Real-world walking cadence in people with COPD

Laura Delgado-Ortiz, Saverio Ranciati, Ane Arbillaga-Etxarri, Eva Balcells, Joren Buekers, Heleen Demeyer, Anja Frei, Elena Gimeno-Santos, Nicholas S. Hopkinson, Corina de Jong, Niklas Karlsson, Zafeiris Louvaris, Luca Palmerini, Michael I. Polkey, Milo A. Puhan, Roberto A. Rabinovich, Diego A. Rodríguez Chiaradia, Robert Rodriguez-Roisin, Pere Toran-Montserrat, Ioannis VogiatzisHenrik Watz, Thierry Troosters, Judith Garcia-Aymerich*

*Corresponding author for this work

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Introduction The clinical validity of real-world walking cadence in people with COPD is unsettled. Our objective was to assess the levels, variability and association with clinically relevant COPD characteristics and outcomes of real-world walking cadence. Methods We assessed walking cadence (steps per minute during walking bouts longer than 10 s) from 7days’ accelerometer data in 593 individuals with COPD from five European countries, and clinical and functional characteristics from validated questionnaires and standardised tests. Severe exacerbations during a 12-month follow-up were recorded from patient reports and medical registries. Results Participants were mostly male (80%) and had mean±SD age of 68±8 years, post-bronchodilator forced expiratory volume in 1 s (FEV 1) of 57±19% predicted and walked 6880±3926 steps·day −1. Mean walking cadence was 88±9 steps·min −1, followed a normal distribution and was highly stable within-person (intraclass correlation coefficient 0.92, 95% CI 0.90–0.93). After adjusting for age, sex, height and number of walking bouts in fractional polynomial or linear regressions, walking cadence was positively associated with FEV 1, 6-min walk distance, physical activity (steps·day −1, time in moderate-to-vigorous physical activity, vector magnitude units, walking time, intensity during locomotion), physical activity experience and health-related quality of life and negatively associated with breathlessness and depression (all p<0.05). These associations remained after further adjustment for daily steps. In negative binomial regression adjusted for multiple confounders, walking cadence related to lower number of severe exacerbations during follow-up (incidence rate ratio 0.94 per step·min −1, 95% CI 0.91–0.99, p=0.009). Conclusions Higher real-world walking cadence is associated with better COPD status and lower severe exacerbations risk, which makes it attractive as a future prognostic marker and clinical outcome.

Original languageEnglish
Article number00673
Pages (from-to)1-11
Number of pages11
JournalERJ Open Research
Issue number2
Early online date26 Jan 2024
Publication statusPublished - 4 Mar 2024

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