Correlations between physical activity and prognostic markers in patients with idiopathic pulmonary fibrosis

Merve Sinem Oguz; Zuleyha  Bingol; Aylin Pihtili; Buket Akinci; Melike  Saritas Arslan; Goksen  Kuran Aslan; Esen  Kiyan; Gulfer Okumus

doi:10.5826/mrm.2025.1021

Correlations between physical activity and prognostic markers in patients with idiopathic pulmonary fibrosis

Authors

Merve Sinem Oguz Department of Chest Diseases, İskenderun State Hospital, Hatay, Turkey https://orcid.org/0000-0003-3152-0263
Zuleyha Bingol Department of Chest Diseases, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey https://orcid.org/0000-0002-1414-617X
Aylin Pihtili Department of Chest Diseases, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey https://orcid.org/0000-0001-8846-048X
Buket Akinci Division of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Biruni University, Istanbul, Turkey https://orcid.org/0000-0002-9878-256X
Melike Saritas Arslan Division of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Marmara University, Istanbul, Turkey https://orcid.org/0000-0002-7235-134X
Goksen Kuran Aslan Division of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istanbul University-Cerrahpasa, Istanbul, Turkey https://orcid.org/0000-0002-0169-0707
Esen Kiyan Department of Chest Diseases, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey https://orcid.org/0000-0003-0023-6518
Gulfer Okumus Department of Chest Diseases, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey https://orcid.org/0000-0001-8309-1216

DOI: https://doi.org/10.5826/mrm.2025.1021

Keywords:

idiopathic pulmonary fibrosis, physical activity, fatigue, dyspnea, disease progression

Abstract

Background: In this study, we investigated the associations between physical activity parameters and prognostic factors in patients with idiopathic pulmonary fibrosis (IPF).
Methods: Physical activity was measured in IPF patients using a SenseWear armband. Demographic data, pulmonary function test results, the 6-minute walk distance (6MWD), the gender-age-physiology (GAP) index score, dyspnea severity (modified Medical Research Council, mMRC), and fatigue severity (Multidimensional Fatigue Inventory, MFI-20) were recorded.
Results: Thirty-five IPF patients (29 males, aged 65.7 ± 8.0 years) were included in the study (forced vital capacity (FVC)=77±16.2%, diffusing capacity for carbon monoxide (DL_CO)=55.7±16.4%, 6MWD=398.4±88 m, GAP index=3.4±1.1 (18 stage 1, 17 stage 2). Patients with GAP stage 2 had lower step counts than those with GAP stage 1 (3325.1±2253 steps vs. 7892±3132 steps, p<0.001). The time spent in moderate to vigorous physical activity (MVPA, defined as the time spent in activities ≥3.0 METs) was significantly shorter in GAP stage 2 patients than in GAP stage 1 patients (7 minutes [IQR: 1.5–18.5] vs 56 minutes [IQR: 30.5–139.5], p<0.001). The step count and GAP index score (Rs=-0.716, p<0.001), age (Rs=-0.381, p=0.024), FVC (Rs=0.443, p=0.008), DL_CO (Rs=0.715, p<0.001), 6MWD (Rs=0.833, p<0.001), MFI-20 score (Rs=-0.783, p<0.001), and mMRC score (Rs=-0.833, p<0.001) were correlated. Multiple regression analysis revealed that the step count was independently associated with the 6MWD (p=0.005) and MFI-20 score (p=0.014). The MVPA time was correlated with the GAP index score (Rs=-0.810, p<0.001), age (Rs=-0.427, p=0.010), FVC (Rs=0.490 p=0.003), DL_CO (Rs=0.736, p<0.001), 6MWD (Rs=0.809, p<0.001), MFI-20 score (Rs=-0.830, p<0.001) and mMRC score
(Rs=-0.826, p<0.001). Multiple regression analysis revealed that the MVPA time was independently associated with the GAP index score (p=0.007).
Conclusions: The physical activity parameters of IPF patients were associated with prognostic markers such as the GAP index score, pulmonary function parameters and the 6MWD.

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