{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T09:09:42Z","timestamp":1789117782021,"version":"build-2803163510"},"reference-count":53,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T00:00:00Z","timestamp":1789084800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Hospital Organization"},{"id":[{"id":"https:\/\/ror.org\/03ntccx93","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Background\/Objectives: Reduced physical activity (PA) and increased sedentary behavior (SB) are associated with adverse outcomes in chronic obstructive pulmonary disease (COPD), but the factors underlying their long-term change are unclear; we investigated the baseline factors associated with these changes. Methods: Japanese outpatients with stable COPD co-enrolled in the SPACE (baseline) and E-PAC (follow-up) studies were analyzed retrospectively. Twenty-nine baseline clinical variables were assessed. PA and SB were measured with a waist-worn triaxial accelerometer and expressed in metabolic equivalents (METs). Annualized percentage changes (per year, relative to baseline) were analyzed by Spearman\u2019s rank correlation and multiple linear regression. Results: Thirty-two participants (all men; median age 71.0 years; median follow-up 5.0 years) were analyzed. Lower baseline body weight, BMI, upper arm circumference, FEV1.0, FEV1.0\/FVC, and lowest percutaneous oxygen saturation (SpO2) during the 6 min walk test (6MWT) were correlated with greater annualized declines in PA. For SB, the annualized change was correlated only with the lowest SpO2 during the 6MWT, FEV1.0\/FVC, and the hemoglobin concentration. In multivariable models adjusted for FEV1.0 %pred and the lowest SpO2 during the 6MWT, BMI remained associated with the declines in total PA and in the duration at \u22653.0 METs; the models for the step count and SB were not significant. Conclusions: In this exploratory analysis, nutrition-related anthropometric measures, poorer pulmonary function, and exercise-induced desaturation were associated with the long-term decline in PA, and a lower BMI remained associated after adjustment. For the change in SB, associations were found only in unadjusted correlation analysis and were not supported by the multivariable model. These hypothesis-generating findings require confirmation in a larger cohort.<\/jats:p>","DOI":"10.3390\/jcm15187038","type":"journal-article","created":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T08:17:42Z","timestamp":1789114662000},"page":"7038","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Low Body Mass Index Is Associated with a Long-Term Decline in Accelerometer-Measured Physical Activity in Patients with COPD: An Exploratory Analysis of Participants Co-Enrolled in Two Prospective Cohort Studies"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-6260-0614","authenticated-orcid":false,"given":"Yusuke","family":"Murakami","sequence":"first","affiliation":[{"name":"Department of Respiratory Medicine, NHO Wakayama Hospital, 1138 Wada, Mihama-Cho, Hidaka-Gun, Wakayama 644-0044, Japan"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"},{"role":"funding-acquisition","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6993-0917","authenticated-orcid":false,"given":"Yoshiaki","family":"Minakata","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, NHO Wakayama Hospital, 1138 Wada, Mihama-Cho, Hidaka-Gun, Wakayama 644-0044, Japan"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"}]},{"given":"Yasushi","family":"Tanimoto","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, NHO Minami-Okayama Medical Center, Okayama 701-0304, Japan"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"investigation","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3600-8595","authenticated-orcid":false,"given":"Keisuke","family":"Miki","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, NHO Osaka Toneyama Medical Center, Osaka 560-8552, Japan"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"investigation","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7106-6854","authenticated-orcid":false,"given":"Shinji","family":"Tamaki","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, NHO Nara Medical Center, Nara 630-8053, Japan"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"investigation","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Toshiyuki","family":"Kita","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, NHO Kanazawa Medical Center, Kanazawa 920-8650, Japan"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"investigation","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,11]]},"reference":[{"key":"ref_1","unstructured":"Global Initiative for Chronic Obstructive Lung Disease (2025, December 10). 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