Gulart Aline Almeida, Munari Anelise Bauer, Klein Suelen Roberta, Santos da Silveira Lucas, Mayer Anamaria Fleig
a Núcleo de Assistência, Ensino e Pesquisa em Reabilitaç , Universidade do Estado de Santa Catarina (UDESC) , Florianópolis , Brazil.
b Programa de Pós Graduação em Ciências do Movimento Humano, Centro de Ciências da Saúde e do Esporte (CEFID) , Universidade do Estado de Santa Catarina (UDESC) , Florianópolis , Brazil.
COPD. 2018 Feb;15(1):73-78. doi: 10.1080/15412555.2017.1369505.
The study objective was to determine a cut-off point for the Glittre activities of daily living (ADL)test (TGlittre) to discriminate patients with normal and abnormal functional capacity. Fifty-nine patients with moderate to very severe COPD (45 males; 65 ± 8.84 years; BMI: 26 ± 4.78 kg/m; FEV: 35.3 ± 13.4% pred) were evaluated for spirometry, TGlittre, 6-minute walk test (6 MWT), physical ADL, modified Medical Research Council scale (mMRC), BODE index, Saint George's Respiratory Questionnaire (SGRQ), and COPD Assessment Test (CAT). The receiver operating characteristic (ROC) curve was used to determine the cut-off point for TGlittre in order to discriminate patients with 6 MWT < 82% pred. The ROC curve indicated a cut-off point of 3.5 minutes for the TGlittre (sensitivity = 92%, specificity = 83%, and area under the ROC curve = 0.95 [95% CI: 0.89-0.99]). Patients with abnormal functional capacity had higher mMRC (median difference 1 point), CAT (mean difference: 4.5 points), SGRQ (mean difference: 12.1 points), and BODE (1.37 points) scores, longer time of physical activity <1.5 metabolic equivalent of task (mean difference: 47.9 minutes) and in sitting position (mean difference: 59.4 minutes) and smaller number of steps (mean difference: 1,549 minutes); p < 0.05 for all. In conclusion, the cut-off point of 3.5 minutes in the TGlittre is sensitive and specific to distinguish COPD patients with abnormal and normal functional capacity.
该研究的目的是确定格利特日常生活活动能力(ADL)测试(TGlittre)的一个临界点,以区分功能能力正常和异常的患者。对59例中度至重度慢性阻塞性肺疾病(COPD)患者(45例男性;65±8.84岁;体重指数:26±4.78kg/m;第一秒用力呼气容积:占预计值的35.3±13.4%)进行了肺量计检查、TGlittre测试、6分钟步行试验(6MWT)、身体ADL评估、改良医学研究委员会量表(mMRC)、BODE指数、圣乔治呼吸问卷(SGRQ)和慢性阻塞性肺疾病评估测试(CAT)。采用受试者工作特征(ROC)曲线来确定TGlittre的临界点,以便区分6MWT<82%预计值的患者。ROC曲线表明TGlittre的临界点为3.5分钟(敏感性=92%,特异性=83%,ROC曲线下面积=0.95[95%可信区间:0.89 - 0.99])。功能能力异常的患者具有更高的mMRC(中位数差异1分)、CAT(平均差异:4.5分)、SGRQ(平均差异:12.1分)和BODE(1.37分)评分,身体活动时间<1.5代谢当量任务的时间更长(平均差异:47.9分钟)以及坐姿时间更长(平均差异:59.4分钟)且步数更少(平均差异:1549分钟);所有差异均P<0.05。总之,TGlittre中3.5分钟的临界点对于区分功能能力异常和正常的COPD患者具有敏感性和特异性。