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Easy to Perform Physical Performance Tests to Identify COPD Patients with Low Physical Activity in Clinical Practice

Matkovic Zinka, Tudoric Neven, Cvetko Danijel, Esquinas Cristina, Rahelic Dario, Zarak Marko, Miravitlles Marc,

Thematic Area
Epidemiology, Rehabilitation paths, Rehabilitation structures, Patients’ perspective
Summary
Background: The study investigates which physical performance or muscle function/mass tests significantly correlate with objectively measured physical activity (PA) in patients with chronic obstructive pulmonary disease (COPD) and could potentially serve to identify physically inactive COPD patients in routine clinical practice.
Methods: A cross-sectional, observational study was conducted in outpatients with moderate to very severe COPD. PA was measured during one week with the StepWatch Activity Monitor®, an ankle-worn accelerometer, and expressed in steps per day. Physical fitness and peripheral muscle function/mass were evaluated by the 4-meter gait speed (4MGS) test, the 6-minute walk distance (6MWD), the 30-second chair stand test (30sCST), the timed up and go test (TUGT), handgrip strength, arm muscle area, calf circumference, the fat-free mass index (FFMI), and ultrasound measurement of the quadriceps muscle. Spearman’s rank correlation analysis and ROC analysis were performed.
Results: The study population (N=111, 69% men, mean age 68 years) walked a mean of 8059 steps/day. The daily step count strongly correlated with the 6MWD (rho=0.684, p<0.001) and moderately with the 4MGS (rho=0.464, p<0.001), the TUGT (rho= −0.463, p<0.001), and the 30sCST (rho=0.402, p<0.001). The correlation with the FFMI was weak (rho=0.210, p=0.027), while the other parameters did not significantly correlate with the daily step count. The 6MWD had the best discriminative power to identify patients with very low PA defined as <5000 steps/day (AUC=0.802 [95% CI: 0.720–0.884], p<0.001), followed by the TUGT, the 4MGS, and the 30sCST.
Conclusion: The 6MWD, the 4MGS, the TUGT, and the 30sCST are easy to perform in any clinical setting and may be used by clinicians in the screening of physically inactive COPD patients.
Relevance
Patients with chronic obstructive pulmonary disease exercise both quantitatively and qualitatively less than healthy individuals of the same age or even patients with other chronic diseases. To identify patients with significantly lower mental activity in routine clinical practice, this study aimed to determine which physical performance or muscle function/mass tests correlate significantly with objectively determined mental activity.
DOI
doi: 10.2147/COPD.S246571
Keywords
chronic obstructive pulmonary disease, physical activity, gait speed, muscle function, muscle mass, exercise capacity