Objectively Measured Physical Activity in Patients with COPD: Recommendations from an International Task Force on Physical Activity.

Physical activity (PA) is of key importance for health among healthy persons and individuals with chronic obstructive pulmonary disease (COPD). PA has multiple dimensions that can be assessed and quantified objectively using activity monitors. Moreover, as shown in the published literature, variable methodologies have been used to date to quantify PA among individuals with COPD, precluding clear comparisons of outcomes across studies. The present paper aims to provide a summary of the available literature for the rationale behind using objectively measured PA and proposes a standardized methodology for assessment, including standard operating procedures for future research. The present paper, therefore, describes the concept of PA, reports on the importance of PA, summarizes the dimensions of PA, provides a standard operating procedure on how to monitor PA using objective assessments, and describes the psychometric properties of objectively measured PA. The present international task force recommends implementation of the standard operating procedure for PA data collection and reporting in the future. This should further clarify the relationship between PA and clinical outcomes, test the impact of treatment interventions on PA in individuals with COPD, and successfully propose a PA endpoint for regulatory qualification in the future. Abbreviations: physical activity, PA; chronic obstructive pulmonary disease, COPD; Chronic Lung Disease Biomarker and Clinical Outcome Assessment Qualification Consortium, CBQC; Innovative Medicines Initiative, IMI; Physical Activity as Crucial Patient-Reported Outcome in COPD project, PRO-active; clinical outcome assessment, COA; Food and Drug Administration, FDA; European Medicines Agency, EMA; St George’s Respiratory Questionnaire, SGRQ; patient-reported outcomes, PROs; metabolic equivalent of tasks, METs; resting metabolic rate, RMR; oxygen uptake, VO2; moderate to vigorous physical activity, MVPA; vector magnitude units, VMU; physical activity level, PAL; micro electromechanical systems, MEMs; COPD Genetic Epidemiology study, COPDGene®; Global initiative for chronic Obstructive Lung Disease, GOLD; standardized response means, SRM; minimal important difference, MID; minimal clinical important difference, MCID; context of use, COU Funding Support: Funding for the Chronic Lung Disease Biomarker Qualification and Clinical Outcome Assessment Qualification Consortium was provided by AstraZeneca, Boehringer Ingelheim, GlaxoSmithKline, and Chiesi. Date of Acceptance: July 26, 2021 | Published Online Date: August 25, 2021 Citation: Demeyer H, Mohan D, Burtin C, et al. Objectively measured physical activity in patients with COPD: recommendations from an international task force on physical activity. Chronic Obstr Pulm Dis. 2021;8(4):528-550. doi: https://doi.org/10.15326/jcopdf.2021. 0213 529 Objective Measures of Physical Activity in COPD journal.copdfoundation. org JCOPDF © 2021 Volume 8 • Number 4 • 2021 For personal use only. Permission required for all other uses. 1 Department of Rehabilitation Sciences, KU Leuven–University of Leuven and Respiratory Division, University Hospitals Leuven, Leuven, Belgium Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium Medical Innovation, Value Evidence and Outcomes, GlaxoSmithKline Research and Development, Collegeville, Pennsylvania, United States Reval Rehabilitation Research Center, Biomed Biomedical Research Institute, Hasselt University, Diepenbeek, Belgium Department of Research and Development, CIRO, Horn, Netherlands Digital Biomarkers, GlaxoSmithKline Research and Development, Stevenage, United Kingdom National Jewish Health, Denver, Colorado, United States Rehabilitation Clinical Trials Center, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, California, United States Departments of Medicine and Physiology, David Geffen School of Medicine, University of California, Los Angeles, California, United States AstraZeneca Research and Development, Global Regulatory Excellence, Paris, France Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland Boehringer Ingelheim Canada, Burlington, Ontario, Canada National Heart and Lung Institute, Imperial College, London, United Kingdom Respiratory Medicine, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom BioPharmaceuticals Research and Development Digital Health, AstraZeneca, Gothenburg, Sweden Harefield Respiratory Research Group, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom Pulmonary, Critical Care, and Sleep Medicine Section, VA Boston Healthcare System, Boston, Massachusetts, United States Harvard Medical School, Boston, Massachusetts, United States Laboratory of Research in Respiratory Physiotherapy, State University of Londrina, Brazil Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska, United States Section of Pulmonary, Critical Care and Sleep, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, United States VA Connecticut Healthcare System, West Haven, Connecticut, United States Faculty of Biological Sciences, University of Leeds, Leeds, United Kingdom Division of Pulmonary, Allergy and Critical Care Medicine, University of Pittsburgh, Pennsylvania, United States Department of Respiratory Science, University of Leicester, Leicester, United Kingdom COPD Foundation, COPD360 Research, Miami, Florida, United States Department of Sport, Exercise, and Rehabilitation, Northumbria University, Newcastle, United Kingdom Pulmonary Research Institute at LungenClinic Grosshansdorf, Airway Research Center North, German Center for Lung Research, Grosshansdorf, Germany 2