title: GOLD B-C-D groups or GOLD II-III-IV grades: Which one better reflects the functionality of patients with chronic obstructive pulmonary disease?
abstract: The aim of this article is to investigate which global initiative for chronic obstructive lung disease (GOLD) classification (B-C-D or II-III-IV) better reflects the functionality of patients with moderate to very severe chronic obstructive pulmonary disease (COPD). Ninety patients with COPD were classified according to the GOLD B-C-D and II-III-IV classifications. Functionality was assessed by different outcomes: 6-min walk test (6MWT), activities of daily living (ADL) (London Chest ADL Scale), and daily life activity/inactivity variables assessed by activity monitoring (SenseWear armband, Pittsburgh, Pennsylvania, USA). The 6MWT was the only outcome significantly associated with both the GOLD classifications. Good functionality as assessed by the 6MWT was observed in 80%, 69%, and 43.5% (GOLD B, C, and D, respectively) and 81%, 59%, and 29% (GOLD II, III, and IV, respectively) of the patients. Association (V Cramer's) and correlation (Spearman) coefficients of 6MWT with GOLD B-C-D and II-III-IV were V = 0.30, r = -0.35, and V = 0.37, r = -0.25, respectively. Neither GOLD classification showed V or r ≥ 0.30 with any other functionality outcome. Both the GOLD B-C-D and II-III-IV classifications do not reflect well COPD patients' functionality. Despite low association and correlation coefficients in general, both GOLD classifications were better associated with functional exercise capacity (6MWT) than with subjectively assessed ADL and objectively assessed outcomes of physical activity/inactivity.
authors.affiliation: GLM and LD contributed equally to this work.
authors.forename: Graciane L
authors.initials: GL
authors.lastname: Moreira
authors.affiliation: GLM and LD contributed equally to this work.
authors.forename: Leila
authors.initials: L
authors.lastname: Donária
authors.affiliation: GLM and LD contributed equally to this work.Laboratory of Research in Respiratory Physiotherapy (LFIP), Department of Physiotherapy, State University of Londrina (UEL), Londrina, Brazil.
authors.forename: Karina C
authors.initials: KC
authors.lastname: Furlanetto
authors.affiliation: GLM and LD contributed equally to this work.Laboratory of Research in Respiratory Physiotherapy (LFIP), Department of Physiotherapy, State University of Londrina (UEL), Londrina, Brazil.
authors.forename: Thais
authors.initials: T
authors.lastname: Paes
authors.affiliation: GLM and LD contributed equally to this work.Laboratory of Research in Respiratory Physiotherapy (LFIP), Department of Physiotherapy, State University of Londrina (UEL), Londrina, Brazil.
authors.forename: Thaís
authors.initials: T
authors.lastname: Sant'Anna
authors.affiliation: GLM and LD contributed equally to this work.Laboratory of Research in Respiratory Physiotherapy (LFIP), Department of Physiotherapy, State University of Londrina (UEL), Londrina, Brazil.
authors.forename: Nidia A
authors.initials: NA
authors.lastname: Hernandes
authors.affiliation: GLM and LD contributed equally to this work.Laboratory of Research in Respiratory Physiotherapy (LFIP), Department of Physiotherapy, State University of Londrina (UEL), Londrina, Brazil fabiopitta@uol.com.br.
authors.forename: Fabio
authors.initials: F
authors.lastname: Pitta
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D018450:Disease Progression; D017079:Exercise Tolerance; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000145:classification* / Q000503:physiopathology; D012720:Severity of Illness Index; D016138:Walking
keywords: Chronic obstructive pulmonary disease; guideline; pulmonary function