Impact of lung volume reduction coils on patient's physical activity

Background:

Implantation of lung volume reduction coils (LVRC) achieves diminishment of emphysema. A growing body of evidence has recently associated LVRC insertion with sustainable improvements in quality of life, but only modest increases in exercise tolerance [1]. Our objective was to assess the changes in physical activity and energy expenditure in patients undergoing LVRC-treatment.

Methods:

We enrolled 13 patients with severe emphysematous COPD scheduled for LVRC insertion. Physical activity in daily life was monitored by the validated SenseWear® Armband 7 days prior to the first coil treatment procedure and at a six-week interval after complementary contralateral coil insertion. Both sequential procedures were six weeks apart.

Results:

Patients were predominantly late middle-aged (65.8 ± 8.7yrs), female (61.5%) and presented advanced COPD emphysema (means FEV1 and RV: 31.4 ± 12.2% and 260.9 ± 69.9% of predicted, respectively). After LVRC treatment, daily total energy expenditure increased significantly by 38.0% in relative terms (3828.8 ± 1666.3 vs. 5284.8 ± 1035.8MET·min·day– 1, p = 0.03) and was accompanied by a significant improvement in daily activity, measured by total daily step count (126.5 ± 96.2 vs. 600.6 ± 118.9, p = 0.04). Moreover, duration of physical activity increased by an absolute of 4 hours and 36 min (p = 0.13). By contrast, six-minute walk test distance did not exhibit any substantial improvement (270.0 ± 114.8 m vs. 279.6 ± 126.6 m, p = 0.69).

Discussion:

LVRC beneficially impacts patient's physical activity in daily life and thereby may contribute to the gain in quality of life, as recently reported [1].

References:

[1] Sciurba FC, Criner GJ, Strange C et al. Effect of Endobronchial Coils vs. Usual Care on Exercise Tolerance in Patients With Severe Emphysema: The RENEW Randomized Clinical Trial. JAMA. 2016; 315: 2178 – 89.