title: Measurement of activities of daily living in patients with COPD: a systematic review.
abstract: 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.
authors.affiliation: Department of Respiratory Medicine, West Park Healthcare Centre; St. John's Rehabilitation Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre; Department of Physical Therapy, University of Toronto, Toronto, ON, Canada. Electronic address: taniajanaudis.ferreira@westpark.org.
authors.forename: Tania
authors.initials: T
authors.lastname: Janaudis-Ferreira
authors.affiliation: Department of Respiratory Medicine, West Park Healthcare Centre.
authors.forename: Marla K
authors.initials: MK
authors.lastname: Beauchamp
authors.affiliation: Department of Respiratory Medicine, West Park Healthcare Centre.
authors.forename: Priscila Games
authors.initials: PG
authors.lastname: Robles
authors.affiliation: Department of Respiratory Medicine, West Park Healthcare Centre; Department of Physical Therapy, University of Toronto, Toronto, ON, Canada; Department of Medicine, University of Toronto, Toronto, ON, Canada.
authors.forename: Roger S
authors.initials: RS
authors.lastname: Goldstein
authors.affiliation: Department of Physical Therapy, University of Toronto, Toronto, ON, Canada.
authors.forename: Dina
authors.initials: D
authors.lastname: Brooks
mesh_terms: D000203:Activities of Daily Living; D019468:Disease Management; D006801:Humans; D017063:Outcome Assessment, Health Care; D011594:Psychometrics; D029424:Pulmonary Disease, Chronic Obstructive; D057566:Self Report