Article Text


Novel outcomes and interventions in pulmonary rehabilitation
S74 Effect of pulmonary rehabilitation on the Short Physical Performance Battery (SPPB) in COPD
  1. M S Patel,
  2. A L Clark,
  3. K A Ingram,
  4. R P Fowler,
  5. A V Donaldson,
  6. S S Kon,
  7. M I Polkey,
  8. W D Man
  1. Respiratory Biomedical Research Unit and Harefield Pulmonary Rehabilitation Team, Royal Brompton & Harefield NHS Foundation Trust, UK


Introduction The Short Physical Performance Battery (SPPB) is a simple objective assessment tool developed by the National Institute on Ageing for evaluating lower extremity function in older persons. It comprises tests of standing balance, normal gait speed and timed sit-to-stand with a maximum score of 12, and predicts nursing home admission rates and mortality. Lower extremity dysfunction is well recognised in COPD, and hence the SPPB may be a useful functional outcome measure in COPD patients. Pulmonary rehabilitation (PR) is a highly effective intervention in COPD and ameliorates lower limb dysfunction. We hypothesised that the SPPB would improve after PR.

Methods 35 COPD (18M:17F) patients underwent an 8 week outpatient pulmonary rehabilitation programme. The SPPB, incremental shuttle walk (ISW) and St George's Respiratory Questionnaire (SGRQ) were measured immediately before and after a PR programme. Paired t-test (or non-parametric equivalent) was used to test the effect of PR.

Results Baseline characteristics are expressed as mean (SD) or median (25th, 75th percentiles): age 69 (8), FEV1% 43 (23), MRC Dyspnoea 4 (3, 4), ISW 130 (60, 270), and SGRQ 57 (16). Following PR, there was a significant improvement in ISW (mean 70 m; p<0.001) and SGRQ (−7.0; p<0.005). SPPB also significantly improved from a median of 9 (6, 11) pre-PR to a median of 11 (7, 12; p<0.004) post-PR. Change in SPPB did not correlate with change in ISW (r=0.22; p=0.20).

Conclusions The SPPB may be a useful functional outcome measure in COPD, and gives different information from the ISW. Larger studies are required to determine the minimum clinically significant change in the SPPB.

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