Abstract
Aim: Breathlessness causes limitations in activities of daily living (ADL) in COPD patients. The aims of the study were to determine most prevalent ADL limitations, and to analyze relationship between changes in occupational performance and dyspnea, respiratory and peripheral muscle strength, fatigue and quality of life in COPD.
Materials and methods: Thirty-five COPD patients (FEV1 50.6±23.0%) participated. Activity limitations were measured with Canadian Activity Performance Measure (COPM). Patients identified activity limitations due to respiratory disorders in self care, productivity, and leisure. They rated the most important five activities as performance and satisfaction score on 1-10 point scale. Quadriceps and respiratory muscle strength were measured. Dyspnea and fatigue were evaluated with modified Medical Research Council dyspnea (MMRC) scale and Fatigue Severity Scale (FSS), respectively. Quality of life was determined with St George Respiratory Questionnaire (SGRQ).
Results: Seventy seven percent of COPD patients reported difficulty in active recreation and functional mobility, 74% in community management, 60% in socialization, and 51% in personal care. COPM performance score was significantly related with quadriceps strength (r=0.34), inspiratory muscle strength (r=0.37), MMRC (r=-0.52), FSS (r=-0.66), and SGRQ-total scores (r=-0.61, p<0.05). FSS and SGRQ explained 75% of the variance in COPM performance.
Conclusion: Performance in ADL is related to respiratory and peripheral muscle strength, dyspnea, fatigue, and quality of life. Fatigue and quality of life are the independent determinants of occupational performance in COPD. ADL performance should be included in pulmonary rehabilitation.
- © 2011 ERS