Systematic Review of Physical Activity, Sedentary Behaviour and Sleep Among Adults Living with Chronic Respiratory Disease in Low- and Middle-Income Countries.

Akila R Jayamaha, Amy V Jones, Winceslaus Katagira, Bhushan Girase, Zainab K Yusuf, Ilaria Pina, Laura Joanne Wilde, Azamat Akylbekov, Pip Divall, Sally J. Singh, Mark Orme

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    Physical activity (PA), sedentary behaviour (SB) and sleep are important lifestyle behaviours associated with chronic
    respiratory disease (CRD) morbidity and mortality. These behaviours need to be understood in low- and middle-income countries
    (LMIC) to develop appropriate interventions.
    Purpose: Where and how have free-living PA, SB and sleep data been collected for adults living with CRD in LMIC? What are the
    free-living PA, SB and sleep levels of adults living with CRD?
    Patients and Methods: The literature on free-living PA, SB and sleep of people living with CRD in LMIC was systematically
    reviewed in five relevant scientific databases. The review included empirical studies conducted in LMIC, reported in any language.
    Reviewers screened the articles and extracted data on prevalence, levels and measurement approach of PA, SB and sleep using
    a standardised form. Quality of reporting was assessed using bespoke criteria.
    Results: Of 89 articles, most were conducted in Brazil (n=43). PA was the commonest behaviour measured (n=66). Questionnaires
    (n=52) were more commonly used to measure physical behaviours than device-based (n=37) methods. International Physical Activity
    Questionnaire was the commonest for measuring PA/SB (n=11). For sleep, most studies used Pittsburgh Sleep Quality Index (n=18).
    The most common ways of reporting were steps per day (n=21), energy expenditure (n=21), sedentary time (n=16), standing time
    (n=13), sitting time (n=11), lying time (n=10) and overall sleep quality (n=32). Studies revealed low PA levels [steps per day (range
    2669–7490steps/day)], sedentary lifestyles [sitting time (range 283–418min/day); standing time (range 139–270min/day); lying time
    (range 76–119min/day)] and poor sleep quality (range 33–100%) among adults with CRD in LMIC.
    Conclusion: Data support low PA levels, sedentary lifestyles and poor sleep among people in LMIC living with CRDs. More studies
    are needed in more diverse populations and would benefit from a harmonised approach to data collection for international
    Original languageEnglish
    Pages (from-to)821-854
    Number of pages34
    JournalInternational Journal of Chronic Obstructive Pulmonary Disease
    Issue number17
    Publication statusPublished - 18 Apr 2022

    Bibliographical note

    This work is published by Dove Medical Press Limited, and licensed under a Creative Commons Attribution License. The full terms of the License are available at The license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


    This research was funded by the National Institute for Health Research (NIHR) (17/63/20) using UK aid from the UK Government to support global health research. The views expressed in this publication are those of the author(s) and not necessarily those of the NIHR or the UK Department of Health and Social Care. Publisher Copyright: © 2022 Jayamaha et al.


    • Adult
    • Chronic Respiratory Disease
    • Developing Countries
    • Exercise
    • Humans
    • Low- And Middle-income Countries
    • Physical Activity
    • Pulmonary Disease, Chronic Obstructive
    • Sedentary Behavior
    • Sedentary Behaviour
    • Sleep
    • Sleep Initiation and Maintenance Disorders


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