Assessing upper-extremity motion: An innovative method to quantify functional capacity in patients with chronic obstructive pulmonary disease.

Nima Toosizadeh,Christian Bime,Monica Kraft,Cristine Berry,Bijan Najafi,Jane Mohler,Sanjay Haresh Chotirmall

doi:10.1371/journal.pone.0172766

Nima Toosizadeh, Christian Bime + Show 5 more

Open Access

https://doi.org/10.1371/journal.pone.0172766

Copy DOI

Journal: PloS one	Publication Date: Feb 24, 2017
Citations: 22	License type: CC BY 4.0

Affiliation: University of Arizona, Baylor College of Medicine

Abstract

BackgroundAssessment of functional capacity is important in directing chronic obstructive pulmonary disease (COPD) care (e.g., rehabilitation and discharge readiness), and in predicting outcomes (e.g., exacerbation, hospitalization, and mortality). The 6-minute walk distance (6MWD) test for functional capacity assessment, may be time-consuming and burdensome.ObjectiveThe purpose of the current study was to evaluate an upper-extremity function (UEF) test for assessing functional capacity in older adults with COPD.MethodsIn this cross-sectional study, 49 older adults (≥55 years) with diagnosed COPD were recruited, and pulmonary function measures and 6MWD were obtained. Participants wore wireless sensors on forearm and upper-arm and performed rapid elbow flexion for 20 seconds (the UEF test). Slowness was assessed by measuring elbow speed, and acceleration and weakness (muscle strength) were assessed by measuring power of movement and elbow moment.ResultsSpeed, power, and moment UEF parameters were independently associated with 6MWD, when controlling for age, gender, and body mass index (BMI) (r = 0.78, p < .001). Elbow moment showed significant Pearson correlations with all pulmonary function measures and maximal inspiratory/expiratory pressure measures (r = 0.35–0.69, p<0.02).ConclusionsResults show promise of a quick upper-extremity measure of functional capacity in patients with COPD, and as an outcome measure in clinical COPD trials.

Highlights

Chronic obstructive pulmonary disease (COPD) is a complex disease, resulting in substantial burden to patients’ and health care systems, and is the third leading cause of death in the United States among adults [1,2]
The diagnosis and severity of chronic obstructive pulmonary disease (COPD) are determined by pulmonary function measurement using spirometry, with low pulmonary function predicting worse health outcomes [4]
Assessment of functional capacity, in addition to pulmonary function measures can be a practical approach in the prediction of COPD health outcomes

Summary

Introduction

Chronic obstructive pulmonary disease (COPD) is a complex disease, resulting in substantial burden to patients’ and health care systems, and is the third leading cause of death in the United States among adults [1,2]. Assessment of functional capacity, in addition to pulmonary function measures can be a practical approach in the prediction of COPD health outcomes. The 6MWD test has been commonly used to assess functional capacity in COPD patients and has been shown to predict mortality better than traditional pulmonary function measures [8,9]. The 6MWD may be impractical in understaffed or small clinical settings For these reasons, an alternative objective and simple approach for assessing functional capacity in COPD may prove beneficial. Assessment of functional capacity is important in directing chronic obstructive pulmonary disease (COPD) care (e.g., rehabilitation and discharge readiness), and in predicting outcomes (e.g., exacerbation, hospitalization, and mortality). The 6-minute walk distance (6MWD) test for functional capacity assessment, may be time-consuming and burdensome

Methods

Results

Conclusion