The relationship between physical function and experience of fatigue in patients with chronic obstructive pulmonary disease

................................................................................................................. 1 LIST OF PAPERS ........................................................................................................ 3 ABBREVIATIONS ...................................................................................................... 4 BACKGROUND.......................................................................................................... 5 Chronic Obstructive Pulmonary Disease ........................................................ 5 Physical function .................................................................................................. 7 Physical capacity ........................................................................................... 10 Physical activity ............................................................................................ 10 Symptoms and symptom burden .................................................................... 12 Dyspnoea ........................................................................................................ 12 Fatigue ............................................................................................................ 13 Depression and anxiety ................................................................................ 16 Symptom burden .......................................................................................... 16 Disease severity .................................................................................................. 17 Body composition .............................................................................................. 18 Rationale of this thesis ...................................................................................... 19 AIMS ........................................................................................................................... 20 PATIENTS AND METHODS................................................................................. 21 Patients ................................................................................................................. 21 Measurements ..................................................................................................... 22 Physical function ........................................................................................... 23 Symptoms and symptom burden ............................................................... 27 Body Measurements ..................................................................................... 29 Disease severity ............................................................................................. 30 Systemic inflammation ................................................................................. 30 Perception of general health ........................................................................ 30 Demographic data ........................................................................................ 31 Procedure ............................................................................................................. 31 Ethical considerations ....................................................................................... 32 Statistical Analysis ............................................................................................. 32 RESULTS .................................................................................................................... 34 Level of physical activity .................................................................................. 35 Experience of fatigue ......................................................................................... 36 Factors associated with low physical activity (paper I) .............................. 37 The relationship between experience of fatigue and factors of physical capacity and disease severity in men and women (paper II) .................... 39 DISCUSSION ............................................................................................................ 41 Factors associated with low physical activity ............................................... 41 The relationship between experience of fatigue and physical capacity and disease severity in men and women....................................................... 43 Methodological issues and limitations .......................................................... 46 Physical activity ............................................................................................ 46 Fatigue ............................................................................................................ 46 Clinical implications and future research ..................................................... 47 CONCLUSIONS ....................................................................................................... 49 POPULÄRVETENSKAPLIG SAMMANFATTNING (SUMMARY IN SWEDISH) .................................................................................................................. 50 ACKNOWLEDGEMENTS ...................................................................................... 52 REFERENCES ............................................................................................................ 54