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Published in: BMC Pulmonary Medicine 1/2014

Open Access 01-12-2014 | Research article

Quality of life is associated with physical activity and fitness in cystic fibrosis

Authors: Helge Hebestreit, Kerstin Schmid, Stephanie Kieser, Sibylle Junge, Manfred Ballmann, Kristina Roth, Alexandra Hebestreit, Thomas Schenk, Christian Schindler, Hans-Georg Posselt, Susi Kriemler

Published in: BMC Pulmonary Medicine | Issue 1/2014

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Abstract

Background

Health-related and disease-specific quality of life (HRQoL) has been increasingly valued as relevant clinical parameter in cystic fibrosis (CF) clinical care and clinical trials. HRQoL measures should assess – among other domains – daily functioning from a patient’s perspective. However, validation studies for the most frequently used HRQoL questionnaire in CF, the Cystic Fibrosis Questionnaire (CFQ), have not included measures of physical activity or fitness. The objective of this study was, therefore, to determine the cross-sectional and longitudinal relationships between HRQoL, physical activity and fitness in patients with CF.

Methods

Baseline (n = 76) and 6-month follow-up data (n = 70) from patients with CF (age ≥12 years, FEV1 ≥35%) were analysed. Patients participated in two multi-centre exercise intervention studies with identical assessment methodology. Outcome variables included HRQoL (German revised multi-dimensional disease-specific CFQ (CFQ-R)), body composition, pulmonary function, physical activity, short-term muscle power, and aerobic fitness by peak oxygen uptake and aerobic power.

Results

Peak oxygen uptake was positively related to 7 of 13 HRQoL scales cross-sectionally (r = 0.30-0.46). Muscle power (r = 0.25-0.32) and peak aerobic power (r = 0.24-0.35) were positively related to 4 scales each, and reported physical activity to 1 scale (r = 0.29). Changes in HRQoL-scores were directly and significantly related to changes in reported activity (r = 0.35-0.39), peak aerobic power (r = 0.31-0.34), and peak oxygen uptake (r = 0.26-0.37) in 3 scales each. Established associates of HRQoL such as FEV1 or body mass index correlated positively with fewer scales (all 0.24 < r < 0.55).

Conclusions

HRQoL was associated with physical fitness, especially aerobic fitness, and to a lesser extent with reported physical activity. These findings underline the importance of physical fitness for HRQoL in CF and provide an additional rationale for exercise testing in this population.

Trial registration

ClinicalTrials.gov, NCT00231686
Appendix
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Literature
2.
go back to reference Abbott J, Hart A: Measuring and reporting quality of life outcomes in clinical trials in cystic fibrosis: a critical review. Health Qual Life Outcomes. 2005, 3: 19-10.1186/1477-7525-3-19.CrossRefPubMedPubMedCentral Abbott J, Hart A: Measuring and reporting quality of life outcomes in clinical trials in cystic fibrosis: a critical review. Health Qual Life Outcomes. 2005, 3: 19-10.1186/1477-7525-3-19.CrossRefPubMedPubMedCentral
3.
go back to reference Abbott J, Hart A, Morton AM, Dey P, Cornway SP, Webb AK: Can health-related quality of life predict survival in adults with cystic fibrosis?. Am J Respir Crit Care Med. 2009, 179: 54-58. 10.1164/rccm.200802-220OC.CrossRefPubMed Abbott J, Hart A, Morton AM, Dey P, Cornway SP, Webb AK: Can health-related quality of life predict survival in adults with cystic fibrosis?. Am J Respir Crit Care Med. 2009, 179: 54-58. 10.1164/rccm.200802-220OC.CrossRefPubMed
4.
go back to reference Gee L, Abbott J, Conway SP, Etherington C, Webb AK: Development of a disease specific health related quality of life measure for adults and adolescents with cystic fibrosis. Thorax. 2000, 55: 946-954. 10.1136/thorax.55.11.946.CrossRefPubMedPubMedCentral Gee L, Abbott J, Conway SP, Etherington C, Webb AK: Development of a disease specific health related quality of life measure for adults and adolescents with cystic fibrosis. Thorax. 2000, 55: 946-954. 10.1136/thorax.55.11.946.CrossRefPubMedPubMedCentral
5.
go back to reference Quittner AL, Buu A, Messer MA, Modi AC, Watrous M: Development and validation of the cystic fibrosis questionnaire in the United States - a health-related quality-of-life measure for cystic fibrosis. Chest. 2005, 128: 2347-2354. 10.1378/chest.128.4.2347.CrossRefPubMed Quittner AL, Buu A, Messer MA, Modi AC, Watrous M: Development and validation of the cystic fibrosis questionnaire in the United States - a health-related quality-of-life measure for cystic fibrosis. Chest. 2005, 128: 2347-2354. 10.1378/chest.128.4.2347.CrossRefPubMed
6.
go back to reference Bize R, Johnson JA, Plotnikoff RC: Physical activity level and health-related quality of life in the general adult population: a systematic review. Prev Med. 2007, 45: 401-415. 10.1016/j.ypmed.2007.07.017.CrossRefPubMed Bize R, Johnson JA, Plotnikoff RC: Physical activity level and health-related quality of life in the general adult population: a systematic review. Prev Med. 2007, 45: 401-415. 10.1016/j.ypmed.2007.07.017.CrossRefPubMed
7.
go back to reference Sloan RA, Sawada SS, Martin CK, Church T, Blair SN: Associations between cardiorespiratory fitness and health-related quality of life. Health Qual Life Outcomes. 2009, 7: 47-10.1186/1477-7525-7-47.CrossRefPubMedPubMedCentral Sloan RA, Sawada SS, Martin CK, Church T, Blair SN: Associations between cardiorespiratory fitness and health-related quality of life. Health Qual Life Outcomes. 2009, 7: 47-10.1186/1477-7525-7-47.CrossRefPubMedPubMedCentral
8.
go back to reference Selvadurai HC, Blimkie CJ, Cooper PJ, Mellis CM, Van Asperen PP: Gender differences in habitual activity in children with cystic fibrosis. Arch Dis Child. 2004, 89: 928-933. 10.1136/adc.2003.034249.CrossRefPubMedPubMedCentral Selvadurai HC, Blimkie CJ, Cooper PJ, Mellis CM, Van Asperen PP: Gender differences in habitual activity in children with cystic fibrosis. Arch Dis Child. 2004, 89: 928-933. 10.1136/adc.2003.034249.CrossRefPubMedPubMedCentral
9.
go back to reference Orenstein DM, Nixon PA, Ross EA, Kaplan RM: The quality of well-being in cystic fibrosis. Chest. 1989, 95: 344-347. 10.1378/chest.95.2.344.CrossRefPubMed Orenstein DM, Nixon PA, Ross EA, Kaplan RM: The quality of well-being in cystic fibrosis. Chest. 1989, 95: 344-347. 10.1378/chest.95.2.344.CrossRefPubMed
10.
go back to reference Congleton J, Hodson ME, Duncan-Skingle F: Do Nottingham Health Profile scores change over time in cystic fibrosis?. Respir Med. 1998, 92: 268-272. 10.1016/S0954-6111(98)90107-X.CrossRefPubMed Congleton J, Hodson ME, Duncan-Skingle F: Do Nottingham Health Profile scores change over time in cystic fibrosis?. Respir Med. 1998, 92: 268-272. 10.1016/S0954-6111(98)90107-X.CrossRefPubMed
11.
go back to reference Wenninger K, Aussage P, Wahn U, Staab D, and the Germany CFQ study group: The revised German Cystic Fibrosis Questionnaire: validation of a disease-specific health-related quality of life instrument. Qual Life Res. 2003, 12: 77-85. 10.1023/A:1022011704399.CrossRefPubMed Wenninger K, Aussage P, Wahn U, Staab D, and the Germany CFQ study group: The revised German Cystic Fibrosis Questionnaire: validation of a disease-specific health-related quality of life instrument. Qual Life Res. 2003, 12: 77-85. 10.1023/A:1022011704399.CrossRefPubMed
12.
go back to reference Groeneveld IF, Sosa ES, Pérez M, Fiuza-Luces C, Gonzalez-Saiz L, Gallardo C, López-Mojares LM, Ruiz JR, Lucia A: Health-related quality of life of Spanish children with cystic fibrosis. Qual Life Res. 2012, 21: 1837-1845. 10.1007/s11136-011-0100-8.CrossRefPubMedPubMedCentral Groeneveld IF, Sosa ES, Pérez M, Fiuza-Luces C, Gonzalez-Saiz L, Gallardo C, López-Mojares LM, Ruiz JR, Lucia A: Health-related quality of life of Spanish children with cystic fibrosis. Qual Life Res. 2012, 21: 1837-1845. 10.1007/s11136-011-0100-8.CrossRefPubMedPubMedCentral
13.
go back to reference Hebestreit H, Kieser S, Junge S, Ballmann M, Hebestreit A, Schenk T, Posselt HG, Kriemler S: Long-term effects of a partially supervised conditioning programme in cystic fibrosis. Eur Respir J. 2010, 35: 578-583. 10.1183/09031936.00062409.CrossRefPubMed Hebestreit H, Kieser S, Junge S, Ballmann M, Hebestreit A, Schenk T, Posselt HG, Kriemler S: Long-term effects of a partially supervised conditioning programme in cystic fibrosis. Eur Respir J. 2010, 35: 578-583. 10.1183/09031936.00062409.CrossRefPubMed
14.
go back to reference Kriemler S, Kieser S, Junge S, Ballmann M, Hebestreit A, Schindler C, Stüssi C, Hebestreit H: Effect of supervised training on FEV1 in cystic fibrosis. J Cyst Fibros. 2013, 12: 714-720. 10.1016/j.jcf.2013.03.003.CrossRefPubMed Kriemler S, Kieser S, Junge S, Ballmann M, Hebestreit A, Schindler C, Stüssi C, Hebestreit H: Effect of supervised training on FEV1 in cystic fibrosis. J Cyst Fibros. 2013, 12: 714-720. 10.1016/j.jcf.2013.03.003.CrossRefPubMed
15.
go back to reference Slaughter MH, Lohman TG, Boileau RA, Horswill CA, Stillman RJ, Van Loan MD, Bemben DA: Skinfold equations for estimation of body fatness in children and youth. Hum Biol. 1988, 60: 709-723.PubMed Slaughter MH, Lohman TG, Boileau RA, Horswill CA, Stillman RJ, Van Loan MD, Bemben DA: Skinfold equations for estimation of body fatness in children and youth. Hum Biol. 1988, 60: 709-723.PubMed
16.
go back to reference Durnin JVGA, Womersley J: Body fat assessed from total body density and its estimation from skinfold thickness: measurements on 481 men and women aged from 16 to 72 years. Br J Nutr. 1974, 32: 77-97. 10.1079/BJN19740060.CrossRefPubMed Durnin JVGA, Womersley J: Body fat assessed from total body density and its estimation from skinfold thickness: measurements on 481 men and women aged from 16 to 72 years. Br J Nutr. 1974, 32: 77-97. 10.1079/BJN19740060.CrossRefPubMed
17.
go back to reference Sherrill DL, Lebowitz MD, Knudson RJ, Burrows B: Continuous longitudinal regression equations for pulmonary function measures. Eur Respir J. 1992, 5: 452-462.PubMed Sherrill DL, Lebowitz MD, Knudson RJ, Burrows B: Continuous longitudinal regression equations for pulmonary function measures. Eur Respir J. 1992, 5: 452-462.PubMed
18.
go back to reference Inbar O, Bar-Or O, Skinner JS: The Wingate Anaerobic Test. 1996, Champaign, IL: Human Kinetics Inbar O, Bar-Or O, Skinner JS: The Wingate Anaerobic Test. 1996, Champaign, IL: Human Kinetics
19.
go back to reference Williams CA, Doré E, Alban J, van Praagh E: Short-term power output in 9-year-old children: typical error between ergometers and protocols. Ped Exerc Sci. 2003, 15: 302-312. Williams CA, Doré E, Alban J, van Praagh E: Short-term power output in 9-year-old children: typical error between ergometers and protocols. Ped Exerc Sci. 2003, 15: 302-312.
20.
go back to reference Godfrey S, Davies CTM, Wozniak E, Barnes CA: Cardio-respiratory response to exercise in normal children. Clin Sci. 1971, 40: 419-431.CrossRefPubMed Godfrey S, Davies CTM, Wozniak E, Barnes CA: Cardio-respiratory response to exercise in normal children. Clin Sci. 1971, 40: 419-431.CrossRefPubMed
21.
go back to reference Orenstein DM: Assessment of exercise pulmonary function. Pediatric Laboratory Exercise Testing. Clinical Guideline.s. Edited by: Rowland TW. 1993, Champaign, IL: Human Kinetics, 141-163. Orenstein DM: Assessment of exercise pulmonary function. Pediatric Laboratory Exercise Testing. Clinical Guideline.s. Edited by: Rowland TW. 1993, Champaign, IL: Human Kinetics, 141-163.
22.
go back to reference Sallis JF, Haskell WL, Wood PD, Fortmann SP, Rogers T, Blair SN, Paffenbarger RS: Physical activity assessment methodology in the five-city project. Am J Epidemiol. 1985, 121: 91-106.PubMed Sallis JF, Haskell WL, Wood PD, Fortmann SP, Rogers T, Blair SN, Paffenbarger RS: Physical activity assessment methodology in the five-city project. Am J Epidemiol. 1985, 121: 91-106.PubMed
23.
go back to reference Sallis JF, Buono MJ, Roby JJ, Micale FG, Nelson JA: Seven-day recall and other physical activity self-reports in children and adolescents. Med Sci Sports Exerc. 1993, 25: 99-108. 10.1249/00005768-199301000-00014.CrossRefPubMed Sallis JF, Buono MJ, Roby JJ, Micale FG, Nelson JA: Seven-day recall and other physical activity self-reports in children and adolescents. Med Sci Sports Exerc. 1993, 25: 99-108. 10.1249/00005768-199301000-00014.CrossRefPubMed
24.
go back to reference Ruf KC, Fehn S, Bachmann M, Moeller A, Roth K, Kriemler S, Hebestreit H: Validation of activity questionnaires in patients with cystic fibrosis by accelerometry and cycle ergometry. BMC Med Res Methodol. 2012, 12: 43-10.1186/1471-2288-12-43.CrossRefPubMedPubMedCentral Ruf KC, Fehn S, Bachmann M, Moeller A, Roth K, Kriemler S, Hebestreit H: Validation of activity questionnaires in patients with cystic fibrosis by accelerometry and cycle ergometry. BMC Med Res Methodol. 2012, 12: 43-10.1186/1471-2288-12-43.CrossRefPubMedPubMedCentral
25.
go back to reference Hebestreit H, Kieser S, Rüdiger S, Schenk T, Junge S, Hebestreit A, Ballmann M, Posselt HG, Kriemler S: Physical activity is independently related to aerobic capacity in cystic fibrosis. Eur Resp J. 2006, 28: 734-739. 10.1183/09031936.06.00128605.CrossRef Hebestreit H, Kieser S, Rüdiger S, Schenk T, Junge S, Hebestreit A, Ballmann M, Posselt HG, Kriemler S: Physical activity is independently related to aerobic capacity in cystic fibrosis. Eur Resp J. 2006, 28: 734-739. 10.1183/09031936.06.00128605.CrossRef
26.
go back to reference McGlone S, Venn A, Walters EH: Physical activity, spirometry and quality-of-life in chronic obstructive pulmonary disease. COPD. 2006, 3: 83-88. 10.1080/15412550600651263.CrossRefPubMed McGlone S, Venn A, Walters EH: Physical activity, spirometry and quality-of-life in chronic obstructive pulmonary disease. COPD. 2006, 3: 83-88. 10.1080/15412550600651263.CrossRefPubMed
27.
go back to reference Chan CB, Ryan DA, Tudor-Locke C: Relationship between objective measures of physical activity and weather: a longitudinal study. Int J Behav Nutr Phys Act. 2006, 3: 21-10.1186/1479-5868-3-21.CrossRefPubMedPubMedCentral Chan CB, Ryan DA, Tudor-Locke C: Relationship between objective measures of physical activity and weather: a longitudinal study. Int J Behav Nutr Phys Act. 2006, 3: 21-10.1186/1479-5868-3-21.CrossRefPubMedPubMedCentral
28.
go back to reference Corder K, Ekelund U, Steele RM, Wareham NJ, Brage S: Assessment of physical activity in youth. J Appl Physiol. 2008, 105: 977-987. 10.1152/japplphysiol.00094.2008.CrossRefPubMed Corder K, Ekelund U, Steele RM, Wareham NJ, Brage S: Assessment of physical activity in youth. J Appl Physiol. 2008, 105: 977-987. 10.1152/japplphysiol.00094.2008.CrossRefPubMed
29.
go back to reference Selvadurai HC, Blimkie CJ, Meyers N, Mellis CM, Cooper PJ, VanAsperen PP: Randomized controlled study of in-hospital exercise training programs in children with cystic fibrosis. Pediatr Pulmonol. 2002, 33: 194-200. 10.1002/ppul.10015.CrossRefPubMed Selvadurai HC, Blimkie CJ, Meyers N, Mellis CM, Cooper PJ, VanAsperen PP: Randomized controlled study of in-hospital exercise training programs in children with cystic fibrosis. Pediatr Pulmonol. 2002, 33: 194-200. 10.1002/ppul.10015.CrossRefPubMed
30.
go back to reference Orenstein DM, Franklin BA, Doerchuk CF, Hellerstein HK, Germann KJ, Horowitz JG, Stern RC: Exercise conditioning and cardiopulmonary fitness in cystic fibrosis. The effects of a three-month supervised running program. Chest. 1981, 80: 392-398.PubMed Orenstein DM, Franklin BA, Doerchuk CF, Hellerstein HK, Germann KJ, Horowitz JG, Stern RC: Exercise conditioning and cardiopulmonary fitness in cystic fibrosis. The effects of a three-month supervised running program. Chest. 1981, 80: 392-398.PubMed
31.
go back to reference Raglin JS, Morgan WP: O´Connor PJ: Changes in mood states during training in female and male college swimmers. Int J Sports Med. 1991, 12: 585-589. 10.1055/s-2007-1024739.CrossRefPubMed Raglin JS, Morgan WP: O´Connor PJ: Changes in mood states during training in female and male college swimmers. Int J Sports Med. 1991, 12: 585-589. 10.1055/s-2007-1024739.CrossRefPubMed
32.
go back to reference Orenstein DM, Hovell MF, Mulvihill M, Keating KK, Hofstetter R, Kelsey S, Morris K, Nixon PA: Strength vs aerobic training in children with cystic fibrosis. Chest. 2004, 126: 1204-1214. 10.1378/chest.126.4.1204.CrossRefPubMed Orenstein DM, Hovell MF, Mulvihill M, Keating KK, Hofstetter R, Kelsey S, Morris K, Nixon PA: Strength vs aerobic training in children with cystic fibrosis. Chest. 2004, 126: 1204-1214. 10.1378/chest.126.4.1204.CrossRefPubMed
33.
go back to reference Adams SA, Matthews CE, Ebbeling CB, Moore CG, Cunningham JE, Fulton J, Hebert JR: The effect of social desirability and social approval on self-reports of physical activity. Am J Epidemiol. 2005, 161: 389-398. 10.1093/aje/kwi054.CrossRefPubMedPubMedCentral Adams SA, Matthews CE, Ebbeling CB, Moore CG, Cunningham JE, Fulton J, Hebert JR: The effect of social desirability and social approval on self-reports of physical activity. Am J Epidemiol. 2005, 161: 389-398. 10.1093/aje/kwi054.CrossRefPubMedPubMedCentral
34.
go back to reference Schneiderman-Walker J, Pollock SL, Corey M, Wilkes DD, Canny GJ, Pedder L, Reisman JJ: A randomized controlled trial of a three year home exercise program in cystic fibrosis. J Pediatr. 2000, 136: 304-310. 10.1067/mpd.2000.103408.CrossRefPubMed Schneiderman-Walker J, Pollock SL, Corey M, Wilkes DD, Canny GJ, Pedder L, Reisman JJ: A randomized controlled trial of a three year home exercise program in cystic fibrosis. J Pediatr. 2000, 136: 304-310. 10.1067/mpd.2000.103408.CrossRefPubMed
Metadata
Title
Quality of life is associated with physical activity and fitness in cystic fibrosis
Authors
Helge Hebestreit
Kerstin Schmid
Stephanie Kieser
Sibylle Junge
Manfred Ballmann
Kristina Roth
Alexandra Hebestreit
Thomas Schenk
Christian Schindler
Hans-Georg Posselt
Susi Kriemler
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Pulmonary Medicine / Issue 1/2014
Electronic ISSN: 1471-2466
DOI
https://doi.org/10.1186/1471-2466-14-26

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