title: Fatigue and multidimensional disease severity in chronic obstructive pulmonary disease.
abstract: OBJECTIVE
  Fatigue is associated with longitudinal ratings of health in patients with chronic obstructive pulmonary disease (COPD). Although the degree of airflow obstruction is often used to grade disease severity in patients with COPD, multidimensional grading systems have recently been developed. The aim of this study was to investigate the relationship between perceived and actual fatigue level and multidimensional disease severity in patients with COPD.
  
  
  METHODS
  Twenty-two patients with COPD (aged 52-74 years) took part in the study. Multidimensional disease severity was measured using the SAFE and BODE indices. Perceived fatigue was assessed using the Fatigue Severity Scale (FSS) and the Fatigue Impact Scale (FIS). Peripheral muscle endurance was evaluated using the number of sit-ups, squats, and modified push-ups that each patient could do.
  
  
  RESULTS
  Thirteen patients (59%) had severe fatigue, and their St George's Respiratory Questionnaire scores were significantly higher (p < 0.05). The SAFE index score was significantly correlated with the number of sit-ups, number of squats, FSS score and FIS score (p < 0.05). The BODE index was significantly associated with the numbers of sit-ups, squats and modified push-ups, and with the FSS and FIS scores (p < 0.05).
  
  
  CONCLUSIONS
  Peripheral muscle endurance and fatigue perception in patients with COPD was related to multidimensional disease severity measured with both the SAFE and BODE indices. Improvements in perceived and actual fatigue levels may positively affect multidimensional disease severity and health status in COPD patients. Further research is needed to investigate the effects of fatigue perception and exercise training on patients with different stages of multidimensional COPD severity.
authors.affiliation: Hacettepe University, Faculty of Health Sciences, Department of Physical Therapy and Rehabilitation, Ankara, Turkey. dinalince@yahoo.com.
authors.forename: Deniz
authors.initials: D
authors.lastname: Inal-Ince
authors.forename: Sema
authors.initials: S
authors.lastname: Savci
authors.forename: Melda
authors.initials: M
authors.lastname: Saglam
authors.forename: Ebru
authors.initials: E
authors.lastname: Calik
authors.forename: Hulya
authors.initials: H
authors.lastname: Arikan
authors.forename: Meral
authors.initials: M
authors.lastname: Bosnak-Guclu
authors.forename: Naciye
authors.initials: N
authors.lastname: Vardar-Yagli
authors.forename: Lutfi
authors.initials: L
authors.lastname: Coplu