Physical activity and inactivity among different body composition phenotypes in individuals with moderate to very severe chronic obstructive pulmonary disease

Background: The phenotype profiling of individuals with chronic obstructive pulmonary disease (COPD) according to impairments in body composition and level of physical activity in daily life (PADL) needs to be determined.Objective: To verify if individuals with COPD classified as physically active/inactive present different characteristics within different body composition phenotypes.Methods: Individuals with COPD were cross-sectionally stratified into four groups according to fat-free and fat mass indexes: Normal Body Composition (NBC), Obese (Ob), Sarcopenic (Sarc), and Sarcopenic/Obese (Sarc/Ob). Additionally, individuals had their PADL level objectively assessed through activity monitoring during two weekdays for at least 10 h/day, and then were classified as physically active (Act) or inactive (Inact) according to international recommendations. Lung function (spirometry), exercise capacity (6-minute walking test [6MWT]) and peripheral muscle strength (1-repetition maximum [1RM]) were also assessed. 176 individuals with COPD (mean +/- standard deviation age: 67 +/- 8 years, body mass index 26 +/- 6 kg/m(2), FEV1 47 +/- 16%predicted) were classified as: NBC + Act (17%), NBC + Inact( 22%), Ob + Act (6%), Ob + Inact (10%), Sarc + Act (12%), Sarc + Inact (9%), Sarc/Ob + Act (8%) and Sarc/ Ob + Inact (16%). The Sarc/Ob + Inact group presented lower 6MWT and 1RM for knee extension compared to NBC + Act, NBC + Inact, and Ob + Act groups (p < 0.05). The Sarc/Ob + Inactgroup also presented lower FEV1% predicted, 1RM for elbow flexion and elbow extension compared to the NBC + Act and NBC + Inact groups and lower 1RM for elbow extension compared to Ob + Inact group (p < 0.05).Conclusion: The combination of sarcopenia, obesity, and physical inactivity was shown to be detrimental in individuals with COPD. Therefore, this profile is a main therapeutic target for improving PADL level and/or body composition. (C) 2020 Associacao Brasileira de Pesquisa e Pos-Graduacao em Fisioterapia. Published by Elsevier Editora Ltda. All rights reserved.