Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas, USA.
Shenzhen Dengding Biopharma Co., Ltd., Shenzhen, China.
Gerontology. 2022;68(7):829-839. doi: 10.1159/000520401. Epub 2021 Nov 29.
An early detection of impaired functional performance is critical to enhance symptom management for patients with chronic obstructive pulmonary disease (COPD). However, conventional functional measures based on walking assessments are often impractical for small clinics where the available space to administrate gait-based test is limited. This study examined the feasibility and effectiveness of an upper-extremity frailty meter (FM) in identifying digital measures of functional performance and assessing frailty in COPD patients.
Forty-eight patients with COPD (age = 68.8 ± 8.5 years, body mass index [BMI] = 28.7 ± 5.8 kg/m2) and 49 controls (age = 70.0 ± 3.0 years, BMI = 28.7 ± 6.1 kg/m2) were recruited. All participants performed a 20-s repetitive elbow flexion-extension test using a wrist-worn FM sensor. Functional performance was quantified by FM metrics, including speed (slowness), range of motion (rigidity), power (weakness), flexion and extension time (slowness), as well as speed and power reduction (exhaustion). Conventional functional measures, including timed-up-and-go test, gait and balance tests, and 5 repetition sit-to-stand test, were also performed.
Compared to controls, COPD patients exhibited deteriorated performances in all conventional functional assessments (d = 0.64-1.26, p < 0.010) and all FM metrics (d = 0.45-1.54, p < 0.050). FM metrics had significant agreements with conventional assessment tools (|r| = 0.35-0.55, p ≤ 0.001). FM metrics efficiently identified COPD patients with pre-frailty and frailty (d = 0.82-2.12, p < 0.050).
This study proposes the feasibility of using a 20-s repetitive elbow flexion-extension test and wrist-worn sensor-derived frailty metrics as an alternative and practical solution to evaluate functional performance in COPD patients. Its simplicity and low risk for test administration may also facilitate its application for remote patient monitoring. Furthermore, in settings where the administration of walking test is impractical, for example, when ventilator support is needed or space is limited, FM may be used as an alternative solution. Future studies are encouraged to use the FM to quantitatively monitor the progressive decline in functional performance and quantify outcomes of rehabilitation interventions.
早期发现功能障碍对于提高慢性阻塞性肺疾病（COPD）患者的症状管理至关重要。然而，基于行走评估的传统功能测量方法在可用空间有限的小型诊所中往往不切实际。本研究旨在探讨一种上肢虚弱测量仪（FM）在识别 COPD 患者数字功能表现测量指标和评估虚弱程度方面的可行性和有效性。
共招募 48 名 COPD 患者（年龄=68.8±8.5 岁，体重指数[BMI]=28.7±5.8kg/m2）和 49 名对照者（年龄=70.0±3.0 岁，BMI=28.7±6.1kg/m2）。所有参与者均使用手腕佩戴的 FM 传感器进行 20 秒重复的肘部屈伸测试。功能表现通过 FM 指标进行量化，包括速度（缓慢）、运动范围（僵硬）、力量（虚弱）、屈伸时间（缓慢）以及速度和力量下降（疲劳）。还进行了传统的功能测量，包括计时起立行走测试、步态和平衡测试以及 5 次重复坐站测试。
与对照组相比，COPD 患者在所有传统功能评估（d=0.64-1.26，p<0.010）和所有 FM 指标（d=0.45-1.54，p<0.050）中表现出恶化。FM 指标与传统评估工具具有显著一致性（|r|=0.35-0.55，p≤0.001）。FM 指标能够有效识别出处于衰弱前期和衰弱期的 COPD 患者（d=0.82-2.12，p<0.050）。
本研究提出了使用 20 秒重复肘部屈伸测试和手腕佩戴传感器衍生的虚弱指标作为评估 COPD 患者功能表现的替代且实用方法的可行性。其简单性和测试管理的低风险也可能促进其在远程患者监测中的应用。此外，在步行测试实施不切实际的情况下，例如需要呼吸机支持或空间有限的情况下，FM 可作为替代方案使用。鼓励未来的研究使用 FM 来定量监测功能表现的逐渐下降，并量化康复干预的结果。
