Physical inactivity in chronic airways disease: an important candidate in the treatable traits paradigm.

The mean daily step count across chronic airways diseases was 5494 steps per day and MVPA was 48.2 minutes per day.

• Mean daily step count was 5494 (95% CI 5152–5636)
• Mean time in moderate-to-vigorous physical activity (MVPA) was 48.2 min·day-1 (95% CI 33.8–62.6)
• Analysis included 236 studies, 353 cohorts, and n=25,278 individuals with chronic airways disease
• Studies included adults with COPD, asthma, noncystic fibrosis bronchiectasis, cystic fibrosis, or primary ciliary dyskinesia
• Physical activity was objectively measured across all included studies

The lowest physical activity levels across chronic airways diseases were observed in patients with COPD.

• COPD patients had the lowest mean daily step count and MVPA compared to other chronic airways disease groups
• Physical activity levels were consistently lower than matched healthy controls across all disease groups
• COPD is the most extensively studied condition in this systematic review and meta-analysis

Body mass index (BMI) and percent predicted FEV1 were significant determinants of physical activity in COPD and asthma.

• Disease-specific determinants of physical activity were identified using univariate and multivariate regression analysis
• BMI and FEV1 % predicted were significant determinants in both COPD and asthma
• Overall, disease-specific determinants of physical activity were described as 'elusive'
• Other chronic airways diseases did not show the same consistent determinants

Step count was positively associated with FEV1 % predicted and 6-minute walk distance, and negatively associated with modified Medical Research Council (mMRC) scores.

• A positive association was found between step count and FEV1 % predicted
• A positive association was found between step count and 6-minute walk distance
• A negative association was found between step count and modified Medical Research Council dyspnoea scores
• These associations support the clinical relevance of objective physical activity assessment in chronic airways disease

Physical inactivity across chronic airways diseases was identified as a candidate treatable trait warranting inclusion in routine disease evaluation and management.

• Physical inactivity was described as 'a common and potentially modifiable trait'
• The findings support consideration of physical activity within the treatable traits framework
• Objective physical activity assessment was highlighted as clinically relevant
• The review followed PRISMA guidelines for systematic review and meta-analysis methodology