伦敦胸科日常生活活动量表和圣乔治呼吸问卷是否反映 COPD 患者日常生活活动中的受限情况？
Do London Chest Activity of Daily Living Scale and St George's Respiratory Questionnaire Reflect Limitations During Activities of Daily Living in Patients With COPD?
机构信息
Laboratory of Spirometry and Respiratory Physiotherapy-LEFiR, Universidade Federal de São Carlos-UFSCar, São Carlos, São Paulo, Brazil.
出版信息
J Cardiopulm Rehabil Prev. 2019 Jul;39(4):274-280. doi: 10.1097/HCR.0000000000000355.
PURPOSE
It is unclear whether activities of daily living (ADL) and quality-of-life scales reflect real ADL limitations. The aim of the study was to assess the limitation during ADL simulation and to identify whether the London Chest Activity of Daily Living (LCADL) Scale and St George's Respiratory Questionnaire (SGRQ) are able to reflect the patient's real limitations during ADL simulation.
METHODS
Forty-eight patients with chronic obstructive pulmonary disease (age = 69 ± 8 y; forced expiratory volume in the first second of expiration [FEV1] = 1.37 ± 0.49 L) were assessed by SGRQ and LCADL Scale. Activities of daily living simulations were performed: showering (ADL1); lifting and lowering containers above the shoulder girdle (ADL2); and raising and lowering pots below the pelvic girdle (ADL3).
RESULTS
SpO2 and ΔSpO2 in ADL2 were statistically lower than in ADL3. Ventilatory demand was statistically higher in ADL2 and ADL3 than in ADL1. Metabolic equivalent values were similar between the ADLs with values above 3.6. Oxygen desaturation was present in 41.7% (ADL1) and 33.3% (ADL2) of the patients. The LCADL% showed a moderate positive correlation with dyspnea in ADL3 and metabolic demand in ADL1. The SGRQ score presented a moderate positive correlation with dyspnea in all ADL simulations and metabolic demand in ADL1 and ADL3. Dyspnea in ADL3 and metabolic demand in ADL1 explained 33% of the variability in LCADL%. The dyspnea and metabolic demand in ADL3 explained 67% of the variability in SGRQ.
CONCLUSION
Activities of daily living lead to oxygen desaturation and high ventilatory demand. London Chest Activity of Daily Living Scale reflected 33% and SGRQ reflected 67% of the functional limitation during ADL simulation, such as dyspnea and the metabolic demand during ADL.
目的
日常生活活动（ADL）和生活质量量表是否能反映真实的 ADL 受限情况尚不清楚。本研究旨在评估 ADL 模拟中的受限情况，并确定伦敦胸部 ADL 量表（LCADL）和圣乔治呼吸问卷（SGRQ）是否能够反映 ADL 模拟过程中患者的真实受限情况。
方法
48 例慢性阻塞性肺疾病患者（年龄=69±8 岁；第 1 秒用力呼气量[FEV1]=1.37±0.49 L）进行了 SGRQ 和 LCADL 量表评估。进行了以下日常生活活动模拟：洗澡（ADL1）；提起和放下肩部以上的容器（ADL2）；提起和放下骨盆以下的锅碗瓢盆（ADL3）。
结果
ADL2 中的 SpO2 和 ΔSpO2 统计学上低于 ADL3。ADL2 和 ADL3 的通气需求均明显高于 ADL1。代谢当量值在 ADL 之间相似，均高于 3.6。41.7%（ADL1）和 33.3%（ADL2）的患者存在氧饱和度下降。LCADL%与 ADL3 中的呼吸困难和 ADL1 中的代谢需求呈中度正相关。SGRQ 评分与所有 ADL 模拟中的呼吸困难以及 ADL1 和 ADL3 中的代谢需求呈中度正相关。ADL3 中的呼吸困难和 ADL1 中的代谢需求解释了 LCADL%变化的 33%。ADL3 中的呼吸困难和 ADL1 中的代谢需求解释了 SGRQ 变化的 67%。
结论
日常生活活动导致氧饱和度下降和高通气需求。LCADL 反映了 33%的 ADL 模拟过程中的功能受限，如呼吸困难和 ADL 过程中的代谢需求，而 SGRQ 反映了 67%。
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