Bernabeu-Mora Roberto, Medina-Mirapeix Françesc, Llamazares-Herrán Eduardo, García-Guillamón Gloria, Giménez-Giménez Luz María, Sánchez-Nieto Juan Miguel
Division of Pneumology, Hospital Morales Meseguer, Spain ; Department of Physical Therapy, University of Murcia, Murcia, Spain.
Department of Physical Therapy, University of Murcia, Murcia, Spain.
Int J Chron Obstruct Pulmon Dis. 2015 Dec 3;10:2619-26. doi: 10.2147/COPD.S94377. eCollection 2015.
Limited mobility is a risk factor for developing chronic obstructive pulmonary disease (COPD)-related disabilities. Little is known about the validity of the Short Physical Performance Battery (SPPB) for identifying mobility limitations in patients with COPD.
To determine the clinical validity of the SPPB summary score and its three components (standing balance, 4-meter gait speed, and five-repetition sit-to-stand) for identifying mobility limitations in patients with COPD.
This cross-sectional study included 137 patients with COPD, recruited from a hospital in Spain. Muscle strength tests and SPPB were measured; then, patients were surveyed for self-reported mobility limitations. The validity of SPPB scores was analyzed by developing receiver operating characteristic curves to analyze the sensitivity and specificity for identifying patients with mobility limitations; by examining group differences in SPPB scores across categories of mobility activities; and by correlating SPPB scores to strength tests.
Only the SPPB summary score and the five-repetition sit-to-stand components showed good discriminative capabilities; both showed areas under the receiver operating characteristic curves greater than 0.7. Patients with limitations had significantly lower SPPB scores than patients without limitations in nine different mobility activities. SPPB scores were moderately correlated with the quadriceps test (r>0.40), and less correlated with the handgrip test (r<0.30), which reinforced convergent and divergent validities. A SPPB summary score cutoff of 10 provided the best accuracy for identifying mobility limitations.
This study provided evidence for the validity of the SPPB summary score and the five-repetition sit-to-stand test for assessing mobility in patients with COPD. These tests also showed potential as a screening test for identifying patients with COPD that have mobility limitations.
活动能力受限是慢性阻塞性肺疾病(COPD)相关残疾发展的一个风险因素。关于简短体能状况量表(SPPB)在识别COPD患者活动能力受限方面的有效性知之甚少。
确定SPPB总分及其三个组成部分(站立平衡、4米步速和五次坐立试验)在识别COPD患者活动能力受限方面的临床有效性。
这项横断面研究纳入了从西班牙一家医院招募的137例COPD患者。测量肌肉力量测试和SPPB;然后,对患者进行自我报告的活动能力受限调查。通过绘制受试者工作特征曲线分析SPPB评分的有效性,以分析识别活动能力受限患者的敏感性和特异性;通过检查不同活动能力类别中SPPB评分的组间差异;以及通过将SPPB评分与力量测试相关联。
只有SPPB总分和五次坐立试验组成部分显示出良好的辨别能力;两者在受试者工作特征曲线下的面积均大于0.7。在九种不同的活动能力中,有活动能力受限的患者的SPPB评分显著低于无活动能力受限的患者。SPPB评分与股四头肌测试中度相关(r>0.40),与握力测试相关性较小(r<0.30),这加强了聚合效度和区分效度。SPPB总分临界值为10时,识别活动能力受限的准确性最高。
本研究为SPPB总分和五次坐立试验在评估COPD患者活动能力方面的有效性提供了证据。这些测试也显示出作为筛查测试识别有活动能力受限的COPD患者的潜力。