Factors Influencing Activities of Daily Living in Subjects With COPD

Abstract

BACKGROUND: Activities of daily living (ADL) are important for an independent life. As COPD progresses, the ability to complete ADL is usually reduced. Knowing the possible factors that influence the ability to perform ADL may allow better targeting of appropriate rehabilitation programs to increase the independence levels and/or to prevent further decreases in patients with COPD. Therefore, the aim of this study was to investigate ADL performance as measured by the London Chest Activity of Daily Living scale, which is a commonly used measure in patients with COPD. METHODS: This cross-sectional study included 44 clinically stable subjects who were not taking antibiotics and had not made any changes in their medications for at least three weeks with a COPD diagnosis based on Global Initiative for Chronic Obstructive Lung Disease. Demographic characteristics, pulmonary function, ADL measured by the London Chest Activity of Daily Living scale, functional exercise capacity via the 6-min walk distance, disease-related symptoms measured by the COPD Assessment Test, and peripheral and respiratory muscle strength were evaluated. A multiple linear regression (stepwise) analysis was used to determine the variables that have the greatest influence on ADL (ie, the London Chest Activity of Daily Living scale score). RESULTS: The London Chest Activity of Daily Living scale score had moderate correlations with the COPD Assessment Test score (r ‫؍‬ 0.31, P ‫؍‬ .041), maximum expiratory pressure value (r ‫؍‬ ؊0.37, P ‫؍‬ .01), 6-min walk distance (r ‫؍‬ ؊0.48, P ‫؍‬ .001), knee extensor muscle strength (r ‫؍‬ ؊0.47, P ‫؍‬ .001), handgrip strength (r ‫؍‬ ؊0.44, P ‫؍‬ .003). The 6-min walk distance, COPD Assessment Test score and maximal expiratory pressure values were significant and independent determinants of the London Chest Activity of Daily Living scale, with 40.1% of the variance in subjects with COPD. CONCLUSIONS: Functional exercise capacity, disease-related symptoms, and expiratory muscle strength have the greatest influence on ADL in the subjects with COPD. The level of independence to perform ADL can be increased by improving functional exercise capacity, reducing symptoms, and increasing expiratory muscle strength in subjects with COPD.

Impact of exercise training and supplemental oxygen on submaximal exercise performance in patients with COPD

“…Functional impairment and dyspnea have a main impact on the limitations of ADL in patients with COPD and thus on their quality of life 2,7 . The evaluation of submaximal exercise capacity is therefore of major interest, since it best reflects the functional performance during daily living 3 .…”

“…Chronic obstructive pulmonary disease (COPD) is one of the most common causes of morbidity and mortality, thus representing a global health burden 1 . Functional impairment and limitations in activities of daily living (ADL) are frequent in patients with COPD 2 . Moreover, disease‐related symptoms and functional exercise capacity have a great influence on ADL also in these patients 2 .…”

“…Functional impairment and limitations in activities of daily living (ADL) are frequent in patients with COPD 2 . Moreover, disease‐related symptoms and functional exercise capacity have a great influence on ADL also in these patients 2 . In this regard, submaximal exercise capacity is of major interest, since it reflects the functional performance during daily living.…”

“…Assessing and improving functional capacity using patient‐centered submaximal outcome measures might thus better reflect the impact of exercise capacity on patients’ quality of life 3 . Furthermore, it is known that the level of independence to perform ADL can be increased by improving functional exercise capacity and reducing symptoms 2,3 . Indeed, physical exercise training is a cornerstone of COPD treatment and thus recommended in all international guidelines 1,4‐10 .…”

New Insights into Activities of Daily Living Performance in Chronic Obstructive Pulmonary Disease

“…Indeed, it appears that there is no relationship between the level of COPD and ADL performance, as also indicated in other studies. 3,63 To summarize the dropouts, no systematic reason was detected to explain the dropouts, which is why we assume the reasons must have been individual.…”