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Original Research

Minimal clinically important difference of 3-minute chair rise test and the DIRECT questionnaire after pulmonary rehabilitation in COPD patients

, , , , , , , , , , , & show all
Pages 261-269 | Published online: 22 Jan 2019
 

Abstract

Background

The 3-minute chair rise test (3-minute CRT) and the Disability Related to COPD Tool (DIRECT) are two reproducible and valid short tests that can assess the benefit of pulmonary rehabilitation (PR) in terms of functional capacity and dyspnea in everyday activities.

Methods

We determined the minimal clinically important difference (MCID) of the DIRECT questionnaire and 3-minute CRT using distribution methods and anchor encroaches with a panel of eight standard tests in a cohort of 116 COPD patients who completed a PR program in real-life settings.

Results

The estimated MCID for the 3-minute CRT and DIRECT scores was five repetitions and two units, respectively, using separate and combined independent anchors. The all-patient (body mass index-obstruction-dyspnea-exercise [BODE] scores 0–7), BODE 0–2 (n=42), and BODE 3–4 (n=50) groups showed improvements greater than the MCID in most tests and questionnaires used. In contrast, the BODE 5–7 group (n=24) showed improvements greater than MCID in only the 3-minute CRT, 6-minute walk test, endurance exercise test, and DIRECT questionnaire.

Discussion and conclusion

This study demonstrates that the short and simple DIRECT questionnaire and 3-minute CRT are responsive to capture the beneficial effects of a PR program in COPD patients, including those with severe disease.

Trial registration number

NCT3286660.

Acknowledgments

The authors would like to thank Anne M O’Rourke, PhD, for editing the manuscript.

Disclosure

Financial support for this study was provided by an unrestricted grant from Boehringer Ingelheim, France. BA reports grants and other from Boehringer Ingelheim, France, during the conduct of the study. The authors report no other conflicts of interest in this work.