Responsiveness of Three Instruments to Assess Self-Reported Functional Status in Patients with COPD

Kovelis, Demétria; Zabatiero, Juliana; Oldemberg, Nicoli; Colange, Ana Lucia; Barzon, Danielle; Nascimento, Cínthia H.S.C.; Probst, Vanessa S.; Pitta, Fábio

doi:10.3109/15412555.2011.594463

Cited by 14 publications

(6 citation statements)

References 30 publications

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“…However, daily dyspnea (as assessed by the LCADL scale) apparently did not affect the performance of ADL; no correlations were found between LCADL scale scores and the results obtained with the accelerometer. Nevertheless, although the LCADL is apparently better for self-assessed changes in COPD patients undergoing training programs than is the mMRC scale, ( 27 ) the difference between the COPD patients and the controls in the present study was four times greater than the change obtained by such programs.…”

Section: Discussioncontrasting

confidence: 73%

“…Entretanto, a dispneia diária durante a realização de AVD registradas pelo LCADL não pareceu interferir, já que não foram encontradas correlações entre o LCADL e os dados obtidos com o acelerômetro. Por outro lado, os valores de LCADL encontrados no presente estudo reforçam que esse é um instrumento melhor que a escala mMRC, tanto para a avaliação de pacientes submetidos a programas de treinamento, ( 27 ) quanto na situação basal: os pacientes avaliados apresentavam resultados quatro vezes piores que os controles.…”

Section: Discussionunclassified

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Barriers associated with reduced physical activity in COPD patients

Amorim¹,

Stelmach²,

Carvalho³

et al. 2014

J. bras. pneumol.

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OBJECTIVE: To evaluate the ability of COPD patients to perform activities of daily living (ADL); to identify barriers that prevent these individuals from performing ADL; and to correlate those barriers with dyspnea severity, six-minute walk test (6MWT), and an ADL limitation score. METHODS: In COPD patients and healthy, age-matched controls, the number of steps, the distance walked, and walking time were recorded with a triaxial accelerometer, for seven consecutive days. A questionnaire regarding perceived barriers and the London Chest Activity of Daily Living (LCADL) scale were used in order to identify the factors that prevent the performance of ADL. The severity of dyspnea was assessed with two scales, whereas submaximal exercise capacity was determined on the basis of the 6MWT. RESULTS: We evaluated 40 COPD patients and 40 controls. In comparison with the control values, the mean walk time was significantly shorter for COPD patients (68.5 ± 25.8 min/day vs. 105.2 ± 49.4 min/day; p < 0.001), as was the distance walked (3.9 ± 1.9 km/day vs. 6.4 ± 3.2 km/day; p < 0.001). The COPD patients also walked fewer steps/day. The most common self-reported barriers to performing ADL were lack of infrastructure, social influences, and lack of willpower. The 6MWT distance correlated with the results obtained with the accelerometer but not with the LCADL scale results. CONCLUSIONS: Patients with COPD are less active than are healthy adults of a comparable age. Physical inactivity and the barriers to performing ADL have immediate implications for clinical practice, calling for early intervention measures.

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Section: Discussioncontrasting

confidence: 73%

Section: Discussionunclassified

Barriers associated with reduced physical activity in COPD patients

Amorim¹,

Stelmach²,

Carvalho³

et al. 2014

J. bras. pneumol.

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“…Rehabilitation resulted in statistically significant improvements in the 6MWT walking distance ( p < 0.001), with a small effect size (Cohen’s d = 0.45). These findings are in accordance with multiple studies, confirming that pulmonary rehabilitation of varying duration, frequency, intensity, and type, leads to improvements in walking distance in patients with COPD [ 8 , 32 , 33 , 34 ].…”

Section: Discussionsupporting

confidence: 91%

Performance Score (T2D)—A New Perspective in the Assessment of Six-Minute Walking Tests in Pulmonary Rehabilitation

et al. 2022

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Because absolute changes in outcomes are difficult to interpret and the minimal clinically important difference (MCID) is not suitable to address this challenge, a novel method of classifying outcomes by relating changes to baseline values is warranted. We used the “performance score” (T2D), which reflects individual performance, enabling us to consider the functional status at the beginning of rehabilitation without dealing with the problems of mathematical coupling or regression effects, as encountered in ANCOVA. To illustrate the T2D, we retrospectively analyzed changes in the six-minute walking test (6MWT) in COPD patients undergoing outpatient pulmonary rehabilitation and compared the results with absolute differences related to a predetermined MCID. We evaluated a total of 575 COPD patients with a mean age of 61.4 ± 9.2 years. 6MWT improved significantly, with a mean change of 32.3 ± 71.2. A total of 105/311 participants who had reached the MCID were still classified as “below average” by the T2D. Conversely, 76/264 patients who had not reached the MCID were classified as “above average”. This new performance measure accounts for the patient’s current status and for changes over time, potentially representing a simple and user-friendly tool that can be used to quantify a patient’s performance and response to rehabilitation.

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“…These include the Canadian Occupational Performance Measure (COPM), London Chest ADL (LCADL) Scale, Manchester Respiratory ADL Scale and the Pulmonary Functional Status and Dyspnoea Questionnaire 27–30. Prospective uncontrolled studies suggest that pulmonary rehabilitation does impact on ADL 25 31 32. Sewell et al 25 compared an individualised exercise programme with a generic exercise programme and demonstrated statistically significant within-group improvements in COPM performance and satisfaction scores for both treatment groups.…”

Section: Evidencementioning

confidence: 99%

“…A further uncontrolled study has shown improvements in LCADL Scale scores 31. A small study of 22 patients compared three measures of self-reported ADL and concluded that the LCADL and modified version of the pulmonary functional status and dyspnoea questionnaire (PFSDQ-M) were more responsive than the MRC scale 32. However, the impact of pulmonary rehabilitation upon ADL has not been reported in a RCT comparing pulmonary rehabilitation with usual care.…”

Section: Evidencementioning

confidence: 99%