DeustoTeka Examinando por Autor "Gimeno Santos, Elena"

Examinando por Autor "Gimeno Santos, Elena"

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Determinants of study completion and response to a 12-month behavioral physical activity intervention in chronic obstructive pulmonary disease: a cohort study
(Public Library of Science, 2019-05-20) Koreny, Maria; Demeyer, Heleen; Arbillaga Etxarri, Ane; Gimeno Santos, Elena; Barberán García, Anael; Benet, Marta; Balcells, Eva; Borrell, Eulàlia; Marín, Alicia; Rodríguez Chiaradía, Diego A.; Vall Casas, Pere; Vilaró, Jordi; Rodríguez Roisin, Robert; García Aymerich, Judith
Objectives Physical activity is key to improve the prognosis of chronic obstructive pulmonary disease (COPD). To help to tailor future interventions we aimed to identify the baseline characteristics of COPD patients which predict 12-month completion and response to a behavioral physical activity intervention. Methods This is a 12-month cohort study of the intervention arm of the Urban Training randomized controlled trial (NCT01897298), an intervention proven to be efficacious to increase physical activity. We considered baseline sociodemographic, interpersonal, environmental, clinical and psychological characteristics as potential determinants of completion and response. We defined completion as attending the 12-month study visit. Among completers, we defined response as increasing physical activity ≥1100 steps/day from baseline to 12 months, measured by accelerometer. We estimated the factors independently for completion and response using multivariable logistic regression models. Results Of a total of 202 patients (m (SD) 69 (9) years, 84% male), 132 (65%) completed the study. Among those, 37 (28%) qualified as responders. Higher numbers of baseline steps/day (OR [95% CI] 1.11 [1.02-1.21] per increase of 1000 steps, p<0.05) and living with a partner (2.77 [1.41-5.48], p<0.01) were related to a higher probability of completion while more neighborhood vulnerability (0.70 [0.57-0.86] per increase of 0.1 units in urban vulnerability index, p<0.01) was related to a lower probability. Among the completers, working (3.14 [1.05-9.33], p<0.05) and having an endocrino-metabolic disease (4.36 [1.49-12.80], p<0.01) were related to a higher probability of response while unwillingness to follow the intervention (0.21 [0.05-0.98], p<0.05) was related to a lower probability. Conclusions This study found that 12-month completion of a behavioral physical activity intervention was generally determined by previous physical activity habits as well as interpersonal and environmental physical activity facilitators while response was related to diverse factors thought to modify the individual motivation to change to an active lifestyle.
Exacerbations and changes in physical activity and sedentary behaviour in patients with bronchiectasis after 1 year
(MDPI, 2021-03-02) Alcaraz Serrano, Victoria; Arbillaga Etxarri, Ane; Oscanoa, Patricia; Fernández Barat, Laia; Bueno, Leticia; Amaro, Rosanel; Gimeno Santos, Elena; Torres, Antoni
Background: Low physical activity and high sedentary behaviour in patients with bron-chiectasis are associated with hospitalisation over one year. However, the factors associated with longitudinal changes in physical activity and sedentary behaviour have not been explored. We aimed to identify clinical and sociodemographic characteristics related to a change in physical activity and sedentary behaviour in patients with bronchiectasis after one year. Methods: This was a prospective observational study during which physical activity measurements were recorded using a SenseWear Armband for one week at baseline and at one year. At each assessment point, patients were classified as active or inactive (measured as steps per day) and as sedentary or not sedentary (measured as sedentary time). Results: 53 patients with bronchiectasis were analysed, and after one year, 18 (34%) had worse activity and sedentary levels. Specifically, 10 patients be-came inactive and sedentary. Multivariable analysis showed that the number of exacerbations during the follow-up period was the only outcome independently associated with change to higher inactivity and sedentary behaviour (odds ratio (OR), 2.19; 95% CI, 1.12 to 4.28). Conclusions: The number of exacerbations in patients with bronchiectasis was associated with changes in physical activity and sedentary behaviour. Exacerbation prevention may appear as a key factor in relation to physical activity and sedentary behaviour in patients with bronchiectasis.
Fisioterapia respiratoria post-COVID-19: algoritmo de decisión terapéutica
(Elsevier Espana S.L.U, 2022-01) Arbillaga Etxarri, Ane; Lista Paz, Ana; Alcaraz Serrano, Victoria; Escudero Romero, Raúl; Herrero Cortina, Beatriz; Balañá, Ana; Sebio, Raquel; Vilaró, Jordi; Gimeno Santos, Elena
La pandemia causada por la enfermedad de la COVID-19 ha supuesto un gran reto para los profesionalesdel sistema sociosanitario, intensificándose con el manejo y atención de las manifestaciones clínicas quepotencialmente pueden presentarse de manera persistente en las personas que han superado la enferme-dad. Para ello, la fisioterapia respiratoria se presenta como piedra angular dentro del modelo de abordajeinterdisciplinar que requiere esta población. Dado que la implementación de esta opción terapéuticacontinúa siendo limitada en Espa˜na, es imprescindible realizar una evaluación integral y exhaustiva de lapersona que nos permita establecer criterios de selección a fin de optimizar el uso de los recursos huma-nos y materiales existentes. Para ello, se propone un algoritmo de decisión terapéutica basado en pruebasde evaluación validadas y objetivas de las posibles manifestaciones clínicas del paciente. La aplicación deeste algoritmo, en cualquier nivel asistencial (atención especializada y atención primaria/comunitaria)junto con la atención centrada en la persona, el impulso del uso de los espacios comunitarios verdes yazules de las ciudades y un adecuado uso de las tecnologías de la comunicación y la información, nospermitirá optimizar el modelo de atención de fisioterapia respiratoria en el contexto actual, marcado porla COVID-19.
Heart rate and oxygen uptake kinetics obtained from continuous measurements with wearable devices during outdoor walks of patients with COPD
(SAGE Publications Inc., 2023) Buekers, Joren; Arbillaga Etxarri, Ane; Gimeno Santos, Elena; Donaire González, David; Chevance, Guillaume; Aerts, Jean-Marie; García Aymerich, Judith
Objective: Continuous physiological measurements during a laboratory-based exercise test can provide physiological biomarkers, such as heart rate (HR) and oxygen uptake (V̇O2) kinetics, that carry clinically relevant information. In contrast, it is not clear how continuous data generated by wearable devices during daily-life routines could provide meaningful biomarkers. We aimed to determine whether valid HR and V̇O2 kinetics can be obtained from measurements with wearable devices during outdoor walks in patients with chronic obstructive pulmonary disease (COPD). Methods: HR (Polar Belt) and V̇O2(METAMAX3B) were measured during 93 physical activity transitions performed by eight patients with COPD during three different outdoor walks (ntr= 77) and a 6-minute walk test (ntr= 16). HR and V̇O2 kinetics were calculated every time a participant started a walk, finished a walk or walked upstairs. HR and V̇O2 kinetics were considered valid if the response magnitude and model fit were adequate, and model parameters were reliable. Results: Continuous measurements with wearable devices provided valid HR kinetics when COPD patients started or finished (range 63%–100%) the different outdoor walks and valid V̇O2 kinetics when they finished (range 63%–100%) an outdoor walk. The amount of valid kinetics and kinetic model performance was comparable between outdoor walks and a laboratory-based exercise test (p >.05). Conclusion: We envision that the presented approach could improve telemonitoring applications of patients with COPD by providing regular, unsupervised assessments of HR kinetics during daily-life routines. This could allow to early identify a decline in the patients’ dynamic physiological functioning, physical fitness and/or health status.
Heart rate recovery after the 6-min walk test in people with bronchiectasis
(European Respiratory Society, 2025-03) Sáez Pérez, Juan Antonio; Arbillaga Etxarri, Ane; Alcaraz Serrano, Victoria; Gimeno Santos, Elena; Torres, Antoni; Herrero Cortina, Beatriz
Background The cardiac autonomic response to exercise and during recovery has been poorly explored in bronchiectasis. Methods A longitudinal study was conducted in adults with bronchiectasis. Sociodemographic and clinical data were collected at baseline and after 12 months of follow-up. The heart rate recovery after the first (HRR1) and second minute (HRR2) of recovery in the six-min walk test (6MWT) was estimated in both assessments. Adjusted regression models were used to identify predictors of a delayed HRR1 (HRR1 ⩽14). Results 104 participants with a mean±SD age of 64±13 years and mostly women (67%) were included. A delayed HRR1 after the baseline 6MWT was identified in 36% of participants. These participants presented a higher proportion of males, increased body mass index, higher disease severity, more likely to require hospitalisation, more impact on quality of life, lower exercise capacity, lower heart rate at the end of the 6MWT and lower HRR2. Disease severity (β, 95% CI) (moderate and severe versus mild, −0.47 (−0.94 to −0.01)) and distance walked (0.34 (0.11 to 0.56)) were the independent variables associated with HRR1. Of the 45 participants who completed the entire follow-up period, 24% exhibited delayed HRR1. The presence of at least two exacerbations during the follow-up period (OR 16.89, 95% CI 1.44 to 197.48) was the only predictor of a delayed HRR1 in the assessment completed at the end of the study. Conclusion HRR1 is related to disease severity and is mainly affected by having severe exacerbations in people with bronchiectasis.
Maximal respiratory pressure reference equations in healthy adults and cut-off points for defining respiratory muscle weakness
(Sociedad Espanola de Neumologia y Cirugia Toracica (SEPAR), 2023-12) Lista Paz, Ana; Langer, Daniel; Barral Fernández, Margarita; Quintela del Río, Alejandro; Gimeno Santos, Elena; Arbillaga Etxarri, Ane; Torres Castro, Rodrigo; Vilaró, Jordi; Varas de la Fuente, Ana B.; Serrano Veguillas, Cristina; Bravo Cortés, Pilar; Martín Cortijo, Concepción; García Delgado, Esther; Herrero Cortina, Beatriz; Valera, José Luis; Fregonezi, Guilherme A.F.; González Montañez, Carolina; Martín Valero, Rocío; Francín Gallego, Marina; Sanesteban Hermida, Yolanda; Giménez Moolhuyzen, Esther; Álvarez Rivas, Jorge; Ríos Cortés, Antonio Tomás; Souto-Camba, Sonia; González Doniz, Luz
Introduction: Maximal inspiratory and expiratory pressures (PImax/PEmax) reference equations obtained in healthy people are needed to correctly interpret respiratory muscle strength. Currently, no clear cut-off points defining respiratory muscle weakness are available. We aimed to establish sex-specific reference equations for PImax/PEmax in a large sample of healthy adults and to objectively determine cut-off points for respiratory muscle weakness. Methods: A multicentre cross-sectional study was conducted across 14 Spanish centres. Healthy non-smoking volunteers aged 18–80 years stratified by sex and age were recruited. PImax/PEmax were assessed using uniform methodology according to international standards. Multiple linear regressions were used to obtain reference equations. Cut-off points for respiratory muscle weakness were established by using T-scores. Results: The final sample consisted of 610 subjects (314 females; 48 [standard deviation, SD: 17] years). Reference equations for PImax/PEmax included body mass index and a squared term of the age as independent variables for both sexes (p < 0.01). Cut-off points for respiratory muscle weakness based on T-scores ≥2.5 SD below the peak mean value achieved at a young age were: 62 and 83 cmH2O for PImax and 81 and 109 cmH2O for PEmax in females and males, respectively. Conclusion: These reference values, based on the largest dataset collected in a European population to date using uniform methodology, help identify cut-off points for respiratory muscle weakness in females and males. These data will help to better identify the presence of respiratory muscle weakness and to determine indications for interventions to improve respiratory muscle function.
Patterns of physical activity progression in patients with COPD
(Elsevier Doyma, 2021-03) Koreny, Maria; Demeyer, Heleen; Benet, Marta; Arbillaga Etxarri, Ane; Balcells, Eva; Barberán García, Anael; Gimeno Santos, Elena; Hopkinson, Nicholas S.; Jong, Corina de; Karlsson, Niklas; Louvaris, Zafeiris; Polkey, Michael I.; Puhan, Milo A.; Rabinovich, Roberto A.; Rodríguez Roisin, Robert; Vall Casas, Pere; Vogiatzis, Ioannis; Troosters, Thierry; García Aymerich, Judith
Introduction: Although mean physical activity in COPD patients declines by 400–500 steps/day annually, it is unknown whether the natural progression is the same for all patients. We aimed to identify distinct physical activity progression patterns using a hypothesis-free approach and to assess their determinants. Methods: We pooled data from two cohorts (usual care arm of Urban Training [NCT01897298] and PROactive initial validation [NCT01388218] studies) measuring physical activity at baseline and 12 months (Dynaport MoveMonitor). We identified clusters (patterns) of physical activity progression (based on levels and changes of steps/day) using k-means, and compared baseline sociodemographic, interpersonal, environmental, clinical and psychological characteristics across patterns. Results: In 291 COPD patients (mean ± SD 68 ± 8 years, 81% male, FEV1 59 ± 19%pred) we identified three distinct physical activity progression patterns: Inactive (n = 173 [59%], baseline: 4621 ± 1757 steps/day, 12-month change (Δ): −487 ± 1201 steps/day), Active Improvers (n = 49 [17%], baseline: 7727 ± 3275 steps/day, Δ: + 3378 ± 2203 steps/day) and Active Decliners (n = 69 [24%], baseline: 11 267 ± 3009 steps/day, Δ: −2217 ± 2085 steps/day). After adjustment in a mixed multinomial logistic regression model using Active Decliners as reference pattern, a lower 6-min walking distance (RRR [95% CI] 0.94 [0.90–0.98] per 10 m, P =.001) and a higher mMRC dyspnea score (1.71 [1.12–2.60] per 1 point, P =.012) were independently related with being Inactive. No baseline variable was independently associated with being an Active Improver. Conclusions: The natural progression in physical activity over time in COPD patients is heterogeneous. While Inactive patients relate to worse scores for clinical COPD characteristics, Active Improvers and Decliners cannot be predicted at baseline.
Physical activity and cardiac autonomic dysfunction in patients with chronic obstructive pulmonary disease: a cross-sectional analysis
(Elsevier Masson s.r.l., 2022-05) Delgado Ortiz, Laura; Arbillaga Etxarri, Ane; Rodríguez Chiaradia, Diego A.; Gimeno Santos, Elena; Barberán García, Anael; Balcells, Eva; Rodríguez Roisin, Robert; García Aymerich, Judith
Background: The cardiac autonomic function in patients with chronic obstructive pulmonary disease (COPD) has been poorly studied. Objectives: We aimed to 1) describe the cardiac autonomic function assessed by heart rate recovery (HRR) and chronotropic response (CR) during a 6-min walk test (6MWT) and afterward and 2) estimate the association of physical activity with HRR and CR in COPD patients. Methods: This cross-sectional analysis included 320 patients with mild to very severe COPD. Physical activity (steps, time in any/moderate-to-vigorous/vigorous physical activity, intensity and sedentary time) was measured during 1 week by accelerometer. CR and HRR were measured during a 6MWT and 5 min after, respectively, and their association with physical activity parameters was estimated by multivariable linear regression models. Results: Patients were 82% male and had a mean (SD) age 68 (8) years, post-bronchodilator FEV1 57 (18) % predicted, and walked a mean of 7716 (4139) steps/day. HRR was slow until 5 min after the 6MWT; the mean (SD) HRR was 15 (10), 22 (11), 25 (12), 25 (12) and 27 (12) bpm after 1, 2, 3, 4 and 5 min, respectively. The mean (SD) CR was 35% (16). After adjusting for relevant confounders, time in vigorous physical activity was significantly associated with a fast decrease in HRR (p = 0.044) and an increase in CR (p = 0.021). We found no independent association for other physical activity parameters. Conclusion: A cardiac autonomic dysfunction is present in patients with mild to very severe COPD and is inversely related to the practice of vigorous physical activity. Trial registration ClinicalTrials.gov NCT01897298.
Real-world walking cadence in people with COPD
(European Respiratory Society, 2024-03) Delgado Ortiz, Laura; Ranciati, Saverio; Arbillaga Etxarri, Ane; Balcells, Eva; Buekers, Joren; Demeyer, Heleen; Frei, Anja; Gimeno Santos, Elena; Hopkinson, Nicholas S.; Jong, Corina de; Karlsson, Niklas; Louvaris, Zafeiris; Palmerini, Luca; Polkey, Michael I.; Puhan, Milo A.; Rabinovich, Roberto A.; Rodríguez Chiaradía, Diego A.; Rodríguez Roisin, Robert; Torán, Pere; Vogiatzis, Ioannis; Watz, Henrik; Troosters, Thierry; García Aymerich, Judith
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 (FEV1) 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 FEV1, 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.
Urban environment and physical activity and capacity in patients with chronic obstructive pulmonary disease
(Academic Press Inc., 2022-11) Koreny, Maria; Arbillaga Etxarri, Ane; Bosch de Basea, Magda; Foraster, María; Carsin, Anne-Elie; Cirach, Marta; Gimeno Santos, Elena; Barberán García, Anael; Nieuwenhuijsen, Mark; Vall Casas, Pere; Rodríguez Roisin, Robert; García Aymerich, Judith
Background: Physical activity and exercise capacity are key prognostic factors in chronic obstructive pulmonary disease (COPD) but their environmental determinants are unknown. Objectives: To test the association between urban environment and objective physical activity, physical activity experience and exercise capacity in COPD. Methods: We studied 404 patients with mild-to-very severe COPD from a multi-city study in Catalonia, Spain. We measured objective physical activity (step count and sedentary time) by the Dynaport MoveMonitor, physical activity experience (difficulty with physical activity) by the Clinical visit-PROactive (C-PPAC) instrument, and exercise capacity by the 6-min walk distance (6MWD). We estimated individually (geocoded to the residential address) population density, pedestrian street length, slope of terrain, and long-term (i.e., annual) exposure to road traffic noise, nitrogen dioxide (NO2) and particulate matter (PM2.5). We built single- and multi-exposure mixed-effects linear regressions with a random intercept for city, adjusting for confounders. Results: Patients were 85% male, had mean (SD) age 69 (9) years and walked 7524 (4045) steps/day. In multi-exposure models, higher population density was associated with fewer steps, more sedentary time and worse exercise capacity (−507 [95% CI: 1135, 121] steps, +0.2 [0.0, 0.4] h/day and −13 [-25, 0] m per IQR). Pedestrian street length related with more steps and less sedentary time (156 [9, 304] steps and −0.1 [-0.1, 0.0] h/day per IQR). Steeper slope was associated with better exercise capacity (15 [3, 27] m per IQR). Higher NO2 levels related with more sedentary time and more difficulty in physical activity. PM2.5 and noise were not associated with physical activity or exercise capacity. Discussion: Population density, pedestrian street length, slope and NO2 exposure relate to physical activity and capacity of COPD patients living in highly populated areas. These findings support the consideration of neighbourhood environmental factors during COPD management and the attention to patients with chronic diseases when developing urban and transport planning policies.

Examinando por Autor "Gimeno Santos, Elena"

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