A Measure of Quality of Life for Clinical Trials in Chronic Lung Disease

Department of Medicine, McMaster University, Hamilton, Ontario.
Thorax (Impact Factor: 8.29). 11/1987; 42(10):773-8. DOI: 10.1136/thx.42.10.773
Source: PubMed


Since the relationships between pulmonary function, exercise capacity, and functional state or quality of life are generally weak, a self report questionnaire has been developed to determine the effect of treatment on quality of life in clinical trials. One hundred patients with chronic airflow limitation were asked how their quality of life was affected by their illness, and how important their symptoms and limitations were. The most frequent and important items were used to construct a questionnaire evaluating four dimensions: dyspnoea, fatigue, emotional function, and the patient's feeling of control over the disease (mastery). Reproducibility, tested by repeated administration to patients in a stable condition, was excellent: the coefficient of variation was less than 12% for all four dimensions. Responsiveness (sensitivity to change) was tested by administering the questionnaire to 13 patients before and after optimisation of their drug treatment and to another 28 before and after participation in a respiratory rehabilitation programme. In both cases large, statistically significant improvements in all four dimensions were noted. Changes in questionnaire score were correlated with changes in spirometric values, exercise capacity, and patients' and physicians' global ratings. Thus it has been shown that the questionnaire is precise, valid, and responsive. It can therefore serve as a useful disease specific measure of quality of life for clinical trials.

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Available from: Larry William Chambers, Sep 29, 2015
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    • "Alternatively, a multidimensional scale, which correlates better with quality of life, can be used (Bausewein, Farquhar, Booth, Gysels, & Higginson, 2007). Consequently, multidimensional clinical instruments were developed in order to provide a more comprehensive assessment of the severity of dyspnea, combined with the Chronic Respiratory Disease Questionnaire (CRQ) incorporates five physical activities that are specific for individual patients (Guyatt et al., 1987). These instruments have been shown to be valid, reliable, and responsive (Reda, Kotz, Kocks, Wesseling, & van Schayck, 2010). "
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    • "The BODE index (bodymass index, airflow obstruction, dyspnea, and exercise capacity index) [27] was assessed as a prognosis factor for COPD patients. The disease-specific health-related quality of life (QOL) was measured using the Japanese version of the Chronic Respiratory Disease Questionnaire (CRQ) [28]. "
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    ABSTRACT: We evaluated the effects of low-intensity and home-based pulmonary rehabilitation (PR) on physical activity (PA) and the feedback provided by a pedometer in stable elderly patients with chronic obstructive pulmonary disease (COPD). We assessed PA using a newly developed triaxial accelerometer (A-MES™, Kumamoto, Japan), which measures the time spent walking, standing, sitting and lying down. Twenty-seven elderly patients with COPD (age 74 ± 8 yrs; %FEV1 56.6 ± 18.7%) participated. They were randomly selected to undergo PR (pulmonary rehabilitation only) or PR + P (PR plus the feedback from using a pedometer). Their PA and pulmonary function, exercise capacity (6-min walking distance; 6MWD), quadriceps femoris muscle force (QF) were evaluated before the PR began (baseline) and at 1 year later. We compared the patients' changes in PA and other factors between the baseline values and those obtained 1 year later and analyzed the relationships between the changes in PA and other factors in the both groups. The increase in the time spent walking in the PR + P group (51.3 ± 63.7 min/day) was significantly greater than that of PR group (12.3 ± 25.5 min/day) after the PR. The improvement rate of daily walking time after PR was significantly correlated with that of the 6MWD and QF in all subjects. These data suggest that low-intensity and home-based PR with the feedback from using pedometer was effective in improving PA, and the improvements of physiological factors were correlated with increased walking time in stable elderly patients with COPD. Copyright © 2015 Elsevier Ltd. All rights reserved.
    Respiratory Medicine 01/2015; 109(3). DOI:10.1016/j.rmed.2015.01.008 · 3.09 Impact Factor
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    • "Symptoms of dyspnea and fatigue were assessed with the Chronic Respiratory Disease Questionnaire (CRQ) [17]. The CRQ was administered during screening to familiarize patients with the dyspnea scale and then administered again at the baseline assessment. "
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    ABSTRACT: Purpose: Aerobic exercise training is a recognized approach for improving functional capacity in COPD. People with greater disease severity often have difficulty achieving higher aerobic exercise training intensity. The effects of resistance training prior to aerobic training were examined to determine if this sequential approach was associated with greater gains in functional status than aerobic training alone or concurrent aerobic and resistance training. Methods: Patients were randomized to: 1) sequential resistance then aerobic training (RT-then-AT) (8 weeks resistance training followed by 8 weeks aerobic exercise training), 2) control group (CE-then-AT + RT) (8 weeks of 'sham' training followed by 8 weeks concurrent aerobic and resistance training), 3) control group (CE-then-AT) (8 weeks 'sham' training followed by 8 weeks aerobic training). Outcomes were assessed at study entry, after week 8, and after week 16: aerobic exercise performance; muscle strength and endurance. Results: 75 patients completed training: FEV1 %pred 40 ± 10, V˙O(2peak) %predicted, 71 ± 22, fat-free mass index 19.5 ± 3.1. RT-then-AT had greater acquisition of peripheral muscle endurance than CE-then-AT + RT and CE-then-AT, but improvements in aerobic exercise performance were similar. Improvements in muscle strength were similar between RT-then-AT and CE-then-AT + RT. Sarcopenia was associated with poorer attendance, and lower aerobic and resistance training volumes. Conclusion: Although the sequential approach to resistance and aerobic training yielded a greater increase in muscle endurance and higher resistance training volume compared to concurrent resistance and aerobic training, other training outcomes were similar between the two groups, thus the sequential approach is not clearly superior to the concurrent approach in severe COPD. Identifier: NCT01058213.
    Respiratory Medicine 06/2014; 108(8). DOI:10.1016/j.rmed.2014.06.001 · 3.09 Impact Factor
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