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      International Journal of COPD (submit here)

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      Effect of tiotropium/olodaterol on sedentary and active time in patients with COPD: post hoc analysis of the VESUTO ® study

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          Abstract

          Background

          Patients with COPD are less physically active. This post hoc analysis of a randomized, double-blind, active-controlled, crossover trial assessed the efficacy of once-daily tiotropium/olodaterol combination therapy versus tiotropium monotherapy in Japanese patients with COPD.

          Patients and methods

          Patients were provided with a three-axis accelerometer to measure sedentary and active behavior defined as 1.0–1.5 metabolic equivalents (METs), ≥2.0 METs, and ≥3.0 METs, respectively. Of the 182 patients enrolled, 131 satisfied the conditions for the present analysis and were randomized to tiotropium monotherapy (n=62) or tiotropium/olodaterol combination therapy (n=69).

          Results

          Tiotropium/olodaterol combination therapy significantly reduced the duration of 1.0–1.5 MET activity by 8.64 mins ( p=0.040) and significantly increased the duration of ≥2.0 MET and ≥3.0 MET activity by 6.51 mins ( p=0.017) and 2.60 mins ( p=0.008), respectively, compared with tiotropium alone. Subgroup analyses showed that better lung function, milder dyspnea, and higher levels of physical activity at baseline were associated with reduced sedentary time and increased duration of physical activity.

          Conclusion

          Tiotropium/olodaterol combination therapy significantly reduced sedentary time and improved physical activity compared with tiotropium monotherapy. This trial was registered in ClinicalTrials.gov (NCT02629965).

          Most cited references28

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          Compendium of physical activities: an update of activity codes and MET intensities.

          We provide an updated version of the Compendium of Physical Activities, a coding scheme that classifies specific physical activity (PA) by rate of energy expenditure. It was developed to enhance the comparability of results across studies using self-reports of PA. The Compendium coding scheme links a five-digit code that describes physical activities by major headings (e.g., occupation, transportation, etc.) and specific activities within each major heading with its intensity, defined as the ratio of work metabolic rate to a standard resting metabolic rate (MET). Energy expenditure in MET-minutes, MET-hours, kcal, or kcal per kilogram body weight can be estimated for specific activities by type or MET intensity. Additions to the Compendium were obtained from studies describing daily PA patterns of adults and studies measuring the energy cost of specific physical activities in field settings. The updated version includes two new major headings of volunteer and religious activities, extends the number of specific activities from 477 to 605, and provides updated MET intensity levels for selected activities.
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            Pulmonary rehabilitation for chronic obstructive pulmonary disease.

            Widespread application of pulmonary rehabilitation (also known as respiratory rehabilitation) in chronic obstructive pulmonary disease (COPD) should be preceded by demonstrable improvements in function (health-related quality of life, functional and maximal exercise capacity) attributable to the programmes. This review updates the review reported in 2006.
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              Breaks in sedentary time: beneficial associations with metabolic risk.

              Total sedentary (absence of whole-body movement) time is associated with obesity, abnormal glucose metabolism, and the metabolic syndrome. In addition to the effects of total sedentary time, the manner in which it is accumulated may also be important. We examined the association of breaks in objectively measured sedentary time with biological markers of metabolic risk. Participants (n = 168, mean age 53.4 years) for this cross-sectional study were recruited from the 2004-2005 Australian Diabetes, Obesity and Lifestyle study. Sedentary time was measured by an accelerometer (counts/minute(-1) or = 100) was considered a break. Fasting plasma glucose, 2-h plasma glucose, serum triglycerides, HDL cholesterol, weight, height, waist circumference, and resting blood pressure were measured. MatLab was used to derive the breaks variable; SPSS was used for the statistical analysis. Independent of total sedentary time and moderate-to-vigorous intensity activity time, increased breaks in sedentary time were beneficially associated with waist circumference (standardized beta = -0.16, 95% CI -0.31 to -0.02, P = 0.026), BMI (beta = -0.19, -0.35 to -0.02, P = 0.026), triglycerides (beta = -0.18, -0.34 to -0.02, P = 0.029), and 2-h plasma glucose (beta = -0.18, -0.34 to -0.02, P = 0.025). This study provides evidence of the importance of avoiding prolonged uninterrupted periods of sedentary (primarily sitting) time. These findings suggest new public health recommendations regarding breaking up sedentary time that are complementary to those for physical activity.
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                Author and article information

                Journal
                Int J Chron Obstruct Pulmon Dis
                Int J Chron Obstruct Pulmon Dis
                COPD
                copd
                International Journal of Chronic Obstructive Pulmonary Disease
                Dove
                1176-9106
                1178-2005
                07 August 2019
                2019
                : 14
                : 1789-1801
                Affiliations
                [1 ] Department of Respiratory Medicine, National Hospital Organization Wakayama Hospital , Wakayama, Japan
                [2 ] Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School , Tokyo, Japan
                [3 ] Clinical Research Unit of Respiratory Pathophysiology, Juntendo University Graduate School of Health Care and Nursing , Chiba, Japan
                [4 ] Division of Respiratory Medicine, Department of Internal Medicine, Nihon University School of Medicine , Tokyo, Japan
                [5 ] Medical Division, Nippon Boehringer Ingelheim Co. Ltd ., Tokyo, Japan
                [6 ] Clinical Information Division Data Science Center, Statistics Analysis Department 1, EPS Corporation , Tokyo, Japan
                [7 ] Department of Respiratory Medicine, Graduate School of Medicine, Osaka City University , Osaka, Japan
                [8 ] Department of Respiratory Medicine, Tohoku University Graduate School of Medicine , Sendai, Japan
                Author notes
                Correspondence: Yoshiaki MinakataDepartment of Respiratory Medicine, National Hospital Organization Wakayama Hospital , 1181 Wada, Mihama-cho, Hidaka-gun, Wakayama644-0044, JapanTel +81 7 3822 3256Fax +81 7 3822 2126Email minakata.yoshiaki.qy@mail.hosp.go.jp
                Author information
                http://orcid.org/0000-0001-6993-0917
                http://orcid.org/0000-0003-0514-3054
                http://orcid.org/0000-0003-1073-2996
                Article
                208081
                10.2147/COPD.S208081
                6689763
                58aeb161-e33f-4d27-a816-ee409dc67667
                © 2019 Minakata et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                : 12 March 2019
                : 10 July 2019
                Page count
                Figures: 4, Tables: 2, References: 38, Pages: 13
                Categories
                Clinical Trial Report

                Respiratory medicine
                copd,japanese,physical activity,sedentary behavior
                Respiratory medicine
                copd, japanese, physical activity, sedentary behavior

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