Skip to main content
Top
Published in: Lung 3/2019

Open Access 01-06-2019 | Sarcoidosis | INTERSTITIAL LUNG DISEASE

Physical Inactivity in Pulmonary Sarcoidosis

Authors: Peter S. P. Cho, Sharmila Vasudevan, Matthew Maddocks, Arietta Spinou, Sarah Chamberlain Mitchell, Claire Wood, Caroline J. Jolley, Surinder S. Birring

Published in: Lung | Issue 3/2019

Login to get access

Abstract

Purpose

Reduced physical activity in many chronic diseases is consistently associated with increased morbidity. Little is known about physical activity in sarcoidosis. The aim of this study was to objectively assess physical activity in patients with pulmonary sarcoidosis and investigate its relationship with lung function, exercise capacity, symptom burden, and health status.

Methods

Physical activity was assessed over one week in 15 patients with pulmonary sarcoidosis and 14 age-matched healthy controls with a tri-axial accelerometer (ActivPal™) and the International Physical Activity Questionnaire (IPAQ). All participants underwent pulmonary function tests, 6-min walk test (6MWT) and completed the Fatigue Assessment Scale (FAS), Medical Research Council (MRC) Dyspnoea Scale and the King’s Sarcoidosis Questionnaire (KSQ).

Results

Patients with sarcoidosis had significantly lower daily step counts than healthy controls; mean (SD) 5624 (1875) versus 10,429 (2942) steps (p < 0.01) and a trend towards fewer sit-to-stand transitions each day (p = 0.095). Only two patients (13%) self-reported undertaking vigorous physical activity (IPAQ) compared to half of healthy individuals (p < 0.01). Daily step count was significantly associated with 6MWT distance in sarcoidosis (r = 0.634, p = 0.01), but not with forced vital capacity (r = 0.290), fatigue (r = 0.041), dyspnoea (r = −0.466) or KSQ health status (r = 0.099–0.484). Time spent upright was associated with fatigue (r = −0.630, p = 0.012) and health status (KSQ Lung scores r = 0.524, p = 0.045), and there was a significant correlation between the number of sit-to-stand transitions and MRC dyspnoea score (r = −0.527, p = 0.044).

Conclusion

Physical activity is significantly reduced in sarcoidosis and is associated with reduced functional exercise capacity (6MWD). Fatigue, exertional symptoms and health status were more closely associated with time spent upright and the number of bouts of physical activity, as compared to step counts. Further studies are warranted to identify the factors that determine different physical activity profiles in sarcoidosis.
Appendix
Available only for authorised users
Literature
1.
go back to reference Baughman RP, Culver DA, Judson MA (2011) A concise review of pulmonary sarcoidosis. Am J Respir Crit Care Med 183:573–581CrossRefPubMed Baughman RP, Culver DA, Judson MA (2011) A concise review of pulmonary sarcoidosis. Am J Respir Crit Care Med 183:573–581CrossRefPubMed
2.
go back to reference Valeyre D, Prasse A, Nunes H, Uzunhan Y, Brillet PY, Müller-Quernheim J (2014) Sarcoidosis. Lancet 383:1155–1167CrossRefPubMed Valeyre D, Prasse A, Nunes H, Uzunhan Y, Brillet PY, Müller-Quernheim J (2014) Sarcoidosis. Lancet 383:1155–1167CrossRefPubMed
3.
go back to reference Marcellis RGJ, Lenssen AF, Drent M, De Vries J (2012) Association between physical activity and quality of life in sarcoidosis. Sarcoidosis Vasc Diffus Lung Dis 46:1–12 Marcellis RGJ, Lenssen AF, Drent M, De Vries J (2012) Association between physical activity and quality of life in sarcoidosis. Sarcoidosis Vasc Diffus Lung Dis 46:1–12
4.
go back to reference Marcellis RGJ, Lenssen AF, Elfferich MDP, De Vries J, Kassim S, Foerster K, Drent M (2011) Exercise capacity, muscle strength and fatigue in sarcoidosis. Eur Respir J 38:628–634CrossRefPubMed Marcellis RGJ, Lenssen AF, Elfferich MDP, De Vries J, Kassim S, Foerster K, Drent M (2011) Exercise capacity, muscle strength and fatigue in sarcoidosis. Eur Respir J 38:628–634CrossRefPubMed
5.
go back to reference Kallianos A, Zarogoulidis P, Ampatzoglou F, Trakada G, Gialafos E, Pitsiou G, Pataka A, Veletza L, Zarogoulidis K, Hohenforst-Schmidt W, Petridis D, Kioumis I, Rapti A (2015) Reduction of exercise capacity in sarcoidosis in relation to disease severity. Patient Prefer Adherence 9:1179–1188PubMedPubMedCentral Kallianos A, Zarogoulidis P, Ampatzoglou F, Trakada G, Gialafos E, Pitsiou G, Pataka A, Veletza L, Zarogoulidis K, Hohenforst-Schmidt W, Petridis D, Kioumis I, Rapti A (2015) Reduction of exercise capacity in sarcoidosis in relation to disease severity. Patient Prefer Adherence 9:1179–1188PubMedPubMedCentral
6.
7.
go back to reference Troosters T, Bourbeau J, Maltais F, Leidy N, Erzen D, De Sousa D, Korducki L, Hamilton A (2016) Enhancing exercise tolerance and physical activity in COPD with combined pharmacological and non-pharmacological interventions: PHYSACTO randomised, placebo-controlled study design. BMJ Open 6:1–9CrossRef Troosters T, Bourbeau J, Maltais F, Leidy N, Erzen D, De Sousa D, Korducki L, Hamilton A (2016) Enhancing exercise tolerance and physical activity in COPD with combined pharmacological and non-pharmacological interventions: PHYSACTO randomised, placebo-controlled study design. BMJ Open 6:1–9CrossRef
8.
go back to reference Wallaert B, Monge E, Le Rouzic O, Wémeau-Stervinou L, Salleron J, Grosbois JM (2013) Physical activity in daily life of patients with fibrotic idiopathic interstitial pneumonia. Chest 144:1652–1658CrossRefPubMed Wallaert B, Monge E, Le Rouzic O, Wémeau-Stervinou L, Salleron J, Grosbois JM (2013) Physical activity in daily life of patients with fibrotic idiopathic interstitial pneumonia. Chest 144:1652–1658CrossRefPubMed
9.
go back to reference Nakayama M, Bando M, Araki K, Sekine T, Kurosaki F, Sawata T, Nakazawa S, Mato N, Yamasawa H, Sugiyama Y (2015) Physical activity in patients with idiopathic pulmonary fibrosis. Respirology 20:640–646CrossRefPubMed Nakayama M, Bando M, Araki K, Sekine T, Kurosaki F, Sawata T, Nakazawa S, Mato N, Yamasawa H, Sugiyama Y (2015) Physical activity in patients with idiopathic pulmonary fibrosis. Respirology 20:640–646CrossRefPubMed
10.
go back to reference Gimeno-Santos E, Frei A, Steurer-Stey C, De Batlle J, Rabinovich RA, Raste Y, Hopkinson NS, Polkey MI, van Remoortel H, Troosters T, Kulich K, Karlsson N, Puhan MA, Garcia- Aymerich J, Garcia-Aymerich J (2014) Determinants and outcomes of physical activity in patients with COPD: a systematic review. Thorax 69:731–739CrossRefPubMedPubMedCentral Gimeno-Santos E, Frei A, Steurer-Stey C, De Batlle J, Rabinovich RA, Raste Y, Hopkinson NS, Polkey MI, van Remoortel H, Troosters T, Kulich K, Karlsson N, Puhan MA, Garcia- Aymerich J, Garcia-Aymerich J (2014) Determinants and outcomes of physical activity in patients with COPD: a systematic review. Thorax 69:731–739CrossRefPubMedPubMedCentral
11.
go back to reference Vasudevan S, Maddocks M, Chamberlain S, Spinou A, Wood C, Jolley CJ, Birring SS (2013) P197 physical inactivity in Sarcoidosis. Thorax 68:A165–A165CrossRef Vasudevan S, Maddocks M, Chamberlain S, Spinou A, Wood C, Jolley CJ, Birring SS (2013) P197 physical inactivity in Sarcoidosis. Thorax 68:A165–A165CrossRef
12.
go back to reference Van Remoortel H, Giavedoni S, Raste Y, Burtin C, Louvaris Z, Gimeno-Santos E, Langer D, Glendenning A, Hopkinson NS, Vogiatzis I, Peterson BT, Wilson F, Mann B, Rabinovich R, Puhan MA, Troosters T (2012) Validity of activity monitors in health and chronic disease: a systematic review. Int J Behav Nutr Phys Act 9:84CrossRefPubMedPubMedCentral Van Remoortel H, Giavedoni S, Raste Y, Burtin C, Louvaris Z, Gimeno-Santos E, Langer D, Glendenning A, Hopkinson NS, Vogiatzis I, Peterson BT, Wilson F, Mann B, Rabinovich R, Puhan MA, Troosters T (2012) Validity of activity monitors in health and chronic disease: a systematic review. Int J Behav Nutr Phys Act 9:84CrossRefPubMedPubMedCentral
13.
go back to reference Gimeno-Santos E, Raste Y, Demeyer H, Louvaris Z, De Jong C, Rabinovich RA, Hopkinson NS, Polkey MI, Vogiatzis I, Tabberer M, Dobbels F, Ivanoff N, De Boer WI, Van Der Molen T, Kulich K, Serra I, Basagaña X, Troosters T, Puhan MA, Karlsson N, Garcia-Aymerich J, Corriol-Rohou S, Jarrod I, Erzen D, Brindicci C, Higenbottam T, Scuri M, McBride P, Kamel N, De Boer P et al (2015) The PROactive instruments to measure physical activity in patients with chronic obstructive pulmonary disease. Eur Respir J 46:988–1000CrossRefPubMedPubMedCentral Gimeno-Santos E, Raste Y, Demeyer H, Louvaris Z, De Jong C, Rabinovich RA, Hopkinson NS, Polkey MI, Vogiatzis I, Tabberer M, Dobbels F, Ivanoff N, De Boer WI, Van Der Molen T, Kulich K, Serra I, Basagaña X, Troosters T, Puhan MA, Karlsson N, Garcia-Aymerich J, Corriol-Rohou S, Jarrod I, Erzen D, Brindicci C, Higenbottam T, Scuri M, McBride P, Kamel N, De Boer P et al (2015) The PROactive instruments to measure physical activity in patients with chronic obstructive pulmonary disease. Eur Respir J 46:988–1000CrossRefPubMedPubMedCentral
14.
go back to reference Watz H, Waschki B, Meyer T, Magnussen H (2009) Physical activity in patients with COPD. Eur Respir J 33:262–272CrossRefPubMed Watz H, Waschki B, Meyer T, Magnussen H (2009) Physical activity in patients with COPD. Eur Respir J 33:262–272CrossRefPubMed
15.
go back to reference Donaire-Gonzalez D, Gimeno-Santos E, Balcells E, Rodríguez DA, Farrero E, De Batlle J, Benet M, Ferrer A, Barberà JA, Gea J, Rodriguez-Roisin R, Antó JM, Garcia-Aymerich J (2013) Physical activity in COPD patients: patterns and bouts. Eur Respir J 42:993–1002CrossRefPubMed Donaire-Gonzalez D, Gimeno-Santos E, Balcells E, Rodríguez DA, Farrero E, De Batlle J, Benet M, Ferrer A, Barberà JA, Gea J, Rodriguez-Roisin R, Antó JM, Garcia-Aymerich J (2013) Physical activity in COPD patients: patterns and bouts. Eur Respir J 42:993–1002CrossRefPubMed
16.
go back to reference Troosters T, Sciurba F, Battaglia S, Langer D, Valluri SR, Martino L, Benzo R, Andre D, Weisman I, Decramer M (2010) Physical inactivity in patients with COPD, a controlled multi-center pilot-study. Respir Med 104:1005–1011CrossRefPubMedPubMedCentral Troosters T, Sciurba F, Battaglia S, Langer D, Valluri SR, Martino L, Benzo R, Andre D, Weisman I, Decramer M (2010) Physical inactivity in patients with COPD, a controlled multi-center pilot-study. Respir Med 104:1005–1011CrossRefPubMedPubMedCentral
17.
go back to reference Garcia-Rio F, Lores V, Mediano O, Rojo B, Hernanz A, López-Collazo E, Alvarez-Sala R (2009) Daily physical activity in patients with chronic obstructive pulmonary disease is mainly associated with dynamic hyperinflation. Am J Respir Crit Care Med 180:506–512CrossRefPubMed Garcia-Rio F, Lores V, Mediano O, Rojo B, Hernanz A, López-Collazo E, Alvarez-Sala R (2009) Daily physical activity in patients with chronic obstructive pulmonary disease is mainly associated with dynamic hyperinflation. Am J Respir Crit Care Med 180:506–512CrossRefPubMed
18.
go back to reference Bahmer T, Watz H, Develaska M, Waschki B, Rabe KF, Magnussen H, Kirsten D, Kirsten A-M (2017) Physical activity and fatigue in patients with sarcoidosis. Respiration 95(1):18–26CrossRefPubMedPubMedCentral Bahmer T, Watz H, Develaska M, Waschki B, Rabe KF, Magnussen H, Kirsten D, Kirsten A-M (2017) Physical activity and fatigue in patients with sarcoidosis. Respiration 95(1):18–26CrossRefPubMedPubMedCentral
19.
go back to reference Maddocks M, Petrou A, Skipper L, Wilcock A (2010) Validity of three accelerometers during treadmill walking and motor vehicle travel. Br J Sport Med 44:606–608CrossRef Maddocks M, Petrou A, Skipper L, Wilcock A (2010) Validity of three accelerometers during treadmill walking and motor vehicle travel. Br J Sport Med 44:606–608CrossRef
20.
go back to reference Cindy Ng LW, Jenkins S, Hill K (2012) Accuracy and responsiveness of the stepwatch activity monitor and ActivPAL in patients with COPD when walking with and without a rollator. Disabil Rehabil 34:1317–1322CrossRefPubMed Cindy Ng LW, Jenkins S, Hill K (2012) Accuracy and responsiveness of the stepwatch activity monitor and ActivPAL in patients with COPD when walking with and without a rollator. Disabil Rehabil 34:1317–1322CrossRefPubMed
21.
go back to reference Harrington DM, Welk GJ, Donnelly AE (2011) Validation of MET estimates and step measurement using the ActivPAL physical activity logger. J Sports Sci 29:627–633CrossRefPubMed Harrington DM, Welk GJ, Donnelly AE (2011) Validation of MET estimates and step measurement using the ActivPAL physical activity logger. J Sports Sci 29:627–633CrossRefPubMed
22.
go back to reference Ryan CG, Grant PM, Tigbe WW, Granat MH, Ryan CG (2006) The validity and reliability of a novel activity monitor as a measure of walking. Br J Sport Med 40:779–784CrossRef Ryan CG, Grant PM, Tigbe WW, Granat MH, Ryan CG (2006) The validity and reliability of a novel activity monitor as a measure of walking. Br J Sport Med 40:779–784CrossRef
23.
go back to reference Judson MA, Baughman RP, Teirstein AS, Terrin ML, Yeager HJ (1999) Defining organ involvement in sarcoidosis: the ACCESS proposed instrument. ACCESS Research Group. A Case Control Etiologic Study of Sarcoidosis. Sarcoidosis Vasc Diffus Lung Dis 16:75–86 Judson MA, Baughman RP, Teirstein AS, Terrin ML, Yeager HJ (1999) Defining organ involvement in sarcoidosis: the ACCESS proposed instrument. ACCESS Research Group. A Case Control Etiologic Study of Sarcoidosis. Sarcoidosis Vasc Diffus Lung Dis 16:75–86
24.
25.
go back to reference Craig CL, Marshall AL, Sjöström M, Bauman AE, Booth ML, Ainsworth BE, Pratt M, Ekelund U, Yngve A, Sallis JF, Oja P (2003) International physical activity questionnaire: 12-Country reliability and validity. Med Sci Sports Exerc 35:1381–1395CrossRef Craig CL, Marshall AL, Sjöström M, Bauman AE, Booth ML, Ainsworth BE, Pratt M, Ekelund U, Yngve A, Sallis JF, Oja P (2003) International physical activity questionnaire: 12-Country reliability and validity. Med Sci Sports Exerc 35:1381–1395CrossRef
26.
go back to reference De Vries J, Michielsen H, Van Heck GL, Drent M (2004) Measuring fatigue in sarcoidosis: the Fatigue Assessment Scale (FAS). Br J Health Psychol 9:279–291CrossRefPubMed De Vries J, Michielsen H, Van Heck GL, Drent M (2004) Measuring fatigue in sarcoidosis: the Fatigue Assessment Scale (FAS). Br J Health Psychol 9:279–291CrossRefPubMed
27.
go back to reference Michielsen HJ, De Vries J, Van Heck GL, Van de Vijver FJR, Sijtsma K (2004) Examination of the dimensionality of fatigue. Eur J Psychol Assess 20:39–48CrossRef Michielsen HJ, De Vries J, Van Heck GL, Van de Vijver FJR, Sijtsma K (2004) Examination of the dimensionality of fatigue. Eur J Psychol Assess 20:39–48CrossRef
28.
go back to reference Fletcher CM (1952) The clinical diagnosis of pulmonary emphysema; an experimental study. Proc R Soc Med 45:577–584PubMed Fletcher CM (1952) The clinical diagnosis of pulmonary emphysema; an experimental study. Proc R Soc Med 45:577–584PubMed
29.
go back to reference Patel AS, Siegert RJ, Creamer D, Larkin G, Maher TM, Renzoni EA, Wells AU, Higginson IJ, Birring SS (2013) The development and validation of the King’s Sarcoidosis Questionnaire for the assessment of health status. Thorax 68:57–65CrossRefPubMed Patel AS, Siegert RJ, Creamer D, Larkin G, Maher TM, Renzoni EA, Wells AU, Higginson IJ, Birring SS (2013) The development and validation of the King’s Sarcoidosis Questionnaire for the assessment of health status. Thorax 68:57–65CrossRefPubMed
30.
go back to reference Baughman RP, Sweiss N, Keijsers R, Birring SS, Shipley R, Saketkoo LA, Lower EE (2017) Repository corticotropin for chronic pulmonary sarcoidosis. Lung 195(3):313–322CrossRef Baughman RP, Sweiss N, Keijsers R, Birring SS, Shipley R, Saketkoo LA, Lower EE (2017) Repository corticotropin for chronic pulmonary sarcoidosis. Lung 195(3):313–322CrossRef
31.
go back to reference Miller MR, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A, Crapo R, Enright P, van der Grinten CPM, Gustafsson P, Jensen R, Johnson DC, MacIntrye N, McKay R, Navajas D, Pedersen OF, Pellegrino R, Viegi G, Wagner J, De Vries J, Michielsen H, Van Heck GL, Drent M (2005) Standardisation of spirometry. Eur Respir J 26:319–338CrossRef Miller MR, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A, Crapo R, Enright P, van der Grinten CPM, Gustafsson P, Jensen R, Johnson DC, MacIntrye N, McKay R, Navajas D, Pedersen OF, Pellegrino R, Viegi G, Wagner J, De Vries J, Michielsen H, Van Heck GL, Drent M (2005) Standardisation of spirometry. Eur Respir J 26:319–338CrossRef
32.
go back to reference Association for Respiratory Technology and Physiology (ARTP) (2013) A guide to performing quality assured diagnostic spirometry. Association for Respiratory Technology and Physiology (ARTP), Lichfield Association for Respiratory Technology and Physiology (ARTP) (2013) A guide to performing quality assured diagnostic spirometry. Association for Respiratory Technology and Physiology (ARTP), Lichfield
33.
go back to reference Holland AE, Spruit MA, Troosters T, Puhan MA, Pepin V, Saey D, McCormack MC, Carlin BW, Sciurba FC, Pitta F, Wanger J, MacIntyre N, Kaminsky DA, Culver BH, Revill SM, Hernandes NA, Andrianopoulos V, Camillo CA, Mitchell KE, Lee AL, Hill CJ, Singh SJ (2014) An official European respiratory society/American thoracic society technical standard: field walking tests in chronic respiratory disease. Eur Respir J 44:1428–1446CrossRefPubMed Holland AE, Spruit MA, Troosters T, Puhan MA, Pepin V, Saey D, McCormack MC, Carlin BW, Sciurba FC, Pitta F, Wanger J, MacIntyre N, Kaminsky DA, Culver BH, Revill SM, Hernandes NA, Andrianopoulos V, Camillo CA, Mitchell KE, Lee AL, Hill CJ, Singh SJ (2014) An official European respiratory society/American thoracic society technical standard: field walking tests in chronic respiratory disease. Eur Respir J 44:1428–1446CrossRefPubMed
34.
go back to reference Lee PH, Macfarlane DJ, Lam T, Stewart SM (2011) Validity of the international physical activity questionnaire short form (IPAQ-SF): a systematic review. Int J Behav Nutr Phys Act 8:115CrossRefPubMedPubMedCentral Lee PH, Macfarlane DJ, Lam T, Stewart SM (2011) Validity of the international physical activity questionnaire short form (IPAQ-SF): a systematic review. Int J Behav Nutr Phys Act 8:115CrossRefPubMedPubMedCentral
35.
go back to reference Aggarwal AN, Sahu KK, Gupta D (2016) Fatigue and health-related quality of life in patients with pulmonary sarcoidosis treated by oral corticosteroids. Sarcoidosis Vasc Diffus lung Dis 33:124–129 Aggarwal AN, Sahu KK, Gupta D (2016) Fatigue and health-related quality of life in patients with pulmonary sarcoidosis treated by oral corticosteroids. Sarcoidosis Vasc Diffus lung Dis 33:124–129
36.
go back to reference Strookappe B, De Vries J, Elfferich M, Kuijpers P, Knevel T, Drent M (2016) Predictors of fatigue in sarcoidosis: the value of exercise testing. Respir Med 116:49–54CrossRefPubMed Strookappe B, De Vries J, Elfferich M, Kuijpers P, Knevel T, Drent M (2016) Predictors of fatigue in sarcoidosis: the value of exercise testing. Respir Med 116:49–54CrossRefPubMed
37.
go back to reference Nguyen HQ, Fan VS, Herting J, Lee J, Fu M, Chen Z, Borson S, Kohen R, Matute-Bello G, Pagalilauan G, Adams SG (2013) Patients with COPD with higher levels of anxiety are more physically active. Chest 144:145–151CrossRefPubMedPubMedCentral Nguyen HQ, Fan VS, Herting J, Lee J, Fu M, Chen Z, Borson S, Kohen R, Matute-Bello G, Pagalilauan G, Adams SG (2013) Patients with COPD with higher levels of anxiety are more physically active. Chest 144:145–151CrossRefPubMedPubMedCentral
38.
go back to reference Garcia-Aymerich J, Félez MA, Escarrabill J, Marrades RM, Morera J, Elosua R, Antó JM (2004) Physical activity and its determinants in severe chronic obstructive pulmonary disease. Med Sci Sports Exerc 36:1667–1673CrossRefPubMed Garcia-Aymerich J, Félez MA, Escarrabill J, Marrades RM, Morera J, Elosua R, Antó JM (2004) Physical activity and its determinants in severe chronic obstructive pulmonary disease. Med Sci Sports Exerc 36:1667–1673CrossRefPubMed
39.
go back to reference Marshall SJ, Jones DA, Ainsworth BE, Reis JP, Levy SS, Macera CA (2007) Race/ethnicity, social class, and leisure-time physical inactivity. Med Sci Sports Exerc 39:44–51CrossRefPubMed Marshall SJ, Jones DA, Ainsworth BE, Reis JP, Levy SS, Macera CA (2007) Race/ethnicity, social class, and leisure-time physical inactivity. Med Sci Sports Exerc 39:44–51CrossRefPubMed
Metadata
Title
Physical Inactivity in Pulmonary Sarcoidosis
Authors
Peter S. P. Cho
Sharmila Vasudevan
Matthew Maddocks
Arietta Spinou
Sarah Chamberlain Mitchell
Claire Wood
Caroline J. Jolley
Surinder S. Birring
Publication date
01-06-2019
Publisher
Springer US
Published in
Lung / Issue 3/2019
Print ISSN: 0341-2040
Electronic ISSN: 1432-1750
DOI
https://doi.org/10.1007/s00408-019-00215-6

Other articles of this Issue 3/2019

Lung 3/2019 Go to the issue