Differential patterns of the relationship between exercise dose and mortality risk across severities of airflow limitation: a prospective cohort study with a 5-year follow-up period
Objective: This study examines the dose–response relationship between physical activity (PA) and all-cause mortality across different severities of airflow limitation, identifying threshold effects that yield new insights into the PA–mortality association. Design: A prospective cohort study with a...
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| Format: | Article |
| Language: | English |
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Medical Journals Sweden
2025-06-01
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| Series: | Journal of Rehabilitation Medicine |
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| Online Access: | https://medicaljournalssweden.se/jrm/article/view/43377 |
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| author | Yide Wang Hongxia Duan Yingqi Wang Yidie Bao Linhong Jiang Xiaoyu Han Fengsen Li Peijun Li Weibing Wu Xiaodan Liu |
| author_facet | Yide Wang Hongxia Duan Yingqi Wang Yidie Bao Linhong Jiang Xiaoyu Han Fengsen Li Peijun Li Weibing Wu Xiaodan Liu |
| author_sort | Yide Wang |
| collection | DOAJ |
| description | Objective: This study examines the dose–response relationship between physical activity (PA) and all-cause mortality across different severities of airflow limitation, identifying threshold effects that yield new insights into the PA–mortality association.
Design: A prospective cohort study with a 5-year follow-up (2018–2023), employing multivariate Cox models and penalized spline smoothing to assess non-linear associations.
Subjects/Patients: A total of 2,975 individuals from a cohort categorized by airflow limitation severity (normal, GOLD 1–4).
Methods: PA levels were quantified in metabolic equivalent hours per week (MET·h/week). Cox proportional hazards models were used to evaluate PA–mortality associations, with penalized spline analysis detecting threshold effects.
Results: Identified thresholds were 41.50 MET·h/week (95% CI: 23.03–64.22) for normal lung function and 13.21 MET·h/week (95% CI: 9.67–16.14) for GOLD 1. Below these thresholds, higher PA levels were associated with a significant reduction in mortality risk (HR = 0.66, HR = 0.41, respectively). In GOLD 2, PA levels below the threshold were associated with a lower mortality risk (HR=0.85), whereas PA exceeding the threshold was associated with a higher mortality risk (HR = 1.23). No significant associations were observed in GOLD 3–4.
Conclusion: PA demonstrates a non-linear, threshold-dependent association with mortality. These findings underscore the importance of individualized PA recommendations for optimizing health outcomes in individuals with chronic respiratory conditions.
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| format | Article |
| id | doaj-art-38c88fc3aebf4629971572a35f3366ca |
| institution | DOAJ |
| issn | 1651-2081 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Medical Journals Sweden |
| record_format | Article |
| series | Journal of Rehabilitation Medicine |
| spelling | doaj-art-38c88fc3aebf4629971572a35f3366ca2025-08-20T02:39:28ZengMedical Journals SwedenJournal of Rehabilitation Medicine1651-20812025-06-015710.2340/jrm.v57.43377Differential patterns of the relationship between exercise dose and mortality risk across severities of airflow limitation: a prospective cohort study with a 5-year follow-up periodYide Wang0Hongxia Duan1Yingqi Wang2Yidie Bao3Linhong Jiang4Xiaoyu Han5Fengsen Li6Peijun Li7Weibing Wu8Xiaodan Liu9Department of Rehabilitation, The Fourth Clinical Medical College of Xinjiang Medical University, Urumqi, Xinjiang, ChinaSchool of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, ChinaSchool of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, ChinaSchool of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, ChinaSchool of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, ChinaDepartment of Sports Rehabilitation, Shanghai University of Sport, Shanghai, ChinaDepartment of Integrated Pulmonology, Fourth Clinical Medical College of Xinjiang Medical University, Urumqi, ChinaSchool of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, ChinaDepartment of Sports Rehabilitation, Shanghai University of Sport, Shanghai, ChinaSchool of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China; Institute of Rehabilitation Medicine, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China; Engineering Research Center of Traditional Chinese Medicine Intelligent Rehabilitation, Ministry of Education, Shanghai, ChinaObjective: This study examines the dose–response relationship between physical activity (PA) and all-cause mortality across different severities of airflow limitation, identifying threshold effects that yield new insights into the PA–mortality association. Design: A prospective cohort study with a 5-year follow-up (2018–2023), employing multivariate Cox models and penalized spline smoothing to assess non-linear associations. Subjects/Patients: A total of 2,975 individuals from a cohort categorized by airflow limitation severity (normal, GOLD 1–4). Methods: PA levels were quantified in metabolic equivalent hours per week (MET·h/week). Cox proportional hazards models were used to evaluate PA–mortality associations, with penalized spline analysis detecting threshold effects. Results: Identified thresholds were 41.50 MET·h/week (95% CI: 23.03–64.22) for normal lung function and 13.21 MET·h/week (95% CI: 9.67–16.14) for GOLD 1. Below these thresholds, higher PA levels were associated with a significant reduction in mortality risk (HR = 0.66, HR = 0.41, respectively). In GOLD 2, PA levels below the threshold were associated with a lower mortality risk (HR=0.85), whereas PA exceeding the threshold was associated with a higher mortality risk (HR = 1.23). No significant associations were observed in GOLD 3–4. Conclusion: PA demonstrates a non-linear, threshold-dependent association with mortality. These findings underscore the importance of individualized PA recommendations for optimizing health outcomes in individuals with chronic respiratory conditions. https://medicaljournalssweden.se/jrm/article/view/43377Airflow limitationMortality riskPhysical activity dosageProspective cohort |
| spellingShingle | Yide Wang Hongxia Duan Yingqi Wang Yidie Bao Linhong Jiang Xiaoyu Han Fengsen Li Peijun Li Weibing Wu Xiaodan Liu Differential patterns of the relationship between exercise dose and mortality risk across severities of airflow limitation: a prospective cohort study with a 5-year follow-up period Journal of Rehabilitation Medicine Airflow limitation Mortality risk Physical activity dosage Prospective cohort |
| title | Differential patterns of the relationship between exercise dose and mortality risk across severities of airflow limitation: a prospective cohort study with a 5-year follow-up period |
| title_full | Differential patterns of the relationship between exercise dose and mortality risk across severities of airflow limitation: a prospective cohort study with a 5-year follow-up period |
| title_fullStr | Differential patterns of the relationship between exercise dose and mortality risk across severities of airflow limitation: a prospective cohort study with a 5-year follow-up period |
| title_full_unstemmed | Differential patterns of the relationship between exercise dose and mortality risk across severities of airflow limitation: a prospective cohort study with a 5-year follow-up period |
| title_short | Differential patterns of the relationship between exercise dose and mortality risk across severities of airflow limitation: a prospective cohort study with a 5-year follow-up period |
| title_sort | differential patterns of the relationship between exercise dose and mortality risk across severities of airflow limitation a prospective cohort study with a 5 year follow up period |
| topic | Airflow limitation Mortality risk Physical activity dosage Prospective cohort |
| url | https://medicaljournalssweden.se/jrm/article/view/43377 |
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