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Functional Status of Patients with COPD Assessed by London Chest Activity of Daily Living Scale: Gender Association and Validity of a Cutoff Point

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Abstract

Purpose

Whether the difference in the impact of chronic obstructive pulmonary disease (COPD) on the functional status of men and women stems from clinical distinctions or to the measuring instrument used is unclear. Like most instruments for assessing functional limitation in COPD, the interpretation of the results of the London Chest Activity of Daily Living (LCADL) scale is limited because a lack of a valid cutoff point to this scale. For that, this study sought to compare the functional status between men and women with COPD; and propose a cutoff point for LCADL capable of discriminating the prognosis of these individuals.

Methods

A sample of 138 subjects with moderate–severe COPD was evaluated by the LCADL. The percentage of the individual maximum score was used to obtain a cutoff point capable of discriminating patients with the worse prognosis according to the BODE Index. The cutoff point was also tested in an independent sample (n = 70).

Results

Regarding the total score, domestic and leisure domains of the LCADL, men had better scores than women (P ≤ 0.01). The cutoff point found was 37% (area under the curve = 0.70, 95% confidence interval = 0.60–0.80, sensitivity = 0.55 and specificity = 0.74). Individuals who scored ≥ 37% had a worse prognosis and level of physical activities of daily living than those who scored below (P ≤ 0.02).

Conclusion

When evaluated by the LCADL, men and women with COPD present difference in the functional status. The established cutoff point (37%) adequately discriminates individuals regarding the prognosis, contributing to improve the interpretation capacity of the LCADL.

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Acknowledgements

The authors are grateful to the colleagues of the Laboratory of Research in Respiratory Physiotherapy for the contribution to study. In addition, we acknowledge, the support of Coordination for the Improvement of Higher Education Personnel and National Council of Technological and Scientific Development, Brazil. The study was carried out at the Laboratory of Research in Respiratory Physiotherapy (LFIP) in the State University of Londrina (UEL), Londrina, Brazil.

Funding

Letícia Fernandes Belo, Antenor Rodrigues, Thaís Paes, Felipe Vilaça Cavalari Machado and Lorena Paltanin Scheneider are supported by the Coordination for the Improvement of Higher Education Personnel (CAPES), Brazil. Fabio Pitta is supported by the National Council of Technological and Scientific Development (CNPq), Brazil. Partial support was made by FAEPE/UEL – PUBLIC 2018.

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Authors and Affiliations

  1. Laboratory of Research in Respiratory Physiotherapy (LFIP), Department of Physiotherapy, State University of Londrina, Londrina, Brazil

    Letícia Fernandes Belo, Antenor Rodrigues, Thaís Paes, Felipe Vilaça Cavallari Machado, Lorena Paltanin Schneider, Ana Paula Vicentin, Fabio Pitta & Nidia Aparecida Hernandes

  2. Faculty of Kinesiology and Rehabilitation Sciences, Department of Rehabilitation Sciences, Research Group for Rehabilitation in Internal Disorders, KU Leuven, Leuven, Belgium

    Antenor Rodrigues

  3. Department of Physiotherapy, State University of Londrina (UEL), Londrina, Brazil

    Vanessa Suziane Probst

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  1. Letícia Fernandes Belo
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  2. Antenor Rodrigues
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  3. Thaís Paes
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  4. Felipe Vilaça Cavallari Machado
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  7. Vanessa Suziane Probst
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  8. Fabio Pitta
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  9. Nidia Aparecida Hernandes
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Correspondence to Nidia Aparecida Hernandes.

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All authors declare that they have no conflict of interest in relation with this work.

Ethical Approval

This study was approved by the institutional ethics committee (number: 173/2012) and all participants gave informed consent.

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Informed consent was obtained from all subjects included in the study.

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Belo, L.F., Rodrigues, A., Paes, T. et al. Functional Status of Patients with COPD Assessed by London Chest Activity of Daily Living Scale: Gender Association and Validity of a Cutoff Point. Lung 197, 509–516 (2019). https://doi.org/10.1007/s00408-019-00235-2

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