Abstract Background Daily physical activity (PA) is the strongest predictor of survival and is associated with the risk of hospitalization, poor quality of life 1-3 in people living with Chronic Obstructive Pulmonary Disease COPD.2 However, symptoms of breathlessness, functional limitations, and poor exercise tolerance may make it difficult to meet the conventional physical activity guidelines of 150 minutes of moderate intensity. There is a knowledge gap in the granular amount and intensity of daily PA that may provide a survival benefit for people living with COPD: specifically in light PA (1.5-3METs) and moderate (3-6 METs) PA, which are the intensities most achievable in moderate-severe disease. We aimed to determine whether different intensities of daily physical activity, accurately measured by a gold-standard activity monitor, were associated with a survival benefit in a large cohort of people living with moderate to severe COPD followed for six years. Methods Participants wore the Actigraph® GT3X-BT, a tri-axial wrist accelerometer, for 7 days. Survival at 72 months was assessed through the National Death Index Inquiry by Accurint® and confirmed by records. Analysis Participants in this cohort were randomly assigned to a training data set (70%) and 30% to a validation set. Classification and regression tree (CART) models were generated using the training data set. Bootstrapping with 3,000 iterations was conducted. 872 patients were part of this study: mean age 69+ 8, 54% female, mMRC score, (scale 0-4) was 2.6 + 0.8 and FEV1% was 46% +19. The mean follow-up was 42+ 21 months with a range of 1-72 months. At the end of the follow up 67.3% were alive, 32.7% were deceased. The bootstrapped CART analysis modeled cut points associated with survival as follows: 296 minutes for light PA, 17 minutes for moderate PA; and 3243 steps after adjusting for age, sex, FEV1% and mMRC score. Consistent with the 17 minutes of moderate PA providing 58% survival benefits, we also found that two 10-minute Freedson bouts of activity per day (2x10 min of PA in moderate intensity) the same provided the same survival benefit1. Cox models are presented in Table 1 Conclusion This report is the first to document the survival benefit of light physical activity in patients with COPD. In the context of most patients with moderate-severe COPD not able to achieve PA guidelines, our results represent a breath of fresh air, suggesting that simple and meaningful (to the patient) light activities may provide a survival benefit. This abstract is funded by: NIH
Benzo et al. (2026) studied this question.