TY  - JOUR
N2  - Background: Physical activity (PA) is associated with disease severity in idiopathic pulmonary fibrosis (IPF), but longitudinal studies evaluating its prognostic value and changes over time are lacking.   Methods: We measured PA (steps per day, SPD) in a cohort of 46 IPF-patients (mean age, 67 years; mean FVC, 76.1%pred.) by accelerometry at baseline, recorded survival status during 3 years follow-up and repeated measurements in survivors. We compared the prognostic value of PA to established mortality predictors including lung function (FVC, DLCO) and 6-min walking-distance (6MWD).   Results: During follow-up (median 34 months) 20 patients (43%) died. SPD and FVC best identified non-survivors (AUROC-curve 0.79, p < 0.01). After adjustment for confounders (sex, age, therapy), a standardized increase (i.e. one SD) in SPD, FVC%pred. or DLCO%pred. was associated with a more than halved risk of death (HR < 0.50; p < 0.01). Compared to baseline, SPD, FVC, and 6MWD annually declined in survivors by 973 SPD, 130 ml and 9 m, resulting in relative declines of 48.3% (p < 0.001), 13.3% (p < 0.001) and 7.8% (p = 0.055), respectively.   Conclusion: While PA predicts mortality of IPF patients similar to established functional measures, longitudinal decline of PA seems to be disproportionally large. Our data suggest that the clinical impact of disease progression could be underestimated by established functional measures.
A1  - Bahmer, Thomas
A1  - Kirsten, Anne-Marie
A1  - Waschki, Benjamin
A1  - Rabe, Klaus F.
A1  - Magnussen, Helgo
A1  - Kirsten, Detlef
A1  - Gramm, Marco
A1  - Hummler, Simone
A1  - Brunnemer, Eva
A1  - Kreuter, Michael
A1  - Watz, Henrik
IS  - 104
Y1  - 2017///
JF  - BMC Pulmonary Medicine
TI  - Prognosis and longitudinal changes of physical activity in idiopathic pulmonary fibrosis
VL  - 17
EP  - 8
UR  - https://archiv.ub.uni-heidelberg.de/volltextserver/23282/
PB  - BioMed Central
ID  - heidok23282
AV  - public
SN  - 1471-2466
SP  - 1
CY  - London
ER  -