Abstract
Objective
To assess the phenotypic characteristics of patients with chronic obstructive pulmonary
disease (COPD) after stratification for Short Physical Performance Battery (SPPB)
summary scores and to determine phenotypic characteristics of the SPPB summary score
at the start of pulmonary rehabilitation (PR).
Design
Retrospective, cross-sectional.
Setting
Baseline assessment for PR program.
Participants
Patients with COPD (n=900; age 65±8y, 52% male, forced expiratory volume in the first
second of expiration, 43% [interquartile range, 31%-62%] predicted).
Interventions
Not applicable.
Main Outcome Measures
Patients were stratified according to their SPPB summary scores into low-performance
(LP), moderate-performance (MP), or high-performance (HP) groups. Furthermore, lung
function, arterial blood gases, body composition, physical capacity, lower limb muscle
strength and endurance, and symptoms of anxiety and depression were assessed.
Results
Generally, physical capacity and muscle function were lower and scores for symptoms
of anxiety and depression were higher in LP patients than MP and HP patients (all
values, P<.01). However, 25% of HP patients with COPD scored high on symptoms of anxiety and/or
depression (≥10 points), and HP patients still had on average an impaired physical
capacity (median, 6-minute walk test [6MWT] distance of 69% predicted). Furthermore,
age and 6MWT distance (m) were the only independent predictors in a multivariate regression
model, explaining 29% of the variance in SPPB summary score.
Conclusions
In COPD, LP patients have the worst physical and emotional functioning. However, HP
patients can still exhibit physical and emotional impairments. Because the explained
variance in SPPB summary score is low, SPPB should not be considered as a test to
discriminate between patients with COPD with a low or preserved physical capacity
and emotional status.
Keywords
List of abbreviations:
CAT (COPD Assessment Test), COPD (chronic obstructive pulmonary disease), CWRT (constant work rate test), FFM (fat-free mass), 5STS (5-repetition sit-to-stand), 4MGS (4-m gait speed), GOLD (Global Initiative for Chronic Obstructive Lung Disease), HP (high-performance), LP (low-performance), mMRC (modified Medical Research Council), MP (moderate-performance), PR (pulmonary rehabilitation), 6MWT (6-minute walk test), SPPB (Short Physical Performance Battery), Wmax (maximal workload)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: May 31, 2020
Footnotes
Supported by the Lung Foundation, the Netherlands (no. 5.1.18.232). Jana De Brandt is funded by the Flemish government. The research of FWO aspirant Jana De Brandt is sponsored by the FWO (grant no. 11B4718N). Dr F.M.E. Franssen is supported by grants and personal fees from AstraZeneca, personal fees from Boehringer Ingelheim, personal fees from Chiesi, personal fees from GlaxoSmithKline, grants and personal fees from Novartis, and personal fees from TEVA outside the submitted work. Dr B. van den Borst is supported by personal lecture fees from AstraZeneca and Boehringer Ingelheim bv. The other authors have nothing to disclose.
Identification
Copyright
© 2020 by the American Congress of Rehabilitation Medicine
