Baseline Characteristics of Subjects with Chronic Obstructive Pulmonary Disease Associated to the Improvement in Activities of Daily Living after Exercise Training

Abstract

This study aimed to identify baseline variables predicting improvement in ADLs following an exercise training program in subjects with COPD. Sixty-seven patients with COPD underwent assessment of spirometry, modified Medical Research Council scale, COPD Assesment Test (CAT), Six Minute Walk Test (6MWT), London Chest Activity of Daily Living (LCADL) scale and Glittre-ADL test (TGlittre). After 24 sessions, they were reassessed for limitation in ADLs (LCADL and TGlittre). The main outcome was the achieving of minimal important difference (MID) of TGlittre, LCADL and both (ADLs). The cut-off points to discriminate the subjects who achieved the MID of TGlittre, LCADL and ADLs were established using the ROC curve. A cut-off point of 3.7 min in baseline TGlittre was able to discriminate subjects who achieved the MID of TGlittre (AUC = 0.77). Subjects with baseline TGlittre ≥3.7 min were 6.92 (95%CI 2.2–20.9) times more likely to achieve the MID of TGlittre post-exercise training. A cut-off point of 32% in LCADL was able to discriminate subjects who achieved the MID of LCADL (AUC = 0.81) and in ADLs (AUC = 0.78). Subjects with baseline LCADL ≥32% were 12.3 (95% CI 2.50 − 60.7) times more likely to achieve the MID of LCADL. In conclusion, the baseline variables that best predict the improvement of individuals after exercise training are TGlittre and LCADL, showing that subjects with significant functional impairment are more likely to clinically significantly improve their ADLs.

Keywords:

• Minimal clinically important difference
• chronic obstructive pulmonary disease
• rehabilitation
• activities of daily living
• outcome assessment

Acknowledgements

The authors thank those who supported the data acquisition, to the Irmandade da Santa Casa de Misericórdia de Porto Alegre, to all the pulmonologists who referred their patients to the study protocol, to the Coordenação de Aperfeiçoamento de Pessoal de Ensino Superior (CAPES/Brazil) and Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq/Brazil—Chamada Universal—MCTI/CNPq N° 14/2014) and to the Fundação de Amparo à Pesquisa e Inovação do Estado de Santa Catarina (FAPESC/Brazil—PAP UDESC—Chamada Publica N° 01/2016—Termo de Outorga: 2017TR645).

Disclosure statement

The authors report no conflict of interest.

Additional information

Funding

This research was supported in part by the Coordenação de Aperfeiçoamento de Pessoal de Ensino Superior—CAPES/Brazil and the Conselho Nacional de Desenvolvimento Científico e Tecnológico—CNPq/Brazil (Chamada Universal—MCTI/CNPq N° 14/2014) and the Fundação de Amparo à Pesquisa e Inovação do Estado de Santa Catarina—FAPESC/Brazil (PAP UDESC—Chamada Publica N° 01/2016—Termo de Outorga: 2017TR645).