Skip to main content
SpringerLink
Log in
Book cover

Textbook of Pulmonary Rehabilitation pp 253–272Cite as

Patient-Centered Outcomes

  • Chapter
  • First Online:

  • 2207 Accesses

Abstract

The term “patient-centered outcomes” can be understood as outcomes from healthcare that are important to patients, and involve both physiological and psychological outcomes which are usually quantified by a variety of assessment tools. These key measures are applied for patient assessment and measurement of change or impact of interventions (such as pulmonary rehabilitation) in patients with chronic respiratory disease. In the context of pulmonary rehabilitation, patient-centered outcomes are useful to characterize individuals and populations, assess the impact of programs, and follow the course of the treatment, as well as the course of the disease itself. This chapter describes different outcomes involving the following assessment domains: lung function and respiratory muscle force, symptoms, exercise capacity, peripheral muscle force, balance, body composition, quality of life, anxiety, depression, functional status, physical activity in daily life, and self-efficacy. In common, the authors aimed to identify the most widely used tests to assess that outcome, providing an overview of its use and its minimal important difference, when available.

This is a preview of subscription content, log in via an institution.

References

  1. Ries AL, Kaplan RM, Limberg TM, Prewitt LM. Effects of pulmonary rehabilitation on physiologic and psychosocial outcomes in patients with chronic obstructive pulmonary disease. Ann Intern Med. 1995;122:823–32.

    Article  PubMed  CAS  Google Scholar 

  2. Troosters T, Gosselink R, Decramer M. Short- and long-term effects of outpatient rehabilitation in patients with chronic obstructive pulmonary disease: a randomized trial. Am J Med. 2000;109:207–12.

    Article  PubMed  CAS  Google Scholar 

  3. Spruit MA, Singh SJ, Garvey C, ZuWallack R, Nici L, Rochester C, Hill K, Holland AE, Lareau SC, Man WD, et al. An official American Thoracic Society/European Respiratory Society statement: key concepts and advances in pulmonary rehabilitation. Am J Respir Crit Care Med. 2013;188:e13–64.

    Article  PubMed  Google Scholar 

  4. Incorvaia C, Russo A, Foresi A, Berra D, Elia R, Passalacqua G, Riario-Sforza GG, Ridolo E. Effects of pulmonary rehabilitation on lung function in chronic obstructive pulmonary disease: the FIRST study. Eur J Phys Rehabil Med. 2014;50:419–26.

    PubMed  CAS  Google Scholar 

  5. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. 2016. www.goldcopd.org

  6. Crisafulli E, Clini EM. Measures of dyspnea in pulmonary rehabilitation. Multidiscip Respir Med. 2010;5:202–10.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Kon SS, Canavan JL, Jones SE, Nolan CM, Clark AL, Dickson MJ, Haselden BM, Polkey MI, Man WD. Minimum clinically important difference for the COPD assessment test: a prospective analysis. Lancet Respir Med. 2014;2:195–203.

    Article  PubMed  Google Scholar 

  8. Redelmeier DA, Guyatt GH, Goldstein RS. Assessing the minimal important difference in symptoms: a comparison of two techniques. J Clin Epidemiol. 1996;49:1215–9.

    Article  PubMed  CAS  Google Scholar 

  9. Regueiro EM, Burtin C, Baten P, Langer D, van Remoortel H, Di Lorenzo VA, Costa D, Janssens W, Decramer M, Gosselink R, Troosters T. The minimal important difference of the pulmonary functional status and dyspnea questionnaire in patients with severe chronic obstructive pulmonary disease. Respir Res. 2013;14:58.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Jones PW. St. George’s respiratory questionnaire: MCID. COPD. 2005;2:75–9.

    Article  PubMed  Google Scholar 

  11. Witek TJ Jr, Mahler DA. Minimal important difference of the transition dyspnoea index in a multinational clinical trial. Eur Respir J. 2003;21:267–72.

    Article  PubMed  Google Scholar 

  12. McCarthy B, Casey D, Devane D, Murphy K, Murphy E, Lacasse Y. Pulmonary rehabilitation for chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2015;2:CD003793.

    Google Scholar 

  13. Troosters T, Gosselink R, Decramer M. Exercise training in COPD: how to distinguish responders from nonresponders. J Cardiopulm Rehabil. 2001;21:10–7.

    Article  PubMed  CAS  Google Scholar 

  14. de Torres JP, Pinto-Plata V, Ingenito E, Bagley P, Gray A, Berger R, Celli B. Power of outcome measurements to detect clinically significant changes in pulmonary rehabilitation of patients with COPD. Chest. 2002;121:1092–8.

    Article  PubMed  Google Scholar 

  15. von Leupoldt A, Hahn E, Taube K, Schubert-Heukeshoven S, Magnussen H, Dahme B. Effects of 3-week outpatient pulmonary rehabilitation on exercise capacity, dyspnea, and quality of life in COPD. Lung. 2008;186:387–91.

    Article  Google Scholar 

  16. Wadell K, Webb KA, Preston ME, Amornputtisathaporn N, Samis L, Patelli J, Guenette JA, O'Donnell DE. Impact of pulmonary rehabilitation on the major dimensions of dyspnea in COPD. COPD. 2013;10:425–35.

    Article  PubMed  Google Scholar 

  17. Nici L, Donner C, Wouters E, Zuwallack R, Ambrosino N, Bourbeau J, Carone M, Celli B, Engelen M, Fahy B, et al. American Thoracic Society/European Respiratory Society statement on pulmonary rehabilitation. Am J Respir Crit Care Med. 2006;173:1390–413.

    Article  PubMed  Google Scholar 

  18. Caspersen CJ, Powell KE, Christenson GM. Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research. Public Health Rep. 1985;100:126–31.

    PubMed  PubMed Central  CAS  Google Scholar 

  19. Palange P, Ward SA, Carlsen KH, Casaburi R, Gallagher CG, Gosselink R, O'Donnell DE, Puente-Maestu L, Schols AM, Singh S, Whipp BJ. Recommendations on the use of exercise testing in clinical practice. Eur Respir J. 2007;29:185–209.

    Article  PubMed  CAS  Google Scholar 

  20. Borel B, Provencher S, Saey D, Maltais F. Responsiveness of various exercise-testing protocols to therapeutic interventions in COPD. Pulm Med. 2013;2013:410748.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Laviolette L, Bourbeau J, Bernard S, Lacasse Y, Pepin V, Breton MJ, Baltzan M, Rouleau M, Maltais F. Assessing the impact of pulmonary rehabilitation on functional status in COPD. Thorax. 2008;63:115–21.

    Article  PubMed  CAS  Google Scholar 

  22. Bisca GW, Morita AA, Hernandes NA, Probst VS, Pitta F. Simple lower limb functional tests in patients with chronic obstructive pulmonary disease: a systematic review. Arch Phys Med Rehabil. 2015;96:2221–30.

    Article  PubMed  Google Scholar 

  23. Kiley JP, Sri Ram J, Croxton TL, Weinmann GG. Challenges associated with estimating minimal clinically important differences in COPD-the NHLBI perspective. COPD. 2005;2:43–6.

    Article  PubMed  Google Scholar 

  24. Puhan MA, Chandra D, Mosenifar Z, Ries A, Make B, Hansel NN, Wise RA, Sciurba F. The minimal important difference of exercise tests in severe COPD. Eur Respir J. 2011;37:784–90.

    Article  PubMed  CAS  Google Scholar 

  25. Sutherland ER, Make BJ. Maximum exercise as an outcome in COPD: minimal clinically important difference. COPD. 2005;2:137–41.

    Article  PubMed  Google Scholar 

  26. Casaburi R. Factors determining constant work rate exercise tolerance in COPD and their role in dictating the minimal clinically important difference in response to interventions. COPD. 2005;2:131–6.

    Article  PubMed  Google Scholar 

  27. Holland AE, Hill CJ, Rasekaba T, Lee A, Naughton MT, McDonald CF. Updating the minimal important difference for six-minute walk distance in patients with chronic obstructive pulmonary disease. Arch Phys Med Rehabil. 2010;91:221–5.

    Article  PubMed  Google Scholar 

  28. Puhan MA, Mador MJ, Held U, Goldstein R, Guyatt GH, Schunemann HJ. Interpretation of treatment changes in 6-minute walk distance in patients with COPD. Eur Respir J. 2008;32:637–43.

    Article  PubMed  CAS  Google Scholar 

  29. Singh SJ, Jones PW, Evans R, Morgan MD. Minimum clinically important improvement for the incremental shuttle walking test. Thorax. 2008;63:775–7.

    Article  PubMed  CAS  Google Scholar 

  30. Pepin V, Laviolette L, Brouillard C, Sewell L, Singh SJ, Revill SM, Lacasse Y, Maltais F. Significance of changes in endurance shuttle walking performance. Thorax. 2011;66:115–20.

    Article  PubMed  Google Scholar 

  31. Kon SS, Canavan JL, Nolan CM, Clark AL, Jones SE, Cullinan P, Polkey MI, Man WD. The 4-metre gait speed in COPD: responsiveness and minimal clinically important difference. Eur Respir J. 2014;43:1298–305.

    Article  PubMed  Google Scholar 

  32. Mesquita R, Wilke S, Smid DE, Janssen DJ, Franssen FM, Probst VS, Wouters EF, Muris JW, Pitta F, Spruit MA. Measurement properties of the Timed Up & Go test in patients with COPD. Chron Respir Dis. 2016. pii: 1479972316647178.

    Google Scholar 

  33. Jones SE, Kon SS, Canavan JL, Patel MS, Clark AL, Nolan CM, Polkey MI, Man WD. The five-repetition sit-to-stand test as a functional outcome measure in COPD. Thorax. 2013;68:1015–20.

    Article  PubMed  Google Scholar 

  34. Cambach W, Chadwick-Straver RV, Wagenaar RC, van Keimpema AR, Kemper HC. The effects of a community-based pulmonary rehabilitation programme on exercise tolerance and quality of life: a randomized controlled trial. Eur Respir J. 1997;10:104–13.

    Article  PubMed  CAS  Google Scholar 

  35. Holland AE, Spruit MA, Troosters T, Puhan MA, Pepin V, Saey D, McCormack MC, Carlin BW, Sciurba FC, Pitta F, et al. An official European Respiratory Society/American Thoracic Society technical standard: field walking tests in chronic respiratory disease. Eur Respir J. 2014;44:1428–46.

    Article  PubMed  Google Scholar 

  36. Singh SJ, Puhan MA, Andrianopoulos V, Hernandes NA, Mitchell KE, Hill CJ, Lee AL, Camillo CA, Troosters T, Spruit MA, 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;44:1447–78.

    Article  PubMed  Google Scholar 

  37. Garber CE, Blissmer B, Deschenes MR, Franklin BA, Lamonte MJ, Lee IM, Nieman DC, Swain DP, American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Med Sci Sports Exerc. 2011;43:1334–59.

    Article  PubMed  Google Scholar 

  38. Burtin C, Saey D, Saglam M, Langer D, Gosselink R, Janssens W, Decramer M, Maltais F, Troosters T. Effectiveness of exercise training in patients with COPD: the role of muscle fatigue. Eur Respir J. 2012;40:338–44.

    Article  PubMed  Google Scholar 

  39. Vogiatzis I, Zakynthinos S. The physiological basis of rehabilitation in chronic heart and lung disease. J Appl Physiol (1985). 2013;115:16–21.

    Article  Google Scholar 

  40. Skeletal muscle dysfunction in chronic obstructive pulmonary disease. A statement of the American Thoracic Society and European Respiratory Society. Am J Respir Crit Care Med. 1999;159:S1–40.

    Google Scholar 

  41. Maltais F, Decramer M, Casaburi R, Barreiro E, Burelle Y, Debigare R, Dekhuijzen PN, Franssen F, Gayan-Ramirez G, Gea J, et al. An official American Thoracic Society/European Respiratory Society statement: update on limb muscle dysfunction in chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2014;189:e15–62.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Evans RA, Kaplovitch E, Beauchamp MK, Dolmage TE, Goldstein RS, Gillies CL, Brooks D, Mathur S. Is quadriceps endurance reduced in COPD? A systematic review. Chest. 2015;147:673–84.

    Article  PubMed  Google Scholar 

  43. Bernard S, LeBlanc P, Whittom F, Carrier G, Jobin J, Belleau R, Maltais F. Peripheral muscle weakness in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 1998;158:629–34.

    Article  PubMed  CAS  Google Scholar 

  44. Maffiuletti NA, Bizzini M, Desbrosses K, Babault N, Munzinger U. Reliability of knee extension and flexion measurements using the Con-Trex isokinetic dynamometer. Clin Physiol Funct Imaging. 2007;27:346–53.

    Article  PubMed  Google Scholar 

  45. Canavan JL, Maddocks M, Nolan CM, Jones SE, Kon SS, Clark AL, Polkey MI, Man WD. Functionally relevant cut point for isometric quadriceps muscle strength in chronic respiratory disease. Am J Respir Crit Care Med. 2015;192:395–7.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Puhan MA, Siebeling L, Zoller M, Muggensturm P, ter Riet G. Simple functional performance tests and mortality in COPD. Eur Respir J. 2013;42:956–63.

    Article  PubMed  PubMed Central  Google Scholar 

  47. Spruit MA, Sillen MJ, Groenen MT, Wouters EF, Franssen FM. New normative values for handgrip strength: results from the UK Biobank. J Am Med Dir Assoc. 2013;14:775 e775–11.

    Article  Google Scholar 

  48. Burtin C, Ter Riet G, Puhan MA, Waschki B, Garcia-Aymerich J, Pinto-Plata V, Celli B, Watz H, Spruit MA. Handgrip weakness and mortality risk in COPD: a multicentre analysis. Thorax. 2016;71:86–7.

    Article  PubMed  Google Scholar 

  49. De Brandt J, Spruit MA, Derave W, Hansen D, Vanfleteren LE, Burtin C. Changes in structural and metabolic muscle characteristics following exercise-based interventions in patients with COPD: a systematic review. Expert Rev Respir Med. 2016;10:521–45.

    Article  PubMed  CAS  Google Scholar 

  50. Spruit MA, Gosselink R, Troosters T, De PK, Decramer M. Resistance versus endurance training in patients with COPD and peripheral muscle weakness. Eur Respir J. 2002;19:1072–8.

    Article  PubMed  CAS  Google Scholar 

  51. O'Shea SD, Taylor NF, Paratz J. Peripheral muscle strength training in COPD: a systematic review. Chest. 2004;126:903–14.

    Article  PubMed  Google Scholar 

  52. Liao WH, Chen JW, Chen X, Lin L, Yan HY, Zhou YQ, Chen R. Impact of resistance training in subjects with COPD: a systematic review and meta-analysis. Respir Care. 2015;60:1130–45.

    Article  PubMed  Google Scholar 

  53. Ortega F, Toral J, Cejudo P, Villagomez R, Sanchez H, Castillo J, Montemayor T. Comparison of effects of strength and endurance training in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2002;166:669–74.

    Article  PubMed  Google Scholar 

  54. Vestbo J, Prescott E, Almdal T, Dahl M, Nordestgaard BG, Andersen T, Sorensen TI, Lange P. Body mass, fat-free body mass, and prognosis in patients with chronic obstructive pulmonary disease from a random population sample: findings from the Copenhagen City Heart Study. Am J Respir Crit Care Med. 2006;173:79–83.

    PubMed  Google Scholar 

  55. Lainscak M, von Haehling S, Doehner W, Sarc I, Jeric T, Ziherl K, Kosnik M, Anker SD, Suskovic S. Body mass index and prognosis in patients hospitalized with acute exacerbation of chronic obstructive pulmonary disease. J Cachexia Sarcopenia Muscle. 2011;2:81–6.

    Article  PubMed  PubMed Central  Google Scholar 

  56. Schols AM, Broekhuizen R, Weling-Scheepers CA, Wouters EF. Body composition and mortality in chronic obstructive pulmonary disease. Am J Clin Nutr. 2005;82:53–9.

    Article  PubMed  CAS  Google Scholar 

  57. Schols AM, Slangen J, Volovics L, Wouters EF. Weight loss is a reversible factor in the prognosis of chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 1998;157:1791–7.

    Article  PubMed  CAS  Google Scholar 

  58. Prescott E, Almdal T, Mikkelsen KL, Tofteng CL, Vestbo J, Lange P. Prognostic value of weight change in chronic obstructive pulmonary disease: results from the Copenhagen City Heart Study. Eur Respir J. 2002;20:539–44.

    Article  PubMed  CAS  Google Scholar 

  59. Rutten EP, Spruit MA, Wouters EF. Critical view on diagnosing muscle wasting by single-frequency bio-electrical impedance in COPD. Respir Med. 2010;104:91–8.

    Article  PubMed  Google Scholar 

  60. Jones SE, Maddocks M, Kon SS, Canavan JL, Nolan CM, Clark AL, Polkey MI, Man WD. Sarcopenia in COPD: prevalence, clinical correlates and response to pulmonary rehabilitation. Thorax. 2015;70:213–8.

    Article  PubMed  Google Scholar 

  61. Sava F, Laviolette L, Bernard S, Breton MJ, Bourbeau J, Maltais F. The impact of obesity on walking and cycling performance and response to pulmonary rehabilitation in COPD. BMC Pulm Med. 2010;6:10–55.

    Google Scholar 

  62. Ramachandran K, McCusker C, Connors M, Zuwallack R, Lahiri B. The influence of obesity on pulmonary rehabilitation outcomes in patients with COPD. Chron Respir Dis. 2008;5:205–9.

    Article  PubMed  CAS  Google Scholar 

  63. Greening NJ, Evans RA, Williams JE, Green RH, Singh SJ, Steiner MC. Does body mass index influence the outcomes of a Waking-based pulmonary rehabilitation programme in COPD? Chron Respir Dis. 2012;9:99–106.

    Article  PubMed  Google Scholar 

  64. Berton DC, Silveira L, Da Costa CC, De Souza RM, Winter CD, Zimermann Teixeira PJ. Effectiveness of pulmonary rehabilitation in exercise capacity and quality of life in chronic obstructive pulmonary disease patients with and without global fat-free mass depletion. Arch Phys Med Rehabil. 2013;94:1607–14.

    Article  PubMed  Google Scholar 

  65. Franssen FM, Broekhuizen R, Janssen PP, Wouters EF, Schols AM. Effects of whole-body exercise training on body composition and functional capacity in normal-weight patients with COPD. Chest. 2004;125:2021–8.

    Article  PubMed  Google Scholar 

  66. McDonald VM, Gibson PG, Scott HA, Baines PJ, Hensley MJ, Pretto JJ, Wood LG. Should we treat obesity in COPD? The effects of diet and resistance exercise training. Respirology. 2016;21:875–82.

    Article  PubMed  Google Scholar 

  67. Emtner M, Hallin R, Arnardottir RH, Janson C. Effect of physical training on fat-free mass in patients with chronic obstructive pulmonary disease (COPD). Ups J Med Sci. 2015;120:52–8.

    Article  PubMed  PubMed Central  Google Scholar 

  68. Beauchamp MK, Sibley KM, Lakhani B, Romano J, Mathur S, Goldstein RS, Brooks D. Impairments in systems underlying control of balance in COPD. Chest. 2012;141:1496–503.

    Article  PubMed  Google Scholar 

  69. de Castro LA, Ribeiro LR, Mesquita R, de Carvalho DR, Felcar JM, Merli MF, Fernandes KB, da Silva RA, Teixeira DC, Spruit MA, et al. Static and functional balance in individuals with COPD: comparison with healthy controls and differences according to sex and disease severity. Respir Care. 2016;61:1488–96.

    Article  PubMed  Google Scholar 

  70. Butcher SJ, Meshke JM, Sheppard MS. Reductions in functional balance, coordination, and mobility measures among patients with stable chronic obstructive pulmonary disease. J Cardiopulm Rehabil. 2004;24:274–80.

    Article  PubMed  Google Scholar 

  71. Beauchamp MK, Hill K, Goldstein RS, Janaudis-Ferreira T, Brooks D. Impairments in balance discriminate fallers from non-fallers in COPD. Respir Med. 2009;103:1885–91.

    Article  PubMed  CAS  Google Scholar 

  72. Jacome C, Cruz J, Oliveira A, Marques A. Validity, reliability, and ability to identify fall status of the berg balance scale, BESTest, Mini-BESTest, and Brief-BESTest in patients with COPD. Phys Ther. 2016;96:1807–15.

    Article  PubMed  Google Scholar 

  73. Mkacher W, Mekki M, Tabka Z, Trabelsi Y. Effect of 6 months of balance training during pulmonary rehabilitation in patients with COPD. J Cardiopulm Rehabil Prev. 2015;35:207–13.

    Article  PubMed  Google Scholar 

  74. Beauchamp MK, Janaudis-Ferreira T, Parreira V, Romano JM, Woon L, Goldstein RS, Brooks D. A randomized controlled trial of balance training during pulmonary rehabilitation for individuals with COPD. Chest. 2013;144:1803–10.

    Article  PubMed  Google Scholar 

  75. Marques A, Jacome C, Cruz J, Gabriel R, Figueiredo D. Effects of a pulmonary rehabilitation program with balance training on patients with COPD. J Cardiopulm Rehabil Prev. 2015;35:154–8.

    Article  PubMed  Google Scholar 

  76. Hakamy A, Bolton CE, McKeever TM. The effect of pulmonary rehabilitation on mortality, balance, and risk of fall in stable patients with chronic obstructive pulmonary disease: a systematic review. Chron Respir Dis. 2017;14(1):54–62.

    Article  PubMed  Google Scholar 

  77. Benzo R, Flume PA, Turner D, Tempest M. Effect of pulmonary rehabilitation on quality of life in patients with COPD: the use of SF-36 summary scores as outcomes measures. J Cardiopulm Rehabil. 2000;20:231–4.

    Article  PubMed  CAS  Google Scholar 

  78. Welling JB, Hartman JE, Ten Hacken NH, Klooster K, Slebos DJ. The minimal important difference for the St George's respiratory questionnaire in patients with severe COPD. Eur Respir J. 2015;46:1598–604.

    Article  PubMed  CAS  Google Scholar 

  79. Jones PW, Harding G, Wiklund I, Berry P, Tabberer M, Yu R, Leidy NK. Tests of the responsiveness of the COPD assessment test following acute exacerbation and pulmonary rehabilitation. Chest. 2012;142:134–40.

    Article  PubMed  Google Scholar 

  80. Bratas O, Espnes GA, Rannestad T, Walstad R. Pulmonary rehabilitation reduces depression and enhances health-related quality of life in COPD patients—especially in patients with mild or moderate disease. Chron Respir Dis. 2010;7:229–37.

    Article  PubMed  CAS  Google Scholar 

  81. Alfarroba S, Rodrigues F, Papoila AL, Santos AF, Morais L. Pulmonary rehabilitation in COPD according to global initiative for chronic obstructive lung disease categories. Respir Care. 2016;61:1331–40.

    Article  PubMed  Google Scholar 

  82. Solanes I, Guell R, Casan P, Sotomayor C, Gonzalez A, Feixas T, Gonzalez M, Guyatt G. Duration of pulmonary rehabilitation to achieve a plateau in quality of life and walk test in COPD. Respir Med. 2009;103:722–8.

    Article  PubMed  Google Scholar 

  83. Reis LF, Guimaraes FS, Fernandes SJ, Cantanhede LA, Dias CM, Lopes AJ, De Menezes SL. A long-term pulmonary rehabilitation program progressively improves exercise tolerance, quality of life and cardiovascular risk factors in patients with COPD. Eur J Phys Rehabil Med. 2013;49:491–7.

    PubMed  CAS  Google Scholar 

  84. Pitta F, Troosters T, Probst VS, Langer D, Decramer M, Gosselink R. Are patients with COPD more active after pulmonary rehabilitation? Chest. 2008;134:273–80.

    Article  PubMed  Google Scholar 

  85. Foglio K, Bianchi L, Bruletti G, Porta R, Vitacca M, Balbi B, Ambrosino N. Seven-year time course of lung function, symptoms, health-related quality of life, and exercise tolerance in COPD patients undergoing pulmonary rehabilitation programs. Respir Med. 2007;101:1961–70.

    Article  PubMed  Google Scholar 

  86. Godoy RF, Teixeira PJ, Becker Junior B, Michelli M, Godoy DV. Long-term repercussions of a pulmonary rehabilitation program on the indices of anxiety, depression, quality of life and physical performance in patients with COPD. J Bras Pneumol. 2009;35:129–36.

    Article  PubMed  Google Scholar 

  87. Coventry PA, Hind D. Comprehensive pulmonary rehabilitation for anxiety and depression in adults with chronic obstructive pulmonary disease: systematic review and meta-analysis. J Psychosom Res. 2007;63:551–65.

    Article  PubMed  Google Scholar 

  88. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67:361–70.

    Article  PubMed  CAS  Google Scholar 

  89. Puhan MA, Frey M, Buchi S, Schunemann HJ. The minimal important difference of the hospital anxiety and depression scale in patients with chronic obstructive pulmonary disease. Health Qual Life Outcomes. 2008;6:46.

    Article  PubMed  PubMed Central  Google Scholar 

  90. Bhandari NJ, Jain T, Marolda C, ZuWallack RL. Comprehensive pulmonary rehabilitation results in clinically meaningful improvements in anxiety and depression in patients with chronic obstructive pulmonary disease. J Cardiopulm Rehabil Prev. 2013;33:123–7.

    Article  PubMed  Google Scholar 

  91. Harrison SL, Greening NJ, Williams JE, Morgan MD, Steiner MC, Singh SJ. Have we underestimated the efficacy of pulmonary rehabilitation in improving mood? Respir Med. 2012;106:838–44.

    Article  PubMed  CAS  Google Scholar 

  92. Pumar MI, Gray CR, Walsh JR, Yang IA, Rolls TA, Ward DL. Anxiety and depression-important psychological comorbidities of COPD. J Thorac Dis. 2014;6:1615–31.

    PubMed  PubMed Central  Google Scholar 

  93. Trappenburg JC, Troosters T, Spruit MA, Vandebrouck N, Decramer M, Gosselink R. Psychosocial conditions do not affect short-term outcome of multidisciplinary rehabilitation in chronic obstructive pulmonary disease. Arch Phys Med Rehabil. 2005;86:1788–92.

    Article  PubMed  Google Scholar 

  94. Liu Y, Li H, Ding N, Wang N, Wen D. Functional status assessment of patients with COPD: a systematic review of performance-based measures and patient-reported measures. Medicine (Baltimore). 2016;95:e3672.

    Article  CAS  Google Scholar 

  95. De Vriendt P, Gorus E, Cornelis E, Velghe A, Petrovic M, Mets T. The process of decline in advanced activities of daily living: a qualitative explorative study in mild cognitive impairment. Int Psychogeriatr. 2012;24:974–86.

    Article  PubMed  Google Scholar 

  96. Lareau SC, Meek PM, Roos PJ. Development and testing of the modified version of the pulmonary functional status and dyspnea questionnaire (PFSDQ-M). Heart Lung. 1998;27:159–68.

    Article  PubMed  CAS  Google Scholar 

  97. Lareau SC, Carrieri-Kohlman V, Janson-Bjerklie S, Roos PJ. Development and testing of the pulmonary functional status and dyspnea questionnaire (PFSDQ). Heart Lung. 1994;23:242–50.

    PubMed  CAS  Google Scholar 

  98. Kovelis D, Zabatiero J, Oldemberg N, Colange AL, Barzon D, Nascimento CH, Probst VS, Pitta F. Responsiveness of three instruments to assess self-reported functional status in patients with COPD. COPD. 2011;8:334–9.

    Article  PubMed  Google Scholar 

  99. Garrod R, Bestall JC, Paul EA, Wedzicha JA, Jones PW. Development and validation of a standardized measure of activity of daily living in patients with severe COPD: the London chest activity of daily living scale (LCADL). Respir Med. 2000;94:589–96.

    Article  PubMed  CAS  Google Scholar 

  100. Bisca GW, Proenca M, Salomao A, Hernandes NA, Pitta F. Minimal detectable change of the London chest activity of daily living scale in patients with COPD. J Cardiopulm Rehabil Prev. 2014;34:213–6.

    Article  PubMed  Google Scholar 

  101. Yohannes AM, Roomi J, Winn S, Connolly MJ. The manchester respiratory activities of daily living questionnaire: development, reliability, validity, and responsiveness to pulmonary rehabilitation. J Am Geriatr Soc. 2000;48:1496–500.

    Article  PubMed  CAS  Google Scholar 

  102. Yohannes AM, Greenwood YA, Connolly MJ. Reliability of the manchester respiratory activities of daily living questionnaire as a postal questionnaire. Age Ageing. 2002;31:355–8.

    Article  PubMed  Google Scholar 

  103. Yohannes AM, Baldwin RC, Connolly MJ. Predictors of 1-year mortality in patients discharged from hospital following acute exacerbation of chronic obstructive pulmonary disease. Age Ageing. 2005;34:491–6.

    Article  PubMed  Google Scholar 

  104. Chen YJ, Narsavage GL, Culp SL, Weaver TE. The development and psychometric analysis of the short-form Pulmonary Functional Status Scale (PFSS-11). Res Nurs Health. 2010;33:477–85.

    Article  PubMed  Google Scholar 

  105. Weaver TE, Narsavage GL, Guilfoyle MJ. The development and psychometric evaluation of the Pulmonary Functional Status Scale: an instrument to assess functional status in pulmonary disease. J Cardiopulm Rehabil. 1998;18:105–11.

    Article  PubMed  CAS  Google Scholar 

  106. Leidy NK, Hamilton A, Becker K. Assessing patient report of function: content validity of the functional performance inventory-short form (FPI-SF) in patients with chronic obstructive pulmonary disease (COPD). Int J Chron Obstruct Pulmon Dis. 2012;7:543–54.

    Article  PubMed  PubMed Central  Google Scholar 

  107. Larson JL, Kapella MC, Wirtz S, Covey MK, Berry J. Reliability and validity of the functional performance inventory in patients with moderate to severe chronic obstructive pulmonary disease. J Nurs Meas. 1998;6:55–73.

    PubMed  CAS  Google Scholar 

  108. Sewell L, Singh SJ, Williams JE, Collier R, Morgan MD. Can individualized rehabilitation improve functional independence in elderly patients with COPD? Chest. 2005;128:1194–200.

    Article  PubMed  Google Scholar 

  109. Ware JE Jr, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992;30:473–83.

    Article  PubMed  Google Scholar 

  110. Jones PW, Quirk FH, Baveystock CM. The St George's respiratory questionnaire. Respir Med. 1991;85(Suppl B):25–31. discussion 33-27

    Article  PubMed  Google Scholar 

  111. Guyatt GH, Berman LB, Townsend M, Pugsley SO, Chambers LW. A measure of quality of life for clinical trials in chronic lung disease. Thorax. 1987;42:773–8.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  112. Tu SP, McDonell MB, Spertus JA, Steele BG, Fihn SD. A new self-administered questionnaire to monitor health-related quality of life in patients with COPD. Ambulatory Care Quality Improvement Project (ACQUIP) Investigators. Chest. 1997;112:614–22.

    Article  PubMed  CAS  Google Scholar 

  113. Probst VS, Kovelis D, Hernandes NA, Camillo CA, Cavalheri V, Pitta F. Effects of 2 exercise training programs on physical activity in daily life in patients with COPD. Respir Care. 2011;56:1799–807.

    Article  PubMed  Google Scholar 

  114. Skumlien S, Hagelund T, Bjortuft O, Ryg MS. A field test of functional status as performance of activities of daily living in COPD patients. Respir Med. 2006;100:316–23.

    Article  PubMed  Google Scholar 

  115. Karloh M, Karsten M, Pissaia FV, de Araujo CL, Mayer AF. Physiological responses to the Glittre-ADL test in patients with chronic obstructive pulmonary disease. J Rehabil Med. 2014;46:88–94.

    Article  PubMed  Google Scholar 

  116. Dos Santos K, Gulart AA, Munari AB, Cani KC, Mayer AF. Reproducibility of ventilatory parameters, dynamic hyperinflation, and performance in the Glittre-ADL TEST in COPD patients. COPD. 2016;13:700–5.

    Article  PubMed  Google Scholar 

  117. Sant’Anna T, Donaria L, Furlanetto KC, Morakami F, Rodrigues A, Grosskreutz T, Hernandes NA, Gosselink R, Pitta F. Development, validity and reliability of the Londrina activities of daily living (ADL) protocol for patients with COPD. Respir Care. 2017;62(3):288–97.

    Article  PubMed  Google Scholar 

  118. Paes T, Belo LF, Silva DR, Morita AA, Donaria L, Furlanetto KC, Sant'Anna T, Pitta F, Hernandes NA. Londrina ADL Protocol: reproducibility, validity and reference values in physically independent adults aged 50 and older. Respir Care. 2017;62(3):298–306.

    Article  PubMed  Google Scholar 

  119. Pitta F, Troosters T, Probst VS, Spruit MA, Decramer M, Gosselink R. Quantifying physical activity in daily life with questionnaires and motion sensors in COPD. Eur Respir J. 2006;27:1040–55.

    Article  PubMed  CAS  Google Scholar 

  120. Pitta F, Troosters T, Spruit MA, Decramer M, Gosselink R. Activity monitoring for assessment of physical activities in daily life in patients with chronic obstructive pulmonary disease. Arch Phys Med Rehabil. 2005;86:1979–85.

    Article  PubMed  Google Scholar 

  121. Ruf KC, Fehn S, Bachmann M, Moeller A, Roth K, Kriemler S, Hebestreit H. Validation of activity questionnaires in patients with cystic fibrosis by accelerometry and cycle ergometry. BMC Med Res Methodol. 2012;12:43.

    Article  PubMed  PubMed Central  Google Scholar 

  122. Garfield BE, Canavan JL, Smith CJ, Ingram KA, Fowler RP, Clark AL, Polkey MI, Man WD. Stanford seven-day physical activity recall questionnaire in COPD. Eur Respir J. 2012;40:356–62.

    Article  PubMed  Google Scholar 

  123. Serres I, Gautier V, Varray A, Prefaut C. Impaired skeletal muscle endurance related to physical inactivity and altered lung function in COPD patients. Chest. 1998;113:900–5.

    Article  PubMed  CAS  Google Scholar 

  124. Donaire-Gonzalez D, Gimeno-Santos E, Serra I, Roca J, Balcells E, Rodriguez E, Farrero E, Anto JM, Garcia-Aymerich J; en representación del PAC-COPD Study Group. Validation of the yale physical activity survey in chronic obstructive pulmonary disease patients. Arch Bronconeumol. 2011;47:552–60.

    Article  PubMed  Google Scholar 

  125. Ainslie P, Reilly T, Westerterp K. Estimating human energy expenditure: a review of techniques with particular reference to doubly labelled water. Sports Med. 2003;33:683–98.

    Article  PubMed  Google Scholar 

  126. Watz H, Waschki B, Meyer T, Magnussen H. Physical activity in patients with COPD. Eur Respir J. 2009;33:262–72.

    Article  PubMed  CAS  Google Scholar 

  127. Turner LJ, Houchen L, Williams J, Singh SJ. Reliability of pedometers to measure step counts in patients with chronic respiratory disease. J Cardiopulm Rehabil Prev. 2012;32:284–91.

    Article  PubMed  Google Scholar 

  128. Van Remoortel H, Raste Y, Louvaris Z, Giavedoni S, Burtin C, Langer D, Wilson F, Rabinovich R, Vogiatzis I, Hopkinson NS, et al. Validity of six activity monitors in chronic obstructive pulmonary disease: a comparison with indirect calorimetry. PLoS One. 2012;7:e39198.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  129. Rabinovich RA, Louvaris Z, Raste Y, Langer D, Van Remoortel H, Giavedoni S, Burtin C, Regueiro EM, Vogiatzis I, Hopkinson NS, et al. Validity of physical activity monitors during daily life in patients with COPD. Eur Respir J. 2013;42:1205–15.

    Article  PubMed  Google Scholar 

  130. Watz H, Pitta F, Rochester CL, Garcia-Aymerich J, ZuWallack R, Troosters T, Vaes AW, Puhan MA, Jehn M, Polkey MI, et al. An official European Respiratory Society statement on physical activity in COPD. Eur Respir J. 2014;44:1521–37.

    Article  PubMed  Google Scholar 

  131. Demeyer H, Burtin C, Van Remoortel H, Hornikx M, Langer D, Decramer M, Gosselink R, Janssens W, Troosters T. Standardizing the analysis of physical activity in patients with COPD following a pulmonary rehabilitation program. Chest. 2014;146:318–27.

    Article  PubMed  PubMed Central  Google Scholar 

  132. Cindy Ng LW, Mackney J, Jenkins S, Hill K. Does exercise training change physical activity in people with COPD? A systematic review and meta-analysis. Chron Respir Dis. 2012;9:17–26.

    Article  PubMed  Google Scholar 

  133. Demeyer H, Burtin C, Hornikx M, Camillo CA, Van Remoortel H, Langer D, Janssens W, Troosters T. The minimal important difference in physical activity in patients with COPD. PLoS One. 2016;11:e0154587.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  134. Gimeno-Santos E, Raste Y, Demeyer H, Louvaris Z, de Jong C, Rabinovich RA, Hopkinson NS, Polkey MI, Vogiatzis I, Tabberer M, et al. The PROactive instruments to measure physical activity in patients with chronic obstructive pulmonary disease. Eur Respir J. 2015;46:988–1000.

    Article  PubMed  PubMed Central  Google Scholar 

  135. Bandura A. Self-efficacy: toward a unifying theory of behavioral change. Psychol Rev. 1977;84:191–215.

    Article  PubMed  CAS  Google Scholar 

  136. 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;140:1534–9.

    Article  PubMed  Google Scholar 

  137. Garrod R, Marshall J, Jones F. Self efficacy measurement and goal attainment after pulmonary rehabilitation. Int J Chron Obstruct Pulmon Dis. 2008;3:791–6.

    Article  PubMed  PubMed Central  Google Scholar 

  138. Scherer YK, Schmieder LE. The effect of a pulmonary rehabilitation program on self-efficacy, perception of dyspnea, and physical endurance. Heart Lung. 1997;26:15–22.

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgements

The authors would like to thank Hindawi Publishing Corporation for granting permission to reproduce material from the article by Borel B, Provencher S, Saey D, Maltais F: Responsiveness of Various Exercise-Testing Protocols to Therapeutic Interventions in COPD. Pulmonary Medicine 2013, 2013:410748; and Elsevier for granting permission to reproduce material from the article by Skumlien S, Hagelund T, Bjortuft O, Ryg MS: A field test of functional status as performance of activities of daily living in COPD patients. Respiratory Medicine 2006, 100:316-323.

Author information

Authors and Affiliations

  1. Departamento de Fisioterapia, Universidade Estadual de Londrina, Londrina, Parana, Brazil

    Karina C. Furlanetto, Nidia A. Hernandes & Fabio Pitta

Authors
  1. Karina C. Furlanetto
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Nidia A. Hernandes
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Fabio Pitta
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Fabio Pitta .

Editor information

Editors and Affiliations

  1. Department of Medical and Surgical Sciences, University of Modena, Azienda Ospedaliero Universitaria di Modena Policlinico, Modena, Italy

    Enrico Clini

  2. Alfred Health and Institute for Breathing and Sleep, La Trobe University, Melbourne, Australia

    Anne E. Holland

  3. State University of Londrina, Londrina, Paraná, Brazil

    Fabio Pitta

  4. Department of Rehabilitation Sciences, KU Leuven, Respiratory Division and Rehabilitation, University Hospital Leuven, Leuven, Belgium

    Thierry Troosters

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG

About this chapter

Cite this chapter

Furlanetto, K.C., Hernandes, N.A., Pitta, F. (2018). Patient-Centered Outcomes. In: Clini, E., Holland, A., Pitta, F., Troosters, T. (eds) Textbook of Pulmonary Rehabilitation. Springer, Cham. https://doi.org/10.1007/978-3-319-65888-9_19

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-65888-9_19

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-65887-2

  • Online ISBN: 978-3-319-65888-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation