Chest
Volume 140, Issue 4, October 2011, Pages 970-979
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Original Research
Obstructive Lung Diseases
Task-Related Oxygen Uptake During Domestic Activities of Daily Life in Patients With COPD and Healthy Elderly Subjects

https://doi.org/10.1378/chest.10-3005Get rights and content

Background

Patients with COPD generally have a poor peak aerobic capacity and, therefore, may experience more inconvenience during domestic activities of daily life (ADLs). Yet, task-related oxygen uptake and symptom perception during ADLs have been studied rarely in COPD. Therefore, it remains unknown whether and to what extent differences may exist in task-related oxygen uptake and symptom perception during ADLs in patients with COPD after stratification for sex; GOLD (Global Initiative for Chronic Obstructive Lung Disease) stage; Medical Research Council (MRC) dyspnea grade; or score on the BMI, obstruction, dyspnea, exercise capacity (BODE) index.

Methods

Ninety-seven patients with COPD and 20 healthy elderly subjects performed the following five self-paced domestic ADLs with 4-min rest intervals: putting on socks, shoes, and vest; folding eight towels; putting away groceries; washing four dishes, cups, and saucers; and sweeping the floor for 4 min. Task-related oxygen uptake was assessed using an Oxycon Mobile device, whereas Borg scores were used to assess task-related dyspnea and fatigue.

Results

Patients with COPD used a significantly higher proportion of their peak aerobic capacity and ventilation to perform ADLs than did the healthy subjects, accompanied by higher task-related Borg dyspnea scores. Patients with GOLD stage IV, MRC dyspnea grade 5, or BODE score ≥ 6 points had the highest task-related oxygen uptake and dyspnea perception during the performance of domestic ADLs. Results showed no sex-related differences.

Conclusion

Patients with COPD experience a relatively high metabolic load and symptom perception during the performance of ADLs that is not the same as seen in their healthy peers, particularly in patients with GOLD stage IV, MRC dyspnea grade 5, or BODE score ≥ 6 points.

Section snippets

Materials and Methods

Details on the methods are provided in e-Appendix 1. One hundred patients with COPD and 20 healthy elderly peers volunteered to participate in the study, which was approved by the institutional review board of the Maastricht University Medical Centre (MEC08-3-032). Informed consent was obtained from potential participants, and study eligibility was determined.

Patients were recruited at CIRO+.28 Patients were clinically stable (no exacerbation in the past 4 weeks) and were on various

Characteristics

Patients had moderate to very severe COPD. The proportion of men and the average age were comparable between patients and healthy subjects. Patients had a significantly lower BMI and FFM index compared with healthy subjects. Moreover, patients had higher scores on the (age-adjusted) Charlson Comorbidity Index (e-Table 2, Table 1).31, 32

Patients obtained a significantly lower peak aerobic capacity (mL/min), peak heart rate (beats/min), and peak ventilation (L) than the healthy elderly subjects.

Discussion

The present study shows that patients with COPD use a higher proportion of their peak aerobic capacity and peak ventilation to perform domestic ADLs than healthy elderly subjects, particularly those patients with GOLD stage IV disease, MRC dyspnea grade 5, or BODE score of ≥ 6 points accompanied by higher task-related Borg dyspnea scores. Moreover, patients with COPD have a significantly higher task-related oxygen uptake per kilogram FFM compared with their healthy peers, even those with GOLD

Acknowledgments

Author contributions: Ms Vaes and Dr Spruit had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Ms Vaes: contributed to the acquisition, analysis, and interpretation of the data; drafting the manuscript and revising it for important intellectual content; and approving the final manuscript.

Dr Wouters: contributed to the study concept and design, revising the manuscript for important intellectual content, and

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    Funding/Support: This work was funded by Foundation ‘De Weijerhorst.’

    Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).

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