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Reliability and validity of 4-metre gait speed in COPD

Samantha S.C. Kon, Mehul S. Patel, Jane L. Canavan, Amy L. Clark, Sarah E. Jones, Claire M. Nolan, Paul Cullinan, Michael I. Polkey, William D-C. Man
European Respiratory Journal 2013 42: 333-340; DOI: 10.1183/09031936.00162712
Samantha S.C. Kon
1NIHR Respiratory Biomedical Research Unit, Royal Brompton and Harefield NHS Foundation Trust and Imperial College, London
3These authors contributed equally
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Mehul S. Patel
1NIHR Respiratory Biomedical Research Unit, Royal Brompton and Harefield NHS Foundation Trust and Imperial College, London
3These authors contributed equally
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Jane L. Canavan
1NIHR Respiratory Biomedical Research Unit, Royal Brompton and Harefield NHS Foundation Trust and Imperial College, London
3These authors contributed equally
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Amy L. Clark
2Harefield Pulmonary Rehabilitation Unit, Royal Brompton and Harefield NHS Foundation Trust, Harefield, UK
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Sarah E. Jones
2Harefield Pulmonary Rehabilitation Unit, Royal Brompton and Harefield NHS Foundation Trust, Harefield, UK
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Claire M. Nolan
1NIHR Respiratory Biomedical Research Unit, Royal Brompton and Harefield NHS Foundation Trust and Imperial College, London
2Harefield Pulmonary Rehabilitation Unit, Royal Brompton and Harefield NHS Foundation Trust, Harefield, UK
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Paul Cullinan
1NIHR Respiratory Biomedical Research Unit, Royal Brompton and Harefield NHS Foundation Trust and Imperial College, London
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Michael I. Polkey
1NIHR Respiratory Biomedical Research Unit, Royal Brompton and Harefield NHS Foundation Trust and Imperial College, London
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William D-C. Man
1NIHR Respiratory Biomedical Research Unit, Royal Brompton and Harefield NHS Foundation Trust and Imperial College, London
2Harefield Pulmonary Rehabilitation Unit, Royal Brompton and Harefield NHS Foundation Trust, Harefield, UK
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  • Figure 1–
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    Figure 1–

    Bland–Altman plots for a) test-retest and b) interobserver reliability.

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    Figure 2–

    The relationship between 4-m gait speed (4MGS) and a) incremental shuttle walk (ISW) distance; b) St George's Respiratory Questionnaire (SGRQ) total score; c) forced expiratory volume in 1 s (FEV1) % predicted.

Tables

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  • Table 1– Baseline characteristics of study subjects
    Subjects586
    Age years70 (63–76)
    Sex male/female372/214
    Height m1.67 (1.58–1.73)
    Weight kg73.0 (61.8–86.9)
    Body mass index kg·m−226.8 (23.2–31.2)
    FEV1 % predicted46 (29–61)
    MRC dyspnoea score3 (2–4)
    ISW test m190 (100–293)
    ISW test % predicted31 (16–49)
    SGRQ
     Symptoms68.6 (52.4–81.2)
     Activity72.8 (59.5–87.3)
     Impact37.1 (24.5–52.8)
     Total53.7 (41.4–66.4)
    Charlson index1 (1–2)
    COTE index0 (0–1)
    Exacerbations in previous year2 (1–3)
    Hospital days in previous year0 (0–4.25)
    Gait speed m·s−10.89 (0.74–1.05)
    • Data are presented as n or median (interquartile range). FEV1: forced expiratory volume in 1 s; MRC: Medical Research Council; ISW: incremental shuttle walk; SGRQ: St George’s Respiratory Questionnaire; COTE: chronic obstructive pulmonary disease-specific comorbidity test.

  • Table 2– Spearman's rank correlation (ρ) to compare the relationship between 4-m gait speed and other health outcome measurements
    ρp-value
    Age-0.21<0.001
    Height0.030.40
    Weight0.010.86
    BMI-0.090.03
    FEV1 % predicted0.100.01
    MRC dyspnoea score-0.55<0.001
    ISW test0.78<0.001
    ISW test % predicted0.72<0.001
    SGRQ
     Symptoms-0.150.007
     Activity-0.51<0.001
     Impact-0.38<0.001
     Total-0.44<0.001
    Charlson index-0.120.004
    COTE index-0.090.03
    • BMI: body mass index; FEV1: forced expiratory volume in 1 s; MRC: Medical Research Council; ISW: incremental shuttle walk; SGRQ: St George’s Respiratory Questionnaire; COTE: chronic obstructive pulmonary disease-specific comorbidity test.

  • Table 3– A comparison between chronic obstructive pulmonary disease (COPD) patients with low or normal 4-m gait speed (4MGS)
    Gait speedp-value
    SlowNormal
    Subjects193393
    Age years73 (64–78)69 (63–75)<0.001
    Sex male/female100/93221/1720.33
    Height m1.65 (1.58–1.74)1.58 (1.41–1.67)0.72
    Weight kg74.6 (61.0–89.0)72.1 (62.0–86.0)0.46
    BMI kg·m−228.4 (23.9–32.5)26.3 (23.0–30.2)0.01
    FEV1 % predicted46 (28–61)46 (30–61)0.37
    MRC dyspnoea score4 (4–5)3 (2–4)<0.001
    ISW distance m80 (40–120)250 (160–350)<0.001
    ISW % predicted14 (7–24)41 (28–57)<0.001
    SGRQ
     Symptoms71.5 (54.3–82.2)67.8 (51.6–80.2)0.11
     Activity85.8 (72.8–92.5)66.3 (53.5–79.8)<0.001
     Impact47.9 (32.1–58.4)34.0 (22.3–47.1)<0.001
     Total63.1 (48.9–71.6)49.6 (387–61.1)<0.001
    Charlson index1 (1–3)1 (1–2)0.02
    COTE index0 (0–1)0 (0–1)0.82
    Exacerbations2 (1–4)2 (1–3)0.77
    Hospital days1 (0–7)0 (0–4)0.004
    Gait speed m·s−10.67 (0.56–0.74)0.99 (0.89–1.12)<0.001
    • Data are presented as n or median (interquartile range), unless otherwise stated. BMI: body mass index; FEV1: forced expiratory volume in 1 s; MRC: Medical Research Council; ISW: incremental shuttle walk; SGRQ: St George’s Respiratory Questionnaire; COTE: chronic obstructive pulmonary disease-specific comorbidity test.

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Reliability and validity of 4-metre gait speed in COPD
Samantha S.C. Kon, Mehul S. Patel, Jane L. Canavan, Amy L. Clark, Sarah E. Jones, Claire M. Nolan, Paul Cullinan, Michael I. Polkey, William D-C. Man
European Respiratory Journal Aug 2013, 42 (2) 333-340; DOI: 10.1183/09031936.00162712

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Reliability and validity of 4-metre gait speed in COPD
Samantha S.C. Kon, Mehul S. Patel, Jane L. Canavan, Amy L. Clark, Sarah E. Jones, Claire M. Nolan, Paul Cullinan, Michael I. Polkey, William D-C. Man
European Respiratory Journal Aug 2013, 42 (2) 333-340; DOI: 10.1183/09031936.00162712
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