Feasibility of Home-based Functional Status Assessment of Chronic Obstructive Pulmonary Disease Patients Recovering from an Exacerbation

Abstract

IntroductionThe Glittre Activities of Daily Living Test (ADL-Test) is a reliable functional status measurement for stable Chronic Obstructive Pulmonary Disease (COPD) patients in a laboratory setting. We aimed to adapt the test to the home setting (mADL-Test) and to follow-up the functional status recovery of post-exacerbation COPD patients included in a home hospitalization (HH) program. MethodWe assessed 17 exacerbated moderate-to-very-severe COPD patients in 3 home visits: at discharge to HH (V0), 10 days (V10post) and 1 month after discharge (V30post). Patients completed the mADL-Test (laps, VO2 and VE), COPD assessment test (CAT), London Chest ADL Test (LCADL), modified Medical Research Council (mMRC) and upper limb strength (handgrip). ResultsThe number of laps of the mADL-Test (4, 5 and 5, P<.05), CAT (19, 12 and 12, P<.01), mMRC (2, 1.5 and 1, P<.01) and the self-care domain of the LCADL (6, 5 and 5, P<.01) improved during follow-up (V0, V10post and V30post, respectively). No significant changes were evidenced in VO2, VE or handgrip. ConclusionOur results suggest that the mADL-Test can be performed in the home setting after a COPD exacerbation, and that functional status continues to improve 10 days after HH discharge.