Health status in COPD according to short physical performance battery summary score

Abstract

Background: Patients with chronic obstructive pulmonary disease (COPD) scoring low on the short physical performance battery (SPPB) have more pronounced functional impairment than patients with a better mobility and balance. A similar pattern is expected for symptoms of anxiety and depression.

Aim: The study aimed to assess physical and emotional status in COPD patients after stratification for summary SPPB scores.

Methods: Retrospectively, cross-sectional data from 900 patients with COPD (age 65±8 years, 52% male, FEV1 43 (31-62)% predicted) who were referred for a pulmonary rehabilitation were analysed. Patients were stratified according to their SPPB summary scores into a low-performance (LP; 0-6), moderate-performance (MP; 7-9) or high-performance (HP; 10-12) group. Additionally, lung function, arterial blood gases, body composition, physical capacity, lower-limb muscle strength and endurance, and symptoms of anxiety and depression (hospital anxiety and depression scale) were assessed.

Results: Physical capacity and muscle strength and endurance were lower and scores for symptoms of anxiety and depression were higher in LP compared to MP and HP (all values, p<0.01). However, 25% of HP patients with COPD scored high on symptoms of anxiety and/or depression (≥10 points) and had an impaired exercise capacity (median peak cycling load: 49 (37-62)% predicted).

Conclusions: Physical and emotional status differs among SPPB performance groups with LP reporting the most impairment and HP the least. However, it is important to notice that HP patients with COPD can also suffer from physical and emotional impairments.