How urban environment influences physical activity in COPD patients: The findings show that patients living close to longer pedestrian streets walk more, while those living in more densely populated areas walk less

The physical activity and exercise capacity of people with chronic obstructive pulmonary disease (COPD) appear to be related to population density, pedestrian street length, slope of terrain and exposure to nitrogen dioxide (NO2) in the vicinity of their homes, according to a new study led by the Barcelona Institute for Global Health (ISGlobal), a centre supported by the “la Caixa” Foundation.

The study, recently published in Environmental Research, found that higher population density was associated with fewer steps taken by patients, more sedentary time and worse exercise capacity (with a stronger association being found in people with symptoms of depression). Longer pedestrian street lengths were associated with more steps and less sedentary time. Steeper slope was associated with greater exercise capacity. Finally, higher long-term exposure to NO2 (an indicator of traffic-related air pollution) was associated with more sedentary time and more difficulty with physical activity.

The researchers concluded that these neighbourhood environmental factors should be considered in clinical contacts with patients and when developing urban and transport planning policies aimed at promoting physical activity in patients with a chronic disease. Research on the urban environment has often ignored this population, which currently accounts for approximately 35% of urban dwellers in Europe.

COPD is characterised by progressive airflow limitation leading to shortness of breath and often limits the ability to perform daily activities. Patients are typically less active than healthy controls from the early stages of the disease onwards and this inactivity has a negative effect on COPD prognosis. Physical activity is therefore recommended for COPD patients and it is essential to know and understand which factors other than the disease itself may influence patients’ physical activity habits.

A Novel Research Question

The study aimed to estimate, in patients with mild to very severe COPD, the association between the urban environment and three variables: objective physical activity (daily step count and sedentary time), physical activity experience (perceived difficulty during activity) and functional exercise capacity (distance covered during six minutes of walking).

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