Minimal Important Difference for the Glittre-ADL Test and London Chest Activity of Daily Living Scale
Condition: Pulmonary Disease, Chronic Obstructive
MeSH terms: Pulmonary Disease, Chronic Obstructive
Study type: Interventional

Summary: 
      Background: The ability to perform activities of daily living (ADL) in patients with chronic
      obstructive pulmonary disease is often impaired. Glittre-ADL Test has been used to assess
      limitations in ADL, and it seems to be responsive to intervention. However, the minimal
      detectable change for Glittre-ADL Test remains unknown. Design: Non-controlled before and
      after study. Setting: The study will be conducted in an outpatient pulmonary rehabilitation
      program in Florianopolis, Brazil. Subjects: Patients with COPD (GOLD II-IV). Interventions:
      Pulmonary rehabilitation program based on physical training, conducted over 24 sessions
      supervised, three times a week, including aerobic training in treadmill and localized
      training for upper limbs and lower limbs. Main measures: Glittre ADL-Test performance,
      six-minute walk test performance, London Chest Activity of Daily Living score, Modified
      Medical Research Council score, COPD Assessment Test score, Saint George Respiratory
      Questionnaire score before and after the pulmonary rehabilitation program.
    

Detailed description: 
      Assigned Interventions: Pulmonary rehabilitation program (PRP) was conducted according to the
      guidelines of the American Thoracic Society/European Respiratory Society (ATS/ERS). Physical
      training was conducted over 24 sessions supervised, three times a week. The program included
      aerobic training in treadmill (with 30 min load determined by the dyspnea sensation - 4 to 6
      on the modified Borg scale) and localized training for upper limbs with free weights or
      elastic bands (movements performed based on the proprioceptive neuromuscular facilitation
      diagonals, performed in two series, lasting two minutes each) and lower limbs (quadriceps and
      triceps sural) with free weights and/or in the bodybuilding station .

      Pulmonary function test: Spirometry will be performed before the PRP, and it will be in
      accordance with ATS/ERS standards in order to provide the level of pulmonary obstruction and
      severity of disease. The predicted values will be calculated with the equations derived from
      Brazilian population.

      Glittre-ADL Test: The patients will be instructed to complete five laps on the follow circuit
      as quickly as possible: from a sitting position, the subject stands up and walks along a flat
      10-m long course, in the middle of which there is a two-step ladder (each step 17 cm high x
      27 cm deep) to be climbed; after completing the 10 m, the subject faces a shelf containing
      three 1-kg objects positioned on the top shelf (shoulder height) and moves them one by one to
      the bottom shelf (waist height) and then to the floor; the objects are then returned to the
      bottom shelf and finally to the top shelf again; the subject walks back, climbing up and down
      the steps, until reaching the starting point (chair), sits down and immediately begins the
      next lap. The subjects carry a weighted backpack (2.5 kg for women, 5.0 kg for men). Two
      Glittre-ADL Tests will be conducted before and after the PRP.

      Six minute walk test (6MWT): The patients will be instructed to walk in order to perform the
      largest distance during six minutes. The walking speed will be selected by the patient,
      according to the guidelines of the ATS. Two 6MWTs will be conducted before and after the PRP.

      London Chest Activity of Daily Living scale: Patients will be asked about their perception of
      limitation in activities of daily living, using the London Chest Activity of Daily Living
      scale (LCADL) before and after the PRP.

      Modified Medical Research Council scale: Patients will be asked about their perception of
      dyspnea, using the modified Medical Research Council scale before and after the PRP.

      Saint George Respiratory Questionnaire: Patients will be asked about their perception of
      health-related quality of life, using the Saint George Respiratory Questionnaire before and
      after the PRP.

      COPD Assessment Test (CAT): Patients will be asked about their perception of the impact of
      COPD (cough, sputum, dyspnea, and chest tightness) on health status, using CAT before and
      after the PRP.
    

Intervention name(s): Pulmonary Rehabilitation
Intervention type(s): Other
Intervention description(s): Pulmonary rehabilitation program (PRP) was conducted according to the guidelines of the American Thoracic Society/European Respiratory Society (Nici et al., 2006; Spruit et al., 2013). Physical training was conducted over 24 sessions supervised, three times a week. The program included aerobic training in treadmill (with 30 min load determined by the dyspnea sensation - 4 to 6 on the modified Borg scale) and localized training for upper limbs with free weights or elastic bands (movements performed based on the proprioceptive neuromuscular facilitation diagonals, performed in two series, lasting two minutes each) and lower limbs (quadriceps and triceps sural) with free weights and/or in the bodybuilding station.
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Minimal Clinically Important Difference; Exercise Test; Rehabilitation; Disability Evaluation