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Objective: To adapt the PROactive Physical Activity in COPD-clinical visit (C-PPAC) instrument to the cultural setting in Brazil and to determine the criterion validity, testretest reliability agreement, and internal consistency of this version. Methods: A protocol for cultural adaptation and validation was provided by the authors of the original instrument and, together with another guideline, was applied in a Portuguese-language version developed by a partner research group from Portugal. The adapted Brazilian Portuguese version was then cross-sectionally administered twice within a seven-day interval to 30 individuals with COPD (57% were men; mean age was 69 ± 6 years; and mean FEV1 was 53 ± 18% of predicted) to evaluate internal consistency and test-retest reliability. Participants also completed the International Physical Activity Questionnaire (IPAQ), the modified Medical Research Council scale, the COPD Assessment Test, and Saint George's Respiratory Questionnaire to evaluate criterion validity. Results: The C-PPAC instrument showed good internal consistency and excellent test-retest reliability: "amount" domain = 0.87 (95% CI, 0.73-0.94) and "difficulty" domain = 0.90 (95% CI, 0.76-0.96). Bland & Altman plots, together with high Lin's concordance correlation coefficients, reinforced that agreement. Criterion validity showed moderate-to-strong correlations of the C-PPAC with all of the other instruments evaluated, especially with the IPAQ (rho = -0.63). Conclusions: The Brazilian Portuguese version of the C-PPAC is a reliable and valid instrument for evaluating the experience of Brazilian individuals with COPD with their physical activity in daily life. [ABSTRACT FROM AUTHOR]

Author(s): Leila Donaria[sup.1] , Rafael Mesquita[sup.1] [sup.2] [sup.3] , Larissa Martinez[sup.1] , Luciana Sipoli[sup.1] , Josiane Marques Felcar[sup.2] , Vanessa Suziane Probst[sup.1] [sup.2] , Nidia Aparecida Hernandes[sup.1] , Fabio Pitta[sup.1] [...], Purpose The aims of this study were to investigate the relationship between sniff nasal inspiratory pressure (SNIP) and severity of chronic obstructive pulmonary disease (COPD) as defined by the BODE index, and to investigate the capacity of different SNIP cutoffs to predict a BODE index score [greater than or equal to]5 (i.e., worse disease severity). Methods Thirty-eight subjects with COPD (21 men, 66 ± 8 years, forced expiratory volume in the first second (FEV.sub.1) 42 ± 16 % predicted) underwent assessments of SNIP, airflow limitation, body mass index (BMI), dyspnea (Medical Research Council scale), and exercise capacity (6-min walking test, 6MWT). The BODE index was calculated, and patients were separated into two groups according to the BODE quartiles (1 and 2, or 3 and 4). Results Patients from quartiles 3 and 4 presented lower values of SNIP than patients from quartiles 1 and 2 (73 ± 18 vs 56 ± 21 cmH.sub.2O, respectively; p = 0.01). There was significant and inverse correlation between SNIP and the BODE index (r = -0.62; p Conclusion SNIP is moderately and significantly related to COPD severity as assessed by the BODE index. Moreover, the cutoff point of 63 cmH2O showed the best combination of sensitivity and specificity for predicting worse scores in the BODE index.

Introduction Chronic obstructive pulmonary disease (COPD) is characterized by airflow limitation, dyspnea, and reduction in exercise capacity, muscle strength, and quality of life [1]. Patients with COPD are frequently characterized [...], Background The aim of this study was to investigate the differences in body composition between physically active and inactive patients with chronic obstructive pulmonary disease (COPD) and the relationship of obesity [according to body mass index (BMI) and percentage of fat mass (%FM)] with physical activity in the daily life (PADL) in this population. Methods Body composition (bioelectrical impedance analysis) and level of PADL (activity monitors DynaPort and SenseWear) were evaluated in 74 patients with COPD (45 men, 65 [+ or -] 9 years old, [FEV.sub.1] = 40 [+ or -] 15%pred, BMI = 27 [+ or -] 6 kg [m.sup.-2]). Patients were divided in two groups: physically active (>30 min/day of physical activity of at least moderate intensity, or TPA > moderate) and inactive (did not achieve these recommendations). The sample was also classified according to BMI (underweight, normal weight, overweight, and obese) and their %FM (moderate obesity, high obesity, and morbid obesity). Results In the whole group, TPA > moderate correlated weakly with BMI (r = -0.28; p = 0.02) and FM (r = -0.30; p = 0.001) but not with fat-free mass (FFM) (r = -0.18; p = 0.13). Physically inactive patients had higher body weight (p = 0.002), FM (p = 0.0005), and lower FFM as % of body weight (p = 0.03) than active patients. Obese patients (according to BMI) had a worse PADL level than underweight and normal-weight patients (p < 0.0001). A poorer PADL level occurred in morbidly obese patients (p = 0.01) despite the weak correlation between FM and TPA > moderate in the whole group. Conclusion Physically active patients with COPD have proportionally more FFM and less FM than inactive patients. More pronounced physical inactivity occurs in obese patients, although body composition does not qualify as an important correlate factor of the level of PADL in patients with COPD. Keywords Chronic obstructive pulmonary disease * Obesity * Body mass index * Body composition * Exercise * Physical activity

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