Physical Activity Levels in Patients with COPD Influenced by Social Determinants Just as Much as by Biological Factors

A study led by ISGlobal finds grandparenting and dog walking to be associated with more prolonged and intense physical activity in patients with COPD

Photo: Photo: Ane Arbillaga / ISGlobal

A study led by researchers from ISGlobal and published in the journal Thorax has provided evidence concerning the non-biological determinants of physical activity in patients with chronic obstructive pulmonary disease (COPD). Their findings could open the door to new complementary approaches in the management of this condition. The team coordinated by Judith Garcia-Aymerich observed that  patients with COPD who took care of their grandchildren or walked a dog were more physically active and did more vigorous exercise than those who did not.

Despite consensus that it is vitally important for patients with COPD to maintain an active life style, strategies for encouraging these patients to increase their level of physical activity have to date been focused on improving their capacity for exercise through interventions such as drug therapy and pulmonary rehabilitation. “Physical activity is still being treated as a purely biological process—and not just in patients with COPD but also in other chronic diseases”, explains one of the study's authors Judith Garcia-Aymerich, an ISGlobal researcher. “In our opinion, it is this very narrow view that has led to a situation in which no effective interventions have yet been found to get these patients to increase their physical activity over the long term”, she adds.

The study that has just been published approaches the problem in an innovative way: by assessing the social and environmental factors that determine the amount of physical activity undertaken by patients with COPD. To do this, the researchers recruited 410 patients with COPD living in five municipalities in the Barcelona metropolitan area (Barcelona, Badalona, Mataró, Viladecans and Gavà). The patients provided information on a number of variables, including their daily habits, socioeconomic status, physical and mental health, and the distance between their homes and green and blue spaces.  In parallel, the amount and intensity of their physical activity was monitored for one week using an accelerometer.

Analysis of the data gathered in this way revealed a significant association between responsibility for taking care of grandchildren or walking a dog and more prolonged and vigorous physical activity. By contrast, no relationships were observed between levels of physical activity and other factors such as the type of neighbourhood or the proximity of the patient’s home to green or blue spaces.

“The results of this study demonstrate the need to take social factors into account when promoting and encouraging physical activity in people with COPD. Finding out more about our patients’ social context, family roles, interpersonal relationships and leisure preferences could provide information that will improve our therapeutic approach to physical activity”, concludes ISGlobal researcher Ane Arbillaga, the lead author of the study.


Arbillaga-Etxarri A, Gimeno-Santos E, Barberan-Garcia A, et al. Thorax. 2017 Mar 1. pii: thoraxjnl-2016-209209. doi: 10.1136/thoraxjnl-2016-209209 . [Epub ahead of print]