Measurement of Activities of Daily Living in Patients With COPD: A Systematic Review

doi:10.1378/chest.13-0016

Chest

Volume 145, Issue 2, February 2014, Pages 253-271

https://doi.org/10.1378/chest.13-0016 Get rights and content

Background

The objectives of this systematic review were to synthesize the literature on measures of activities of daily living (ADLs) that have been used in individuals with COPD and to provide an overview of the psychometric properties of the identified measures and describe the relationship of the disease-specific instruments with other relevant outcome measures for individuals with COPD and health-care use.

Methods

Studies that included a measure of ADLs in individuals with COPD were identified using electronic and hand searches. Two investigators performed the literature search. One investigator reviewed the study title, abstract, and full text of the articles to determine study eligibility and performed the data extraction and tabulation. In cases of uncertainty, a second reviewer was consulted.

Results

A total of 679 articles were identified. Of those, 116 met the inclusion criteria. Twenty-seven ADLs instruments were identified, of which 11 instruments were respiratory disease-specific, whereas 16 were generic. Most instruments combined instrumental ADLs (IADLs) with basic ADLs (BADLs). The majority of the instruments were self-reported; only three instruments were performance based. Twenty-one studies assessed psychometric properties of 16 ADLs instruments in patients with COPD.

Conclusions

Although several ADLs instruments were identified, psychometric properties have only been reported in a few. Selection of the most appropriate measure should focus on the target construct (BADLs or IADLs or both), type of test (disease-specific vs generic and self-reported vs performance-based), depth of information obtained, and psychometric properties of the instruments. Given the relevance of ADLs to the lives of patients with COPD, its assessment should be more frequently incorporated as a clinical outcome in their management.

Section snippets

Search Strategy and Data Sources

Two investigators (T. J.-F., M. K. B.) performed electronic literature searches of MEDLINE, PubMed, EMBASE, CINAHL, PEDro, and Cochrane from inception until October 2012. Search terms included COPD, ADLs, daily activities, day to day activities, daily life activities, instrument, measure, test, questionnaire, scale, assessment, and outcome (Table 1). We also conducted hand searches of the reference lists of all studies that met the inclusion criteria. Ethics approval was not necessary as this

Literature Search

A total of 679 articles were identified through the electronic and hand searches. Of those, 188 were duplicate articles, leaving a total of 491 articles for title and abstract screening. Following screening of study titles and abstracts, 305 were considered to be unrelated to the review objectives, and 186 remained for full-text analysis. Of these, 70 articles were excluded, leaving a total of 116 articles11, 12, 16, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40

Discussion

This review identified a variety of instruments used to assess ADLs in COPD. However, only 59% of them included information of their psychometric properties in patients with COPD. Assessing ADLs in individuals with COPD is important, as limitations during ADLs have been shown to predict mortality in this population,11, 12 reduce independence, and, therefore, influence HRQL, which itself is a predictor of mortality in COPD.12, 135, 136

There are a number of factors that need to be considered when

Acknowledgments

Author contributions: Dr Janaudis-Ferreira had full access to all of the data in the study and takes full responsibility for the integrity of all of the data and the accuracy of the data analysis, including and especially any adverse effects.

Dr Janaudis-Ferreira: contributed to conceiving and designing the study, searching literature and extracting the data, interpreting the data, writing the manuscript, and approving the final version of the manuscript.

Dr Beauchamp: contributed to searching

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Systematic review. Data sources: PubMed, BIREME and Epistemonikos. Three searches were carried out: two in 2018 (March and September) and one in 2020 (December).
Observational studies (cohort studies and cross-sectional studies) and Systematic Reviews that contemplated the assessment of IADL in people over 18 years of age, in English or Spanish, published since 1998 and open access.
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Funding/Support: This study was supported by the Ontario Respiratory Care Society and the Canadian Respiratory Health Professionals.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.

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Chest

Original Research: COPD: FeaturedMeasurement of Activities of Daily Living in Patients With COPD: A Systematic Review

Background

Methods

Results

Conclusions

Section snippets

Search Strategy and Data Sources

Literature Search

Discussion

Acknowledgments

Chest

Chest

Am J Med

Heart Lung

Respir Med

Chest

Arch Gerontol Geriatr

Chest

Respir Med

J Clin Epidemiol

Arch Gerontol Geriatr

Chest

Chest

Arch Gerontol Geriatr

Respir Med

Chest

Patient Educ Couns

J Am Med Dir Assoc

Arch Bronconeumol

Respir Med

Chest

Chest

Heart Lung

Respir Med

Respir Med

Allergol Int

Respir Med

Respir Med

Chest

Complement Ther Clin Pract

Lancet

Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. NHLBI/WHO Global Initiative for Chronic Obstructive Lung Disease (GOLD) Workshop summary

Am J Respir Crit Care Med

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

Predicting ADLs disability in community-dwelling elderly people using physical frailty indicators: a systematic review

BMC Geriatr

Mortality predictors in disabling chronic obstructive pulmonary disease in old age

Age Ageing

Predictors of 1-year mortality in patients discharged from hospital following acute exacerbation of chronic obstructive pulmonary disease

Age Ageing

Characterization of pulmonary rehabilitation programs in Canada in 2005

Can Respir J

Pulmonary rehabilitation programmes in the UK: a national representative survey

Clin Rehabil

Development of an activity of daily living scale for patients with COPD: the Activity of Daily Living Dyspnoea scale

Respirology

Air quality influence on chronic obstructive pulmonary disease (COPD) patients' quality of life

Indoor Air

Preferred reporting items for systematic reviews and meta-analyses: the PRISMA Statement

Open Med

Screening of cognitive impairment in chronic obstructive pulmonary disease

Dement Geriatr Cogn Disord

Out-patient rehabilitation improves activities of daily living, quality of life and exercise tolerance in chronic obstructive pulmonary disease

Eur Respir J

Usefulness of the Medical Research Council (MRC) dyspnoea scale as a measure of disability in patients with chronic obstructive pulmonary disease

Thorax

Heart rate variability and disease characteristics in patients with COPD

Lung

Noninvasive ventilation in patients with acute hypercapnic exacerbation of chronic obstructive pulmonary disease who refused endotracheal intubation

Crit Care Med

Health status in older hospitalized patients with cancer or non-neoplastic chronic diseases

BMC Geriatr

Functional recovery following physical training in tracheotomized and chronically ventilated patients

Respir Care

Health-related quality of life in COPD patients with chronic respiratory failure

Eur Respir J

The incremental shuttle walking test in elderly people with chronic airflow limitation

Thorax

Original Research: COPD: Featured
Measurement of Activities of Daily Living in Patients With COPD: A Systematic Review