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格利特 ADL 测试可区分有和无自我报告的功能受限的 COPD 患者。

The Glittre ADL-Test Differentiates COPD Patients with and without Self-Reported Functional Limitation.

机构信息

Department of Physiotherapy, Universidade Federal Do Rio Grande Do Norte (UFRN), Natal, Brazil.

Pulmonary Rehabilitation Center, Universidade Federal de São Paulo, São Paulo, Brazil.

出版信息

COPD. 2020 Apr;17(2):143-149. doi: 10.1080/15412555.2020.1716707. Epub 2020 Jan 31.

Abstract

The Glittre ADL-test is based on important and common activities of daily living (ADLs), and it is an useful test to objectively distinguish patients with and without self-reported functional limitations. This study aims to analyze if difficulty to perform ADLs, as self-reported by patients with COPD, would reflect a worse Glittre ADL-test performance. In the first visit, patients were evaluated for clinical and nutritional status, spirometry, maximal cardiopulmonary exercise test on a treadmill. One week later, the patients performed two Glittre ADL-tests. Maximal voluntary ventilation (MVV) and the VE/MVV, VO/VO, and HR/HR ratios were calculated to analyze the ventilatory, metabolic, and cardiac reserves. The London Chest Activity of Daily Living (LCADL) scale was only answered after the two Glittre ADL-test were performed. Patients were splited into two subgroups based on the anchor question of the LCADL: those with and those without self-reported ADL limitation. Sixty-two COPD patients were included (65.3 ± 8.6 years, FEV 62 ± 22%pred). Those with ADL limitation (39 patients) completed the Glittre ADL-test with a significantly longer time ( = 0.002), as well as higher VE/MVV (  0.005) and lower oxygen pulse ( = 0.021) than those without ADL limitation. The time spent to perform the Glittre ADL-test was significantly associated with total LCADL score ( = 0.327,  < 0.05). A cutoff of 253 s was able to distinguish those patients without and with ADL limitation. COPD patients who self-reported ADL limitation according to the LCADL scale took a longer time to perform the Glittre ADL-test with higher VE/MVV and lower oxygen pulse than those without ADL limitation.

摘要

格利特日常生活活动(ADL)测试基于重要且常见的日常生活活动,是一种客观区分有和无自我报告功能障碍患者的有用测试。本研究旨在分析 COPD 患者自我报告的 ADL 困难是否反映出格利特 ADL 测试表现更差。在首次就诊时,对患者进行临床和营养状况、肺量计检查、跑步机上最大心肺运动测试评估。一周后,患者进行了两次格利特 ADL 测试。计算最大自主通气量(MVV)和 VE/MVV、VO/VO 和 HR/HR 比值,以分析通气、代谢和心脏储备。仅在完成两次格利特 ADL 测试后回答伦敦胸部日常生活活动量表(LCADL)。根据 LCADL 的锚定问题,患者分为两组:自我报告有和无日常生活活动受限。共纳入 62 例 COPD 患者(65.3±8.6 岁,FEV 62±22%预计值)。有日常生活活动受限的 39 例患者完成格利特 ADL 测试的时间明显更长( =0.002),VE/MVV 更高(  0.005),氧脉搏更低( =0.021)。完成格利特 ADL 测试的时间与总 LCADL 评分显著相关( =0.327, <0.05)。253 秒的截断值可区分有无日常生活活动受限的患者。根据 LCADL 量表自我报告日常生活活动受限的 COPD 患者完成格利特 ADL 测试的时间明显更长,VE/MVV 更高,氧脉搏更低。

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