação inexistente ou fraca e sem significância estatística entre o tempo gasto/dia em atividade física moderada a vigorosa (AFMV) com os questionários PRAISE e UCOPD (r= 0,25 e 0,10, respectivamente, p>0,05 para ambos), assim como também entre o tempo sedentário/dia com os mesmos instrumentos (r= -0,05 e 0,25, respectivamente, p>0,05 para ambos). Conclusão: Em indivíduos com DPOC, o nível de inatividade física e comportamento sedentário não se correlacionam de forma relevante com o conhecimento e o automanejo da doença.
Palavras-chave
Abstract
Background: Chronic obstructive pulmonary disease (COPD) is characterized by persistent airway obstruction and systemic manifestations, leading to symptoms such as dyspnea and fatigue, which contribute to a typical behavior of physical inactivity and high sedentary time in daily life. However, it is still unclear whether disease knowledge has any correlation with this behavior. Aim: To identify whether the level of knowledge and disease self-management in individuals with COPD are correlated with higher levels of sedentary behavior, physical inactivity, or both. Methods: This is a cross-sectional study including individuals with COPD who underwent assessment of physical activity in daily life over seven consecutive days using an accelerometer. Additionally, pulmonary function was assessed by spirometry, and disease knowledge was evaluated using the Understanding COPD (UCOPD) and the Pulmonary Rehabilitation Adapted Index of Self-Efficacy (PRAISE) questionnaires. Results: 34 individuals with COPD were analyzed (17 men, 69±6 years, FEV1 48±19% predict). Only weak or non-existing and not statistically significant correlations were observed between time spent/day in activities of moderate-to-vigorous intensity (MVPA) and the PRAISE and UCOPD questionnaires (r = 0.25 and 0.10, respectively, p > 0.05 for both), as well as between sedentary time and the same instruments (r = -0.05 and 0.25, respectively, p>0.05 for both).Conclusion: In individuals with COPD, the level of physical inactivity and sedentary behavior are not well correlated with the knowledge and self-management of the disease.
Keywords
References
1. Warburton DE, Nicol CW, Bredin SS. Health benefits of physical activity: the evidence. CMAJ. 2006;174(6):801-9. https://doi.org/10.1503/cmaj.051351. PMid:16534088.
2. McCarthy B, Casey D, Devane D, Murphy K, Murphy E, Lacasse Y. Pulmonary rehabilitation for chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2015;2015(2):CD003793. https://doi.org/10.1002/14651858. CD003793.pub3. PMid:25705944.
3. Waschki B, Kirsten A, Holz O, Muller KC, Meyer T, Watz H, et al. Physical activity is the strongest predictor of all-cause mortality in patients with COPD: a prospective cohort study. Chest. 2011;140(2):331-42. https://doi.org/10.1378/ chest.10-2521. PMid:21273294.
4. Caspersen CJ, Powell KE, Christenson GM. Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research. Public Health Rep. 1985;100(2): 126-31. PMid:3920711.
5. Furlanetto KC, Donaria L, Schneider LP, Lopes JR, Ribeiro M, Fernandes KB, et al. Sedentary behavior is an independent predictor of mortality in subjects with COPD. Respir Care. 2017;62(5):579-87. https://doi.org/10.4187/respcare.05306. PMid:28270544.
6. Cavalheri V, Straker L, Gucciardi DF, Gardiner PA, Hill K. Changing physical activity and sedentary behaviour in people with COPD. Respirology. 2016;21(3):419-26. https://doi.org/10.1111/resp.12680. PMid:26560834.
7. Tofoli TM, Santin L, Medeiros L, Silva H, Garcia IO, Camillo CA, et al. Determinant factors of sedentary time in individuals with COPD. Respir Med. 2024;234:107839. https://doi. org/10.1016/j.rmed.2024.107839. PMid:39406281.
8. Driver CN, Novotny PJ, Benzo RP. Differences in Sedentary Time, Light Physical Activity, and Steps Associated with Better COPD Quality of Life. Chronic Obstr Pulm Dis (Miami). 2022;9(1):34-44. https://doi.org/10.15326/jcopdf.2021.0230. PMid:34783232.
9. Worth H, Dhein Y. Does patient education modify behaviour in the management of COPD? Patient Educ Couns. 2004;52(3):267-70. https://doi.org/10.1016/S0738- 3991(03)00101-0. PMid:14998596.
10. Wshah A, Selzler AM, Hill K, Brooks D, Goldstein R. Determinants of Sedentary Behaviour in Individuals with COPD: A Qualitative Exploration Guided by the Theoretical Domains Framework. COPD. 2020;17(1):65-73. https://doi. org/10.1080/15412555.2019.1708883. PMid:31909650.
11. Armstrong M, Hume E, McNeillie L, Chambers F, Wakenshaw L, Burns G, et al. Behavioural modification interventions alongside pulmonary rehabilitation improve COPD patients’ experiences of physical activity. Respir Med. 2021;180:106353. https://doi.org/10.1016/j. rmed.2021.106353. PMid:33735798.
12. GOLD: Global Initiative for Chronic Obstructive Lung Disease. Global strategy for prevention, diagnosis and management of COPD: 2024 Report. GOLD; 2024 [citado em 2025 Ago 1]. Disponível em: https://goldcopd.org/2024-gold-report/
13. Graham BL, Steenbruggen I, Miller MR, Barjaktarevic IZ, Cooper BG, Hall GL, et al. Standardization of Spirometry 2019 Update. An Official American Thoracic Society and European Respiratory Society Technical Statement. Am J Respir Crit Care Med. 2019;200(8):e70-88. https://doi. org/10.1164/rccm.201908-1590ST. PMid:31613151.
14. Miller MR, Crapo R, Hankinson J, Brusasco V, Burgos F, Casaburi R, et al. General considerations for lung function testing. Eur Respir J. 2005;26(1):153-61. https://doi.org/10. 1183/09031936.05.00034505. PMid:15994402.
15. Pereira CA, Sato T, Rodrigues SC. New reference values for forced spirometry in white adults in Brazil. J Bras Pneumol. 2007;33(4):397-406. https://doi.org/10.1590/S1806- 37132007000400008. PMid:17982531.
16. Kozey-Keadle S, Libertine A, Lyden K, Staudenmayer J, Freedson PS. Validation of wearable monitors for assessing sedentary behavior. Med Sci Sports Exerc. 2011;43(8): 1561-7. https://doi.org/10.1249/MSS.0b013e31820ce174. PMid:21233777.
17. Bertoche MP, Furlanetto KC, Hirata RP, Sartori L, Schneider LP, Mantoani LC, et al. Assessment of sedentary behaviour in individuals with COPD: how many days are necessary? ERJ Open Res. 2023;9(4):00732-2022. https://doi. org/10.1183/23120541.00732-2022. PMid:37650084.
18. Demeyer H, Mohan D, Burtin C, Vaes AW, Heasley M, Bowler RP, et al. Objectively Measured Physical Activity in Patients with COPD: Recommendations from an International Task Force on Physical Activity. Chronic Obstr Pulm Dis (Miami). 2021;8(4):528-50. https://doi.org/10.15326/ jcopdf.2021.0213. PMid:34433239.
19. Mayer AF, Gulart AA, Santos KD, Cani KC, Karloh M, O’Neill B. Translation, cross-cultural adaptation, and reliability of the Understanding COPD questionnaire for use in Brazil. J Bras Pneumol. 2018;44(4):285-91. https://doi.org/10.1590/ s1806-37562017000000154. PMid:30328927.
20. O’Neill B, Cosgrove D, MacMahon J, McCrum-Gardner E, Bradley JM. Assessing education in pulmonary rehabilitation: the Understanding COPD (UCOPD) questionnaire. COPD. 2012;9(2):166-74. https://doi.org/10.3109/15412555.2011. 644601. PMid:22409266.
21. Santos CD, Santos AJ, Santos M, Rodrigues F, Barbara C. Pulmonary rehabilitation adapted index of self-efficacy (PRAISE) validated to Portuguese respiratory patients. Pulmonology. 2019;25(6):334-9. https://doi.org/10.1016/j. pulmoe.2019.06.003. PMid:31540750.
22. Vincent E, Sewell L, Wagg K, Deacon S, Williams J, Singh S. Measuring a change in self-efficacy following pulmonary rehabilitation: an evaluation of the PRAISE tool. Chest. 2011;140(6):1534-9. https://doi.org/10.1378/chest.10-2649. PMid:21737490.
23. Holland AE, Spruit MA, Troosters T, Puhan MA, Pepin V, Saey D, et al. An official European Respiratory Society/American Thoracic Society technical standard: field walking tests in chronic respiratory disease. Eur Respir J. 2014;44(6):1428-46. https://doi.org/10.1183/09031936.00150314. PMid:25359355.
24. Britto RR, Probst VS, de Andrade AF, Samora GA, Hernandes NA, Marinho PE, et al. Reference equations for the six-minute walk distance based on a Brazilian multicenter study. Braz J Phys Ther. 2013;17(6):556-63. https://doi.org/10.1590/ S1413-35552012005000122. PMid:24271092.
25. Akoglu H. User’s guide to correlation coefficients. Turk J Emerg Med. 2018;18(3):91-3. https://doi.org/10.1016/j. tjem.2018.08.001. PMid:30191186.
26. Murakami Y, Minakata Y, Kato M, Sasaki S, Azuma Y, Kawabe K, et al. Determinants of activity phenotype in patients with chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis. 2023;18:1919-29. https://doi.org/10.2147/ COPD.S421755. PMid:37671143.
27. Ainsworth BE, Haskell WL, Herrmann SD, Meckes N, Bassett DR Jr, Tudor-Locke C, et al. 2011 Compendium of Physical Activities: a second update of codes and MET values. Med Sci Sports Exerc. 2011;43(8):1575-81. https://doi.org/10.1249/ MSS.0b013e31821ece12. PMid:21681120.
28. Clark NM, Becker MH, Janz NK, Lorig K, Rakowski W, Anderson L. Self-management of chronic disease by older adults:a review and questions for research. J Aging Health. 1991;3(1):3- 27. https://doi.org/10.1177/089826439100300101.
29. Blackstock F, Webster K. Disease-specific health education for COPD: a systematic review of changes in health outcomes. Health Educ Res. 2007;22(5):703-17. https://doi. org/10.1093/her/cyl150. PMid:17138617.
30. Thorpe O, Johnston K, Kumar S. Barriers and enablers to physical activity participation in patients with COPD: a systematic review. J Cardiopulm Rehabil Prev. 2012;32(6): 359-69. https://doi.org/10.1097/HCR.0b013e318262d7df. PMid:22941449.
31. Selzler AM, Moore V, Habash R, Ellerton L, Lenton E, Goldstein R, et al. The Relationship between Self-Efficacy, Functional Exercise Capacity and Physical Activity in People with COPD: A Systematic Review and Meta- Analyses. COPD. 2020;17(4):452-61. https://doi.org/10.1 080/15412555.2020.1782866. PMid:32633148.
32. Chen Z, Fan VS, Belza B, Pike K, Nguyen HQ. Association between social support and self-care behaviors in adults with chronic obstructive pulmonary disease. Ann Am Thorac Soc. 2017;14(9):1419-27. https://doi.org/10.1513/ AnnalsATS.201701-026OC. PMid:28719225.
33. Cheng SWM, Guan C, Dennis S, Alison J, Stamatakis E, McKeough Z. A behaviour change intervention to reduce sedentary behaviour in chronic obstructive pulmonary disease: a qualitative study. Physiotherapy. 2024;124:9- 20. https://doi.org/10.1016/j.physio.2024.04.347. PMid:38795529.
34. Liacos A, McDonald CF, Mahal A, Hill CJ, Lee AL, Burge AT, et al. The Pulmonary Rehabilitation Adapted Index of Self-Efficacy (PRAISE) tool predicts reduction in sedentary time following pulmonary rehabilitation in people with chronic obstructive pulmonary disease (COPD). Physiotherapy. 2019;105(1):90-7. https://doi.org/10.1016/j. physio.2018.07.009. PMid:30316548.
35. Hartman JE, Boezen HM, de Greef MH, Ten Hacken NH. Physical and psychosocial factors associated with physical activity in patients with chronic obstructive pulmonary disease. Arch Phys Med Rehabil. 2013;94(12):2396-402.e7. https://doi.org/10.1016/j.apmr.2013.06.029. PMid:23872081.
36. Gimeno-Santos E, Frei A, Steurer-Stey C, de Batlle J, Rabinovich RA, Raste Y, et al. Determinants and outcomes of physical activity in patients with COPD: a systematic review. Thorax. 2014;69(8):731-9. https://doi.org/10.1136/ thoraxjnl-2013-204763. PMid:24558112.
37. Hartman JE, ten Hacken NH, Boezen HM, de Greef MH. Self-efficacy for physical activity and insight into its benefits are modifiable factors associated with physical activity in people with COPD: a mixed-methods study. J Physiother. 2013;59(2):117-24. https://doi.org/10.1016/ S1836-9553(13)70164-4. PMid:23663797.
38. Cameron-Tucker HL, Wood-Baker R, Owen C, Joseph L, Walters EH. Chronic disease self-management and exercise in COPD as pulmonary rehabilitation: a randomized controlled trial. Int J Chron Obstruct Pulmon Dis. 2014;9:513-23. https://doi.org/10.2147/COPD.S58478. PMid:24876771.
39. McGeoch GR, Willsman KJ, Dowson CA, Town GI, Frampton CM, McCartin FJ, et al. Self-management plans in the primary care of patients with chronic obstructive pulmonary disease. Respirology. 2006;11(5):611-8. https://doi.org/10.1111/ j.1440-1843.2006.00892.x. PMid:16916335.
40. Kelly MP, Barker M. Why is changing health-related behaviour so difficult? Public Health. 2016;136:109-16. https://doi. org/10.1016/j.puhe.2016.03.030. PMid:27184821.
41. Wshah A, Selzler AM, Ellerton L, Hill K, Brooks D, Goldstein R. Reducing sedentary behavior in individuals with COPD: healthcare professionals’ perspectives. Physiother Theory Pract. 2022;38(11):1693-704. https://doi.org/10.1080/0959 3985.2021.1885088. PMid:33586622.
42. Harding S, Richardson A, Glynn A, Hodgson L. Effectiveness of interventions to reduce sedentary behaviour in people with chronic obstructive pulmonary disease: a systematic review of randomised controlled trials. COPD. 2025;22(1):2482710. https:// doi.org/10.1080/15412555.2025.2482710. PMid:40719387.
Submitted date:
12/17/2025
Accepted date:
05/29/2026
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