RT Journal Article SR Electronic T1 Association between morning symptoms and physical activity in COPD: a systematic review JF European Respiratory Review JO EUROPEAN RESPIRATORY REVIEW FD European Respiratory Society SP 160033 DO 10.1183/16000617.0033-2016 VO 26 IS 143 A1 Amanda R. van Buul A1 Marise J. Kasteleyn A1 Niels H. Chavannes A1 Christian Taube YR 2017 UL http://err.ersjournals.com/content/26/143/160033.abstract AB Morning symptoms are common in chronic obstructive pulmonary disease (COPD). Many COPD patients consider the morning as the most troublesome part of the day, in which they experience more symptoms and physical activity limitations.To systematically report evidence of the association between morning symptoms and physical activity in COPD patients, a literature search was conducted using relevant MESH terms and text words in PubMed, Embase, Web of Science, COCHRANE, CINAHL and PsycINFO. Quality of the articles was assessed with validated checklists.Eight studies were included. Morning symptoms were present in 39.8–94.4%. In 37.0–90.6% of all COPD patients, there was an association between physical activity and morning symptoms. However, causality could not be proved. Morning symptoms were associated with a sedentary lifestyle (p<0.05). Treatment in line with the guidelines improved the degree of activity limitations due to morning symptoms (p<0.0001).Across all disease stages, COPD patients experience morning symptoms which are negatively associated with physical activity. Physicians should consider morning symptoms as a treatment goal. Pharmacotherapy may improve the degree of activity limitations due to morning symptoms. More objective research should focus on symptoms, activity limitations and physical inactivity of COPD patients, especially in the morning.Association between morning symptoms and physical activity in COPD http://ow.ly/SJQi301fvdD