2026-04-14T08:16:08Zhttps://recercat.cat/oai/request
oai:recercat.cat:10230/550462025-12-12T03:48:03Zcom_2072_6col_2072_452952
RECERCAT author Koreny, Maria, 1972- author Arbillaga Etxarri, Ane, 1986- author Bosch de Basea i Gómez, Magda, 1982- author Foraster Pulido, Maria, 1984- author Carsin, Anne-Elie author Cirach, Marta author Gimeno Santos, Elena, 1980- author Barberan-Garcia, Anael author Nieuwenhuijsen, Mark J. author Vall Casas, Pere author Rodríguez-Roisin, Robert author García Aymerich, Judith 2022-11-30T07:44:08Z2022-11-30T07:44:08Z2022 Background: Physical activity and exercise capacity are key prognostic factors in chronic obstructive pulmonary disease (COPD) but their environmental determinants are unknown. Objectives: To test the association between urban environment and objective physical activity, physical activity experience and exercise capacity in COPD. Methods: We studied 404 patients with mild-to-very severe COPD from a multi-city study in Catalonia, Spain. We measured objective physical activity (step count and sedentary time) by the Dynaport MoveMonitor, physical activity experience (difficulty with physical activity) by the Clinical visit-PROactive (C-PPAC) instrument, and exercise capacity by the 6-min walk distance (6MWD). We estimated individually (geocoded to the residential address) population density, pedestrian street length, slope of terrain, and long-term (i.e., annual) exposure to road traffic noise, nitrogen dioxide (NO2) and particulate matter (PM2.5). We built single- and multi-exposure mixed-effects linear regressions with a random intercept for city, adjusting for confounders. Results: Patients were 85% male, had mean (SD) age 69 (9) years and walked 7524 (4045) steps/day. In multi-exposure models, higher population density was associated with fewer steps, more sedentary time and worse exercise capacity (-507 [95% CI: 1135, 121] steps, +0.2 [0.0, 0.4] h/day and -13 [-25, 0] m per IQR). Pedestrian street length related with more steps and less sedentary time (156 [9, 304] steps and -0.1 [-0.1, 0.0] h/day per IQR). Steeper slope was associated with better exercise capacity (15 [3, 27] m per IQR). Higher NO2 levels related with more sedentary time and more difficulty in physical activity. PM2.5 and noise were not associated with physical activity or exercise capacity. Discussion: Population density, pedestrian street length, slope and NO2 exposure relate to physical activity and capacity of COPD patients living in highly populated areas. These findings support the consideration of neighbourhood environmental factors during COPD management and the attention to patients with chronic diseases when developing urban and transport planning policies. © 2022 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). http://creativecommons.org/licenses/by-nc-nd/4.0/ info:eu-repo/semantics/openAccess Air pollution Chronic obstructive pulmonary disease Exercise capacity Noise Physical activity Urban environment Urban environment and physical activity and capacity in patients with chronic obstructive pulmonary disease info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion