Physical Tests Are Poorly Related to Patient-Reported Outcome Measures during Severe Acute Exacerbations of COPD

Kirsten Quadflieg; Ana Machado; Sarah Haesevoets; Marc Daenen; Michiel Thomeer; David Ruttens; Martijn A Spruit; Chris Burtin

doi:10.3390/jcm11010150

Physical Tests Are Poorly Related to Patient-Reported Outcome Measures during Severe Acute Exacerbations of COPD

J Clin Med. 2021 Dec 28;11(1):150. doi: 10.3390/jcm11010150.

Authors

Kirsten Quadflieg^{1

2}, Ana Machado^{1

2

3

4}, Sarah Haesevoets^{1

2}, Marc Daenen⁵, Michiel Thomeer^{5

6}, David Ruttens^{5

6}, Martijn A Spruit^{7

8}, Chris Burtin^{1

2}

Affiliations

¹ REVAL-Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium.
² BIOMED-Biomedical Research Institute, Hasselt University, 3590 Diepenbeek, Belgium.
³ Respiratory Research and Rehabilitation Laboratory (Lab 3R), School of Health Sciences (ESSUA), University of Aveiro, 3810-193 Aveiro, Portugal.
⁴ Institute of Biomedicine (iBiMED), University of Aveiro, 3810-193 Aveiro, Portugal.
⁵ Department Respiratory Medicine, Ziekenhuis Oost-Limburg, 3600 Genk, Belgium.
⁶ Faculty of Medicine and Life Sciences, Hasselt University, 3590 Diepenbeek, Belgium.
⁷ CIRO, Center of Expertise for Chronic Organ Failure, Department of Research and Education, 6085 NM Horn, The Netherlands.
⁸ Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, 6229 HX Maastricht, The Netherlands.

Abstract

Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) have a negative impact on patients' health status, including physical function and patient-reported outcomes. We aimed to explore the associations between physical tests and patient-reported outcome measures (PROMs) in hospitalised patients for an AECOPD. Patients were assessed on the day of discharge. Quadriceps force, handgrip strength, short physical performance battery (SPPB), five-repetition sit-to-stand test (5STS), four-meter gait speed test (4MGS), balance test, six-minute walk test (6MWT), COPD Assessment Test (CAT), London Chest Activity of Daily Living scale (LCADL), modified Medical Research Council (mMRC) dyspnea scale, Checklist of Individual Strength (CIS)-fatigue subscale, and Patient Health Questionnaire (PHQ-9) were collected. Sixty-nine patients with an AECOPD were included (54% female; age 69 ± 9 years; FEV₁ 39.2 (28.6-49.1%) predicted). Six-minute walk distance was strongly correlated with mMRC (ρ: -0.64, p < 0.0001) and moderately correlated with LCADL total score, subscales self-care and household activities (ρ ranging from -0.40 to -0.58, p < 0.01). Moreover, 4MGS was moderately correlated with mMRC (ρ: -0.49, p < 0.0001). Other correlations were weak or non-significant. During a severe AECOPD, physical tests are generally poorly related to PROMs. Therefore, a comprehensive assessment combining both physical tests and PROMs needs to be conducted in these patients to understand their health status.

Keywords: acute exacerbations; chronic obstructive pulmonary disease; exercise capacity; muscle function; patient-reported outcome measures.