title: Limitation of Activities of Daily Living and Quality of Life Based on COPD Combined Classification.
abstract: BACKGROUND
  The Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2011 update recommends that the management and treatment of COPD be made to combine the impact of disease and future risk of exacerbation. These patients have worsening quality of life and limitation of activities of daily living (ADLs), which can be manifested as a decrease in S(pO2) and progressive dyspnea. The aim of this study was to determine whether the COPD combined classification proposed by GOLD 2011 is able to differentiate patients with ADL limitation, such as oxygen desaturation or dyspnea, and impaired quality of life.
  
  
  METHODS
  This was an observational, cross-sectional study. Forty-four subjects were categorized in 4 GOLD groups (A-D). The mean age was 69 ± 8.8 y, with FEV1 of 1.33 ± 0.53 L (49 ± 15.7% of predicted). The Modified Medical Research Council dyspnea and London Chest Activity of Daily Living (LCADL) scales and the St George Respiratory Questionnaire (SGRQ) were applied. The 6-min walk test and ADL simulation in an appropriate laboratory were also conducted.
  
  
  RESULTS
  There was no association between the COPD combined evaluation groups and the presence of oxygen desaturation and dyspnea (chi-square test), although a higher prevalence of oxygen desaturation was noticed in group D subjects. With regard to dyspnea, there were subjects with dyspnea in all groups when ADLs were performed. No correlation between dyspnea and oxygen desaturation variation was found. Group B and D subjects showed higher ADL dyspnea (total LCADL scores of 28% and 30%) compared with group A subjects. Group D subjects showed poorer quality of life (total SGRQ score of 49.3%) compared with less symptomatic groups.
  
  
  CONCLUSIONS
  The COPD combined classification was not efficient in determining oxygen desaturation and dyspnea while subjects were performing ADLs. The subjects in the symptomatic groups with increased risk of exacerbation showed poorer quality of life and higher dyspnea levels. (ClinicalTrials.gov registration NCT01977469).
authors.affiliation: Laboratory of Spirometry and Respiratory Physiotherapy, Physiotherapy Department, Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil.
authors.forename: Marina S
authors.initials: MS
authors.lastname: Barusso
authors.affiliation: Laboratory of Spirometry and Respiratory Physiotherapy, Physiotherapy Department, Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil.
authors.forename: Júlia
authors.initials: J
authors.lastname: Gianjoppe-Santos
authors.affiliation: Laboratory of Spirometry and Respiratory Physiotherapy, Physiotherapy Department, Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil.
authors.forename: Renata P
authors.initials: RP
authors.lastname: Basso-Vanelli
authors.affiliation: Centro Universitário UNIFAFIBE, Bebedouro, and the Centro Universitário Claretiano, Batatais, São Paulo, Brazil.
authors.forename: Eloisa M G
authors.initials: EM
authors.lastname: Regueiro
authors.affiliation: Laboratory of Spirometry and Respiratory Physiotherapy, Physiotherapy Department, Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil.
authors.forename: Jéssica C
authors.initials: JC
authors.lastname: Panin
authors.affiliation: Laboratory of Spirometry and Respiratory Physiotherapy, Physiotherapy Department, Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil. vallorenzo@ufscar.br.
authors.forename: Valéria A Pires
authors.initials: VA
authors.lastname: Di Lorenzo
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010101:Oxygen Consumption; D029424:Pulmonary Disease, Chronic Obstructive / Q000145:classification* / Q000503:physiopathology / Q000523:psychology; D011788:Quality of Life; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D016138:Walking / Q000502:physiology*
keywords: COPD classification; daily living activities; dyspnea; oxygen desaturation; quality of life