Global Assessment

  • Sally SinghEmail author


The initial assessment of the patient is critical to the overall success of pulmonary rehabilitation, it is important to invest time with the patient and if possible the carer/partner to secure a comprehensive evaluation of the patient, their social circumstances and their willingness and barriers to engagement. Furthermore the exercise and education components of the programme, delivered by the multidisciplinary team require specific detail information on exercise limitation and symptom burden to prescribe an exercise training programme to maximise the opportunities for a successful outcome for both the individual and the service delivering the programme.


  1. 1.
    Spruit MA, Augustin IM, Vanfleteren LE, Janssen DJ, Gaffron S, Pennings H, et al. Differential response to pulmonary rehabilitation in COPD: multidimensional profiling. Eur Respir J. 2015;46(6):1625–35.CrossRefPubMedGoogle Scholar
  2. 2.
    Kon SS, Dilaver D, Mittal M, Nolan CM, Clark AL, Canavan JL, et al. The Clinical COPD Questionnaire: response to pulmonary rehabilitation and minimal clinically important difference. Thorax. 2014;69(9):793–8.CrossRefPubMedGoogle Scholar
  3. 3.
    Revill SM, Morgan MD, Singh SJ, Williams J, Hardman AE. The endurance shuttle walk: a new field test for the assessment of endurance capacity in chronic obstructive pulmonary disease. Thorax. 1999;54(3):213–22.CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Eaton T, Young P, Nicol K, Kolbe J. The endurance shuttle walking test: a responsive measure in pulmonary rehabilitation for COPD patients. Chron Respir Dis. 2006;3(1):3–9.CrossRefPubMedGoogle Scholar
  5. 5.
    Dodd JW, Hogg L, Nolan J, Jefford H, Grant A, Lord VM, et al. The COPD assessment test (CAT): response to pulmonary rehabilitation. A multicentre, prospective study. Thorax. 2011;66(5):425–9.CrossRefPubMedGoogle Scholar
  6. 6.
    Singh SJ, Puhan MA, Andrianopoulos V, Hernandes NA, Mitchell KE, Hill CJ, et al. An official systematic review of the European Respiratory Society/American Thoracic Society: measurement properties of field walking tests in chronic respiratory disease. Eur Respir J. 2014;44(6):1447–78.CrossRefPubMedGoogle Scholar
  7. 7.
    Spruit MA, Pitta F, Garvey C, ZuWallack RL, Roberts CM, Collins EG, et al. Differences in content and organisational aspects of pulmonary rehabilitation programmes. Eur Respir J. 2014;43(5):1326–37.CrossRefPubMedGoogle Scholar
  8. 8.
    Garvey C, Fullwood MD, Rigler J. Pulmonary rehabilitation exercise prescription in chronic obstructive lung disease: US survey and review of guidelines and clinical practices. J Cardiopulm Rehabil Prev. 2013;33(5):314–22.CrossRefPubMedGoogle Scholar
  9. 9.
    Desveaux L, Janaudis-Ferreira T, Goldstein R, Brooks D. An international comparison of pulmonary rehabilitation: a systematic review. COPD. 2015;12(2):144–53.CrossRefPubMedGoogle Scholar
  10. 10.
    Steiner MC, Lowe D, Beckford K, Blakey J, Bolton CE, Elkin S, et al. Socioeconomic deprivation and the outcome of pulmonary rehabilitation in England and Wales. Thorax. 2017;72(6):530–7.CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Holland AE, Spruit MA, Troosters T, Puhan MA, Pepin V, Saey D, et al. An official European Respiratory Society/American Thoracic Society technical standard: field walking tests in chronic respiratory disease. Eur Respir J. 2014;44(6):1428–46.CrossRefPubMedGoogle Scholar
  12. 12.
    Berg KO, Wood-Dauphinee SL, Ivan Williams J, Maki B. Measuring balance in the elderly: validation of an instrument. Can J Public Health. 1992;83:S11.Google Scholar
  13. 13.
    Myers AM, Fletcher PC, Myers AH, Sherk W. Discriminative and evaluative properties of the activities-specific balance confidence (ABC) scale. J Gerontol A Biol Sci Med Sci. 1998;53(4):M294.Google Scholar
  14. 14.
    Horak FB, Wrisley DM, Frank J. The balance evaluation systems test (BESTest) to differentiate balance deficits. Phys Ther. 2009;89(5):484–98.CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Patel MS, Clark AL, Ingram KA, Fowler RP, Donaldson AV, Kon SS, et al. S74 Effect of pulmonary rehabilitation on the Short Physical Performance Battery (SPPB) in COPD. Thorax. 2010;65(Suppl 4):A35.CrossRefGoogle Scholar
  16. 16.
    Wells P. No sex please, I’m dying. A common myth explored. Eur J Palliat Care. 2002;9(3):119–22.Google Scholar
  17. 17.
    Vincent EE, Singh SJ. Review article: addressing the sexual health of patients with COPD: the needs of the patient and implications for health care professionals. Chron Respir Dis. 2007;4(2):111–5.CrossRefPubMedGoogle Scholar
  18. 18.
    Schols AM, Ferreira IM, Franssen FM, Gosker HR, Janssens W, Muscaritoli M, et al. Nutritional assessment and therapy in COPD: a European Respiratory Society statement. Eur Respir J. 2014;44(6):1504–20.CrossRefPubMedGoogle Scholar
  19. 19.
    White R, Walker P, Roberts S, Kalisky S, White P. Bristol COPD Knowledge Questionnaire (BCKQ): testing what we teach patients about COPD. Chron Respir Dis. 2006;3(3):123–31.CrossRefPubMedGoogle Scholar
  20. 20.
    Jones RC, Wang X, Harding S, Bott J, Hyland M. Educational impact of pulmonary rehabilitation: lung Information Needs Questionnaire. Respir Med. 2008;102(10):1439–45.CrossRefPubMedGoogle Scholar
  21. 21.
    Nasreddine ZS, Phillips NA, Bedirian V, Charbonneau S, Whitehead V, Collin I, et al. The montreal cognitive assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc. 2005;53(4):695–9.CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Folstein M, Folstein S, McHugh P. Mini-mental state: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12(3):189–98.CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Royall DR, Cordes JA, Polk M. CLOX: an executive clock drawing task. J Neurol Neurosurg Psychiatry. 1998;64(5):588–94.CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    Shum J, Poureslami I, Doyle-Waters MM, FitzGerald JM. The application of health literacy measurement tools (collective or individual domains) in assessing chronic disease management: a systematic review protocol. Syst Rev. 2016;5(1):97.CrossRefPubMedPubMedCentralGoogle Scholar
  25. 25.
    Ward S, Sewell L, Singh S. P144 Evaluation of multidisciplinary pulmonary rehabilitation education delivered by either DVD or spoken talk. Thorax. 2011;66(Suppl 4):A126.Google Scholar
  26. 26.
    Sohanpal R, Steed L, Mars T, Taylor SJ. Understanding patient participation behaviour in studies of COPD support programmes such as pulmonary rehabilitation and self-management: a qualitative synthesis with application of theory. NPJ Prim Care Respir Med. 2015;25:15054.CrossRefPubMedPubMedCentralGoogle Scholar
  27. 27.
    Thorpe O, Johnston K, Kumar S. Barriers and enablers to physical activity participation in patients with COPD: a systematic review. J Cardiopulm Rehabil Prev. 2012;32(6):359–69.CrossRefPubMedGoogle Scholar
  28. 28.
    Kosteli MC, Heneghan NR, Roskell C, Williams SE, Adab P, Dickens AP, et al. Barriers and enablers of physical activity engagement for patients with COPD in primary care. Int J COPD. 2017;12:1019–31.CrossRefGoogle Scholar
  29. 29.
    Bandura A. Self-efficacy: toward a unifying theory of behavioral change. Psychol Rev. 1977;84:191–215.CrossRefPubMedGoogle Scholar
  30. 30.
    Vincent E, Sewell L, Wagg K, Deacon S, Williams J, Singh S. Measuring a change in self-efficacy following pulmonary rehabilitation: an evaluation of the PRAISE tool. Chest. 2011;140(6):1534–9.CrossRefPubMedGoogle Scholar
  31. 31.
    Riegel B, Lee C, Dickson VV, Carlson B. An update on the self-care of heart failure index. J Cardiovasc Nurs. 2009;24(6):485–97.CrossRefPubMedPubMedCentralGoogle Scholar
  32. 32.
    Riegel B, Carlson B, Glaser D. Development and testing of a clinical tool measuring self-management of heart failure. Heart Lung. 2000;29(1):4–15.CrossRefPubMedGoogle Scholar
  33. 33.
    Jaarsma T, Stromberg A, Martensson J, cup K. Development and testing of the European heart failure self-care behaviour scale. Eur J Heart Fail. 2003;5(3):363–70.CrossRefPubMedGoogle Scholar
  34. 34.
    Mesquita R, Nakken N, Janssen DJA, van den Bogaart EHA, Delbressine JML, Essers JMN, et al. Activity levels and exercise motivation in COPD patients and their resident loved ones. Chest. 2017;151(5):1028–38.CrossRefPubMedGoogle Scholar
  35. 35.
    Roberts NJ, Kidd L, Dougall N, Patel IS, McNarry S, Nixon C. Measuring patient activation: the utility of the Patient Activation Measure within a UK context-Results from four exemplar studies and potential future applications. Patient Educ Couns. 2016;99(10):1739–46.CrossRefPubMedGoogle Scholar
  36. 36.
    Puhan M, Scharplatz M, Troosters T, Walters EH, Steurer J. Pulmonary rehabilitation following exacerbations of chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2009;1:CD005305.Google Scholar
  37. 37.
    Jones SE, Green SA, Clark AL, Dickson MJ, Nolan AM, Moloney C, et al. Pulmonary rehabilitation following hospitalisation for acute exacerbation of COPD: referrals, uptake and adherence. Thorax. 2014;69(2):181–2.CrossRefPubMedGoogle Scholar
  38. 38.
    The Health Foundation. Quality improvement made simple: what everyone should know about health care quality improvement. The Health Foundation; 2013 August.Google Scholar
  39. 39.
    Institute of Medicine. Crossing the quality chasm: a new health system for the 21st century. Washington, DC: National Academy Press; 1990.Google Scholar

Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  1. 1.Centre for Exercise and Rehabilitation ScienceUniversity Hospitals of Leicester NHS Trust, Glenfield HospitalLeicesterUK

Personalised recommendations