Program Development Centre, CIRO+, Horn, The Netherlands; Physiotherapy, CIRO+, Horn, The Netherlands.
Program Development Centre, CIRO+, Horn, The Netherlands; Respiratory Medicine, School for Nutrition, Toxicology and Metabolism, MUMC+, Maastricht, The Netherlands.
Chest. 2011 Oct;140(4):970-979. doi: 10.1378/chest.10-3005. Epub 2011 Mar 17.
Patients with COPD generally have a poor peak aerobic capacity and, therefore, may experience more inconvenience during domestic activities of daily life (ADLs). Yet, task-related oxygen uptake and symptom perception during ADLs have been studied rarely in COPD. Therefore, it remains unknown whether and to what extent differences may exist in task-related oxygen uptake and symptom perception during ADLs in patients with COPD after stratification for sex; GOLD (Global Initiative for Chronic Obstructive Lung Disease) stage; Medical Research Council (MRC) dyspnea grade; or score on the BMI, obstruction, dyspnea, exercise capacity (BODE) index.
Ninety-seven patients with COPD and 20 healthy elderly subjects performed the following five self-paced domestic ADLs with 4-min rest intervals: putting on socks, shoes, and vest; folding eight towels; putting away groceries; washing four dishes, cups, and saucers; and sweeping the floor for 4 min. Task-related oxygen uptake was assessed using an Oxycon Mobile device, whereas Borg scores were used to assess task-related dyspnea and fatigue.
Patients with COPD used a significantly higher proportion of their peak aerobic capacity and ventilation to perform ADLs than did the healthy subjects, accompanied by higher task-related Borg dyspnea scores. Patients with GOLD stage IV, MRC dyspnea grade 5, or BODE score ≥ 6 points had the highest task-related oxygen uptake and dyspnea perception during the performance of domestic ADLs. Results showed no sex-related differences.
Patients with COPD experience a relatively high metabolic load and symptom perception during the performance of ADLs that is not the same as seen in their healthy peers, particularly in patients with GOLD stage IV, MRC dyspnea grade 5, or BODE score ≥ 6 points.
COPD 患者通常峰值有氧能力较差,因此在进行日常生活活动(ADL)时可能会感到更加不便。然而,在 COPD 患者中,ADL 期间与任务相关的摄氧量和症状感知尚未得到充分研究。因此,尚不清楚在按性别、GOLD(全球慢性阻塞性肺疾病倡议)分期、医学研究委员会(MRC)呼吸困难分级或 BMI、阻塞、呼吸困难、运动能力(BODE)指数评分分层后,COPD 患者在 ADL 期间与任务相关的摄氧量和症状感知是否存在差异,以及存在何种差异。
97 例 COPD 患者和 20 例健康老年人分别进行以下 5 项自行设定速度的日常 ADL,每次之间休息 4 分钟:穿袜子、鞋子和背心;叠 8 条毛巾;将杂货放好;清洗 4 个碗、杯子和碟子;以及扫地 4 分钟。使用 Oxycon Mobile 设备评估与任务相关的摄氧量,而 Borg 评分用于评估与任务相关的呼吸困难和疲劳。
与健康受试者相比,COPD 患者在进行 ADL 时,其峰值有氧能力和通气量的使用比例明显更高,同时伴有更高的与任务相关的 Borg 呼吸困难评分。GOLD 分期 IV、MRC 呼吸困难分级 5 级或 BODE 评分≥6 分的患者在进行日常 ADL 时,其与任务相关的摄氧量和呼吸困难感知最高。结果未显示出与性别相关的差异。
COPD 患者在进行 ADL 时,会经历相对较高的代谢负荷和症状感知,与健康同龄人不同,尤其是在 GOLD 分期 IV、MRC 呼吸困难分级 5 级或 BODE 评分≥6 分的患者中。