Department of Pulmonary Diseases, Dekkerswald Radboudumc, Nijmegen, the Netherlands; Department of Research and Development, CIRO, Horn, the Netherlands.
Reval Rehabilitation Research, Biomedical Research Institute, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium.
Arch Phys Med Rehabil. 2020 Nov;101(11):1887-1897. doi: 10.1016/j.apmr.2020.05.011. Epub 2020 Jun 1.
To assess the phenotypic characteristics of patients with chronic obstructive pulmonary disease (COPD) after stratification for Short Physical Performance Battery (SPPB) summary scores and to determine phenotypic characteristics of the SPPB summary score at the start of pulmonary rehabilitation (PR).
Retrospective, cross-sectional.
Baseline assessment for PR program.
Patients with COPD (n=900; age 65±8y, 52% male, forced expiratory volume in the first second of expiration, 43% [interquartile range, 31%-62%] predicted).
Not applicable.
Patients were stratified according to their SPPB summary scores into low-performance (LP), moderate-performance (MP), or high-performance (HP) groups. Furthermore, lung function, arterial blood gases, body composition, physical capacity, lower limb muscle strength and endurance, and symptoms of anxiety and depression were assessed.
Generally, physical capacity and muscle function were lower and scores for symptoms of anxiety and depression were higher in LP patients than MP and HP patients (all values, P<.01). However, 25% of HP patients with COPD scored high on symptoms of anxiety and/or depression (≥10 points), and HP patients still had on average an impaired physical capacity (median, 6-minute walk test [6MWT] distance of 69% predicted). Furthermore, age and 6MWT distance (m) were the only independent predictors in a multivariate regression model, explaining 29% of the variance in SPPB summary score.
In COPD, LP patients have the worst physical and emotional functioning. However, HP patients can still exhibit physical and emotional impairments. Because the explained variance in SPPB summary score is low, SPPB should not be considered as a test to discriminate between patients with COPD with a low or preserved physical capacity and emotional status.
根据简短体能测试（SPPB）综合评分对慢性阻塞性肺疾病（COPD）患者进行分层，评估 COPD 患者的表型特征，并确定肺康复（PR）起始时 SPPB 综合评分的表型特征。
回顾性、横断面研究。
PR 计划的基线评估。
COPD 患者（n=900；年龄 65±8 岁，52%为男性，第 1 秒用力呼气量占预计值的 43%[四分位间距，31%-62%]）。
无。
根据 SPPB 综合评分将患者分为低表现（LP）、中表现（MP）或高表现（HP）组。此外，评估肺功能、动脉血气、身体成分、体力、下肢肌肉力量和耐力以及焦虑和抑郁症状。
一般来说，LP 患者的体力和肌肉功能较低，焦虑和抑郁症状评分较高（所有指标，P<.01）。然而，25%的 HP COPD 患者存在焦虑和/或抑郁症状评分较高（≥10 分），且 HP 患者的体力仍存在一定程度的受损（中位值，6 分钟步行试验[6MWT]距离为预计值的 69%）。此外，年龄和 6MWT 距离（m）是多元回归模型中唯一的独立预测因子，可解释 SPPB 综合评分变异的 29%。
在 COPD 中，LP 患者的身体和情绪功能最差。然而，HP 患者仍可能存在身体和情绪损伤。由于 SPPB 综合评分的解释变异较低，因此 SPPB 不应用于区分 COPD 患者中体力和情绪状态较差或较好的患者。
