Gupta Prahlad Rai, Feroz Asif, Dawar Sachet, Bhangoo Harshdeep, Swami Shivani, Khublani T K
Department of Respiratory Medicine, NIMS University, Jaipur, Rajasthan, India.
Lung India. 2017 May-Jun;34(3):251-255. doi: 10.4103/0970-2113.205320.
Assessment of functional status is vital for proper therapy and rehabilitation programs in chronic obstructive pulmonary disease (COPD) patients. Traditionally, 6 min walk test (6MWT) has been used but it by itself may not reflect the total functional status in these patients as it poorly correlates to the disease severity. A sit-to-stand test (STST) has been proposed as a better alternative to 6MWT but to test their ability to stand from the squatting position, i.e., a squat-to-stand test (SqTST) will be more appropriate in rural patients.
All patients, diagnosed to have stable COPD, after exclusion of asthma and other respiratory or nonrespiratory diseases were evaluated by applying 6MWT, STST, and SqTST in them. Data so obtained were statistically analyzed.
Ninety patients and twenty healthy controls were studied. Sixteen, 24, 23, and 27 of the patients were classed as COPD risk category A, B, C, and D, respectively. The mean post bronchodilator forced expiratory volume in 1st second (PB FEV1) and body mass index (BMI) were significantly lower in category D as compared to the rest. The cutoff values for 6MWT, STST, and SqTST were derived as 184M, 11, and 07, respectively. 6MWT correlates poorly to disease severity (P = 0.109) but there was a strong correlation between disease severity and SqTST and STST (P = 0.000).
SqTST is a feasible and effective tool to assess functional status of COPD patients residing in rural areas. BMI is an important surrogate marker of the functional status in these patients.
评估功能状态对于慢性阻塞性肺疾病(COPD)患者的恰当治疗和康复计划至关重要。传统上使用6分钟步行试验(6MWT),但它本身可能无法反映这些患者的整体功能状态,因为它与疾病严重程度的相关性较差。有人提出坐立试验(STST)是6MWT的更好替代方法,但要测试他们从蹲姿站立的能力,即蹲立试验(SqTST)对农村患者更为合适。
所有诊断为稳定期COPD的患者,在排除哮喘和其他呼吸或非呼吸疾病后,对他们进行6MWT、STST和SqTST评估。对所获得的数据进行统计学分析。
研究了90例患者和20名健康对照者。分别有16例、24例、23例和27例患者被归类为COPD风险类别A、B、C和D。与其他类别相比,D类患者的支气管扩张剂使用后第1秒用力呼气量(PB FEV1)和体重指数(BMI)显著更低。6MWT、STST和SqTST的截断值分别为184米、11次和7次。6MWT与疾病严重程度的相关性较差(P = 0.109),但疾病严重程度与SqTST和STST之间存在强相关性(P = 0.000)。
SqTST是评估农村地区COPD患者功能状态的一种可行且有效的工具。BMI是这些患者功能状态的重要替代标志物。