Prediction of long-term clinical outcomes using simple functional exercise performance tests in patients with COPD: a 5-year prospective cohort study

Abstract

The 1-min sit-to-stand (1-min STS) test and handgrip strength test have been proposed as simple tests of functional exercise performance in chronic obstructive pulmonary disease (COPD) patients. We assessed the long-term (5-year) predictive performance of the 1-min sit-to-stand and handgrip strength tests for mortality, health-related quality of life (HRQoL) and exacerbations in COPD patients. In 409 primary care patients, we found the 1-min STS test to be strongly associated with long-term morality (hazard ratio per 3 more repetitions: 0.81, 95% CI 0.65 to 0.86) and moderately associated with long-term HRQoL. Neither test was associated with exacerbations. Our results suggest that the 1-min STS test may be useful for assessing the health status and long-term prognosis of COPD patients. This study was registered at http://www.clinicaltrials.gov/ (NCT00706602, 25 June 2008).

Prognostic value of simple measures of physical function and muscle strength in COPD: A systematic review

“…The included studies considered a variety of simple measures of physical function and muscle strength. Four studies included performance-based tests [17,18,21] (handgrip strength (HGS), 1-min sit-to-stand (1-min STS), 5 repetitions sit-to-stand (5STS) and Time Up and Go (TUG) tests) and three included self-reported measures [15,16,19] (Manchester respiratory activities of daily living (MRADL) and Groningen activities for daily living restriction scale (GARS) questionnaires). The handgrip strength (HGS) test was the only muscle strength test that was considered in the included studies.…”

“…The total scores ranged from 8 to 18 out of a possible maximum of 22 (average score was 14). No study was classified as "excellent", three studies were classified as "good" [15][16][17], two classified as "fair" [18,19], and two as "poor" [20,21].…”

“…Six articles examined the relationship of physical function measures or simple measures of muscle strength to mortality [15][16][17][18][19]21]. All articles reported mortality using true observation of all-cause deaths, except one which used probability of survival as the main outcome [16].…”

“…In addition, the authors showed that, 1-min STS test and HGS were substantially lower at baseline in patients who died compared to those who were alive at two-year follow up (11.8 versus 19.5 repetitions; 30.1 kg versus 36.4 kg, respectively). Crook et al [21] followed up this same cohort for five years. Contrary to the first work, the authors did not observe statistically significantly association between HGS test and mortality.…”

Pulmonary rehabilitation, physical activity, respiratory failure and palliative respiratory care

“…The STS could therefore potentially serve as an additional or alternate test from which to formulate the PR exercise prescription. STS testing also helps to predict long-term patient outcomes including mortality,5 hence its routine measurement in PR may have prognostic value for patients. Furthermore, responsiveness and minimal clinically important difference values for the COPD assessment test, clinical COPD questionnaire, and hospital anxiety and depression score have been published 6.…”