Chest
Original ResearchPhenotypic Characteristics Associated With Reduced Short Physical Performance Battery Score in COPD
Section snippets
Materials and Methods
The data were prospectively collected from four studies with shared protocols investigating the pathophysiologic determinants and associations of skeletal muscle dysfunction in COPD. Each study received ethical committee approval (West London REC 3: 10/H0706/9; North West London REC: 11/LO/1636; North London REC: 11/H0717/3; NRES Committee London–Chelsea: 12/LO/0523); all patients provided written informed consent.
One hundred nine stable patients diagnosed with COPD according to GOLD (Global
Results
The demographic data, clinical characteristics, and predictors of the SPPB are shown in Table 1; data from the biopsy cohort are shown in Table 2. Daily steps could not be entered into the regression analysis as the data were skewed.
In the full cohort (N = 109), age, MRC dyspnea score, SGRQ, QMVC, RFCSA, and 6MWD were univariate predictors of SPPB score; sex, height, FEV1 % predicted, BMI, and FFMI were not predictors. In a multivariate analysis excluding RFCSA due to the strong colinearity
Discussion
The main finding of this study is that the principal determinants of the SPPB were quadriceps strength and functional exercise capacity rather than lung function as judged by FEV1. In a biopsy substudy, patients with SPPB limitation were also more likely to have fiber shift, suggesting a possible role for the test as a biomarker. The data show that the SPPB remains a valid measure of lower extremity function despite the presence of COPD and that SPPB limitation arises primarily because of
Acknowledgments
Author contributions: Prof Polkey is the guarantor of the paper, taking responsibility for the integrity of the work as a whole, from inception to published article.
Dr Patel: contributed to the design of the study, analysis of data, and preparation of the final manuscript; conceived the idea; recruited patients and collected the data; and drafting of the manuscript.
Dr Mohan: contributed to the drafting and preparation of the final manuscript, recruited patients, and collected the data.
Ms
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2020, Archives of Physical Medicine and RehabilitationCitation Excerpt :Many phenotypic factors were univariate predictors of the SPPB summary score, but age and 6MWT were the only independent predictors in a multivariate regression model. This finding is consistent with the literature15,16,42 and highlights the importance of age and physical capacity in maintaining balance and mobility. The strength of the study is the large sample size of patients with COPD with well-defined and well-characterized data that provides for the first time an extensive overview on phenotypic characteristics per SPPB performance of patients with COPD in a non–United Kingdom PR setting.
Funding/Support: This project was supported by an unrestricted grant from AstraZeneca and by the NIHR Respiratory Disease Biomedical Research Unit at the Royal Brompton & Harefield NHS Foundation Trust and Imperial College London, who partly fund Prof Polkey's and completely fund Dr Canavan's salary. Dr Kon is supported by the Medical Research Council. Dr Man is supported by an NIHR Clinician Scientist Award, Medical Research Council New Investigator Grant, and an NIHR Clinical Trials Fellowship.
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