Analysis of Clinical Methods Used to Evaluate Dyspnea  in Patients with Chronic Obstructive Pulmonary Disease

Hajiro, Takashi; Nishimura, Koichi; Tsukino, Mitsuhiro; Ikeda, Akihiko; Koyama, Hiroshi; Izumi, Tohru

doi:10.1164/ajrccm.158.4.9802091

Cited by 221 publications

(198 citation statements)

References 16 publications

Supporting

Mentioning

176

Contrasting

Unclassified

Order By: Relevance

“…Patients hospitalized for CAP presented lower performance on the 6MWT (66% of predicted), indicating a reduction in FC, as previously demonstrated in patients with stable COPD [22][23][24] . In a study by Solh et al 7 , elderly patients hospitalized for CAP showed a decline in functional capacity as assessed by an ADL scale.…”

Section: Discussionsupporting

confidence: 75%

Patients hospitalized for community-acquired pneumonia present reduced functional performance

José¹,

Corso²

2013

Braz. J. Phys. Ther.

View full text Add to dashboard Cite

| Background: Symptoms of fatigue and dyspnea, treatment with oral corticosteroids, high circulating levels of cytokines, and oxidant/antioxidant imbalance in patients hospitalized with community-acquired pneumonia (CAP) could affect the patients' exercise tolerance and peripheral muscle strength (PMS). Objective: To evaluate the functional capacity (FC) of patients hospitalized for CAP and to correlate the FC with length of hospital stay. Method: We prospectively evaluated 45 patients (49±16 years; CAP group) and 20 healthy subjects (53±17 years; control group). They were randomized to perform, on separate days, a 6-minute walk test (6MWT), a test of PMS, and the Glittre test (GT). Additionally, the SF-36 questionnaire and the MRC scale were completed and evaluated. Results: There were significant differences between the groups (CAP and controls) for the 6MWT (381.3±108 vs. 587.1±86.8 m) and GT (272.8±104.3 vs. 174±39 sec). The CAP group also presented worse health-related quality of life (HRQoL) scores, reduced strength (quadriceps and biceps), and higher scores of dyspnea. The time required to perform the GT correlated with the length of hospital stay (r=0.35, P=0.02) and dyspnea (r=0.36, P=0.02). Significant correlations were observed between GT and 6MWT (r=-0.66, P=0.0001) and between GT with the physical functioning domain of SF-36 (r=-0.51, P=0.0001). Conclusions:Patients hospitalized for CAP presented with reduced FC, PMS, and HRQoL during hospitalization. In addition, GT performance was related to the length of hospital stay.Keywords: pneumonia; physical therapy; exercise tolerance; quality of life; muscle strength. HOW TO CITE THIS ARTICLE

show abstract

Section: Discussionsupporting

confidence: 75%

Patients hospitalized for community-acquired pneumonia present reduced functional performance

José¹,

Corso²

2013

Braz. J. Phys. Ther.

View full text Add to dashboard Cite

show abstract

“…Clinical characteristics collected included age, sex, body mass index (BMI), and subjective dyspnea as measured by the Modified Medical Research Council (MMRC) dyspnea scale. 19 Approval was obtained from the Mayo Foundation Institutional Review Board.…”

Section: Subjectsmentioning

confidence: 99%

Measuring Gait Speed in the Out-Patient Clinic: Methodology and Feasibility

et al. 2013

View full text Add to dashboard Cite

BACKGROUND: Gait speed is a simple physical function measure associated with key outcomes in the elderly population. Gait speed measurements may improve clinical care in patients with COPD. However, there is a knowledge gap about the reliability and variability of gait speed testing protocols in COPD. We evaluated established techniques of measuring gait speed in patients with COPD and assessed feasibility of implementing gait speed as a routine vital sign in an out-patient clinic. METHODS: The usual 4-meter gait speed (4MGS) ("walk at a comfortable/natural pace"), maximal 4MGS ("walk as fast as you can safely"), usual 10-meter gait speed (10MGS), and maximal 10MGS of subjects with stable COPD were measured. Walks were measured using a stopwatch and automated timing system. For the feasibility/implementation phase, patients from the entire spectrum of respiratory diseases completed acceptability surveys, and clinical assistants administered gait speed measurements using an automated timing system. Time to train and to administer the test and acceptability by the staff were evaluated. RESULTS: Seventy subjects enrolled; 60% were men, and the mean age ؎ SD was 69 ؎ 10 years. All methods showed excellent test-retest reliability (intraclass correlation coefficient of 0.95-0.97). The difference between the two timing systems did not exceed the suggested minimal clinically important difference of 0.1 m/s for the usual pace instructions but did exceed 0.1 m/s for maximal pace walks. The difference between 4MGS and 10MGS was 0.13 ؎ 0.10 m/s. FEASIBILITY: Most subjects reported that gait speed measurement prior to clinic appointment was very acceptable (66%) or acceptable (33%). Time added to clinic visit measuring 4MGS was 95 ؎ 20 seconds, and clinical assistants reported gait speed measurements as very acceptable (60%), acceptable (30%), and somewhat acceptable (10%). CONCLU-SIONS: Gait speed is a reliable measure in COPD, regardless of instructed pace, distance, or timing mechanism; however, adhering to one protocol is suggested. 4MGS was easily implemented into clinical practice with high acceptability by patients and clinic staff.

show abstract

“…Bij 27 deelnemers (6%) was de spirometrietest niet adequaat en bij 14 deelnemers (3%) waren een of meer vragenlijsten 23 De meeste rokers zonder eerdere diagnose COPD hebben een lichte vorm van de aandoening. Onze resultaten zijn daarom niet zonder meer van toepassing op patiënten met ernstig COPD.…”

Section: Resultaatunclassified

Kwaliteit van leven bij rokers: zijn functionele beperkingen belangrijker dan longfunctie?

Geijer¹,

Sachs²,

Verheij³

et al. 2009

HUWE

View full text Add to dashboard Cite

InleidingIn vrijwel alle richtlijnen is de graad van chronisch obstructief longlijden (COPD) alleen gebaseerd op de mate van luchtwegobstructie, dat wil zeggen het geforceerde expiratoire volume in één seconde (FEV 1 ), zonder rekening te houden met andere aspecten, zoals de ernst van de luchtwegklachten. 1,2 Opmerkelijk is dat de gezondheidsgerelateerde kwaliteit van leven, dat wil zeggen individuele tevredenheid of geluk voor zover die afhankelijk is van de gezondheid, nauwelijks verband houdt met de ernst van de luchtwegobstructie. [3][4][5][6][7][8] Belangrijker in dit opzicht is de functionele status, dat wil zeggen het individuele vermogen om normale dagelijkse activiteiten uit te voeren in de verschillende domeinen van het leven. 3 Dyspneu heeft bij patiënten met COPD het grootste negatieve effect op deze functionele status: de score op een dyspneuschaal lijkt sterker te correleren met de kwaliteit van leven dan de longfunctie. 9 Bekend is ook dat patiënten de huisarts consulteren vanwege toenemende luchtwegklachten en niet zozeer vanwege een afnemende longfunctie. Er is dan ook kritiek gerezen op de criteria van het Global Initiative for Chronic Obstructive Lung Disease (GOLD), die eenzijdig gebaseerd zijn op de longfunctie. 7 In de dagelijkse behandeling van rokers, al dan niet met een vroeg stadium van COPD, is er behoefte aan een eenvoudig en gestandaardiseerd instrument om de gezondheidsgerelateerde kwaliteit van leven vast te stellen -bijvoorbeeld voorafgaand aan een gerichte stoppen-met-rokeninterventie. De dyspneuschaal van de Medical Research Council (MRC) zou een dergelijk instrument kunnen zijn, omdat deze de mogelijkheid biedt patiënten met ernstig COPD te categoriseren op basis van hun lichamelijk functioneren. 6 Nog niet bekend was echter in hoeverre de MRCdyspneuschaal enerzijds en de ernst van de luchtwegobstructie anderzijds samenhangen met de kwaliteit van leven van rokers die een verhoogde kans op of een vroeg stadium van COPD hebben. Het doel van ons onderzoek was deze verbanden te bestuderen. Samenvatting

show abstract

Analysis of Clinical Methods Used to Evaluate Dyspnea in Patients with Chronic Obstructive Pulmonary Disease

Cited by 221 publications

References 16 publications

Patients hospitalized for community-acquired pneumonia present reduced functional performance

Patients hospitalized for community-acquired pneumonia present reduced functional performance

Measuring Gait Speed in the Out-Patient Clinic: Methodology and Feasibility

Kwaliteit van leven bij rokers: zijn functionele beperkingen belangrijker dan longfunctie?

Contact Info

Product

Resources

About