Do London Chest Activity of Daily Living Scale and St George's Respiratory Questionnaire Reflect Limitations During Activities of Daily Living in Patients With COPD?

Purpose: It is unclear whether activities of daily living (ADL) and quality-of-life scales reflect real ADL limitations. The aim of the study was to assess the limitation during ADL simulation and to identify whether the London Chest Activity of Daily Living (LCADL) Scale and St George's Respiratory Questionnaire (SGRQ) are able to reflect the patient's real limitations during ADL simulation.

Methods: Forty-eight patients with chronic obstructive pulmonary disease (age = 69 ± 8 y; forced expiratory volume in the first second of expiration [FEV1] = 1.37 ± 0.49 L) were assessed by SGRQ and LCADL Scale. Activities of daily living simulations were performed: showering (ADL1); lifting and lowering containers above the shoulder girdle (ADL2); and raising and lowering pots below the pelvic girdle (ADL3).

Results: SpO2 and ΔSpO2 in ADL2 were statistically lower than in ADL3. Ventilatory demand was statistically higher in ADL2 and ADL3 than in ADL1. Metabolic equivalent values were similar between the ADLs with values above 3.6. Oxygen desaturation was present in 41.7% (ADL1) and 33.3% (ADL2) of the patients. The LCADL% showed a moderate positive correlation with dyspnea in ADL3 and metabolic demand in ADL1. The SGRQ score presented a moderate positive correlation with dyspnea in all ADL simulations and metabolic demand in ADL1 and ADL3. Dyspnea in ADL3 and metabolic demand in ADL1 explained 33% of the variability in LCADL%. The dyspnea and metabolic demand in ADL3 explained 67% of the variability in SGRQ.

Conclusion: Activities of daily living lead to oxygen desaturation and high ventilatory demand. London Chest Activity of Daily Living Scale reflected 33% and SGRQ reflected 67% of the functional limitation during ADL simulation, such as dyspnea and the metabolic demand during ADL.