Laboratório de Pesquisa em Fisioterapia Pulmonar (LFIP), Departamento de Fisioterapia, Universidade Estadual de Londrina (UEL), Londrina, Brazil.
COPD. 2011 Oct;8(5):334-9. doi: 10.3109/15412555.2011.594463. Epub 2011 Jul 20.
The study aimed to compare the responsiveness of three instruments to assess self-reported changes in functional status after exercise training in patients with COPD: Pulmonary Functional Status and Dyspnea Questionnaire -modified version (PFSDQ-M), London Chest Activity of Daily Living (LCADL) and Medical Research Council scale (MRC). Twenty-two patients (11 female, 66[62-71] years, FEV1 42[33-61]%predicted) participated in a 3-month high-intensity exercise program. The three instruments were applied pre- and post-program, as well as assessment of lung function, muscle strength, exercise capacity (6-minute walking test, 6MWT) and quality of life (St. George's Respiratory Questionnaire, SGRQ). SGRQ, 6MWT and quadriceps femoris, biceps and triceps brachialis strength improved significantly after the program (p < 0.05 for all). Training also yielded significant improvement in the LCADL total score and self-care, domestic and leisure domains and in the PFSDQ-M 'change in activities' domain, with no improvement in the MRC (p = 0.11). Calculation of effects sizes also indicated higher responsiveness in the LCADL than the other instruments. There were no significant correlations between changes in the three instruments and changes in lung function, SGRQ or 6MWT. In conclusion, PFSDQ-M's 'change in activity' domain and specially the LCADL (to a higher extent) showed responsiveness to detect changes in functional status after three months of high-intensity exercise training in patients with COPD, whereas the MRC scale did not. In this population, the improvement in functional status was not related with improvement in exercise capacity, lung function or quality of life.
本研究旨在比较三种工具在评估 COPD 患者运动训练后自我报告的功能状态变化时的反应性：改良版肺功能状态和呼吸困难问卷（PFSDQ-M）、伦敦胸部日常生活活动量表（LCADL）和医学研究委员会量表（MRC）。22 名患者（11 名女性，66[62-71]岁，FEV1 42[33-61]%预计值）参加了为期 3 个月的高强度运动计划。在计划前和计划后应用了这三种工具，同时评估了肺功能、肌肉力量、运动能力（6 分钟步行测试，6MWT）和生活质量（圣乔治呼吸问卷，SGRQ）。计划后 SGRQ、6MWT 和股四头肌、肱二头肌和肱三头肌握力均显著改善（p < 0.05 均有）。训练还使 LCADL 总分以及自我护理、家务和休闲领域以及 PFSDQ-M“活动变化”领域显著改善，而 MRC 无改善（p = 0.11）。效应量的计算也表明，LCADL 的反应性高于其他工具。三种工具的变化与肺功能、SGRQ 或 6MWT 的变化之间均无显著相关性。结论：PFSDQ-M 的“活动变化”领域和特别地 LCADL（程度更高）在 COPD 患者接受三个月高强度运动训练后显示出对功能状态变化的反应性，而 MRC 量表则没有。在该人群中，功能状态的改善与运动能力、肺功能或生活质量的改善无关。
