The Short Physical Performance Battery in Chronic Obstructive Pulmonary Disease (COPD)

Study Overview
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Brief Summary
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Patients with COPD often have limitations to physical performance. There are several tests for evaluating physical performance, unfortunately many of them can be time consuming and require specialized equipment an substantial space. Short physical performance battery is a simple test that requires little resources and can be performed both at institutions and in the homes of patients. SPPB has high predictive abilities in identifying older adults at greater risk for mortality, nursing home admission, hospitalization, and incidence of disability. The investigators would like to evaluate possible changes in the SPPB score after a 4-week rehabilitation program. The investigators would also like to look at possible relationships between the SPPB and other physical performance measures, dyspnea, anxiety, depression, fatigue, and health related quality of life.

Official Title
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The Short Physical Performance Battery in COPD - Possible Impact of a Pulmonary Rehabilitation Program and Relationships to Other Physical Performance Measures, Symptoms, and Quality of Life.

Conditions
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Chronic Obstructive Pulmonary Disease

Intervention / Treatment
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* Other: Pulmonary rehabilitation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients with all stages of COPD Decision making capacity to provide informed written consent Ability to understand and complete the questionnaires Exclusion Criteria: Exacerbation within the last four weeks Co-morbidities that limits the patient's physical performance more than COPD Any patient whom is deemed unsafe to exercise Patients tested on treadmill protocol 4 (i.e. Glittre testing protocol)
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Pulmonary rehabilitation<br>Multi-disciplinary pulmonary rehabilitation | Other: Pulmonary rehabilitation<br>* In-patient pulmonary rehabilitation including individualized exercise prescription, group based exercise training, education, individual sessions with a multi professional health care team<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Short physical performance battery (SPPB) | SPPB is comprised of 3 tasks: a hierarchial standing balance test (side by side, semi-tandem and tandem), 4-m habitual gait speed, and 5 sit to stand from a chair. Each task is scored (based on time) from 0-4 Points (p) and then summarized into a total score of 0-12 p, where 12 p represents the highest performance. | Pre and posttest with 4 weeks in between | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Lung function | spirometry and/or whole body plethysmography | 4 weeks | 
| 6-minute walk test (6MWT) | The 6 MWT is a timed walk test. Participants are asked to walk as far as possible, in 6 minutes. Borg CR-10 score and SpO2 will be measured before, during and/or after the 6 MWT. | 4 weeks | 
| Borg category ratio-10 scale (Borg CR-10 scale) | The Borg CR-10 scale is a rating scale for self-reported symptoms, in this case dyspnea. 0 represents no symptoms and 10 the worst previously experienced symptoms. | 4 weeks | 
| Peripheral oxygenation level | Peripheral oxygenation level (SpO2) will be measured indirectly by pulse oximetry during the 6 MWT. | 4 weeks | 
| Bilateral leg press 1 repetition Maximum (RM) | 1 RM bilateral leg press will be administered, after a brief warm-up, as a measure of leg strength. Starting position: Legs shoulder width apart and knee at 90 degrees angle. | 4 weeks | 
| Modified Medical Research Council Dyspnea Scale (MMRC) | A score from 0-4 is used to classify the impact of dyspnea on physical function in patients with COPD. 0 represents a person who suffers from dyspnea only with strenuous exercise. 4 is a person who are to breathless to leave the house, or breathless when dressing/undressing. | 4 weeks | 
| COPD assessment test (CAT) | CAT is a disease-specific quality of life questionnaire. It has 8-items and a total range of 0-40, where 40 represents more severe impact of COPD on a patient's life. | 4 weeks | 
| Hospital anxiety and depression scale (HADS) | 14-item questionnaire for screening for anxiety and depression. Each item is scored from 0-3 and each person can have a score between 0-21 for either anxiety or depression. | 4 weeks | 
| Fatigue severity scale (FSS) | 9- item scale that measures the impact of fatigue on a person's activities and lifestyle. Range 9-63. Higher score- greater fatigue severity. | 4 weeks |