"Can do" versus "do do": A Novel Concept to Better Understand Physical Functioning in Patients with Chronic Obstructive Pulmonary Disease

Eleonore H. Koolen*, Hieronymus W. van Hees, Rob C. van Lummel, Richard Dekhuijzen, Remco S. Djamin, Martijn A. Spruit, Alex J. van't Hul

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background: Physical capacity (PC) and physical activity (PA) represent associated but separate domains of physical function. It remains unknown whether this framework may support a better understanding of the impaired physical function in patients with chronic obstructive pulmonary disease (COPD). The current study had two aims: (1) to determine the distribution of patients with COPD over the PC-PA quadrants, and (2) to explore whether differences exist in clinical characteristics between these quadrants. Methods: In this retrospective study, PC was measured using the six-minute walk distance (6MWD), and PA was assessed with an accelerometer. Moreover, patients’ clinical characteristics were obtained. Patients were divided into the following quadrants: (I) low PC (6MWD <70% predicted), low PA, using a step-defined inactivity index (<5000 steps/day, ”can’t do, don’t do” quadrant); (II) preserved PC, low PA (“can do, don’t do” quadrant); (III) low PC, preserved PA (“can’t do, do do” quadrant); and (IV) preserved PC, preserved PA (“can do, do do” quadrant). Results: The distribution of the 662 COPD patients over the quadrants was as follows: “can’t do, don’t do”: 34%; “can do, don’t do”: 14%; “can’t do, do do”: 21%; and “can do, do do”: 31%. Statistically significant differences between quadrants were found for all clinical characteristics, except for educational levels. Conclusions: This study proves the applicability of the PC-PA quadrant concept in COPD. This concept serves as a pragmatic clinical tool, that may be useful in the understanding of the impaired physical functioning in COPD patients and therefore, may improve the selection of appropriate interventions to improve physical function.
Original languageEnglish
Article number340
Pages (from-to)1-10
Number of pages10
JournalJournal of Clinical Medicine
Volume8
Issue number3
DOIs
Publication statusPublished - 11 Mar 2019

Keywords

  • chronic obstructive pulmonary disease
  • exercise
  • physical function
  • physical activity
  • RESPIRATORY SOCIETY STATEMENT
  • FIELD WALKING TESTS
  • COPD
  • REHABILITATION
  • EXERCISE
  • EXACERBATION
  • INTERVENTION
  • DETERMINANTS
  • BARRIERS
  • ENABLERS

Cite this

Koolen, Eleonore H. ; van Hees, Hieronymus W. ; van Lummel, Rob C. ; Dekhuijzen, Richard ; Djamin, Remco S. ; Spruit, Martijn A. ; van't Hul, Alex J. / "Can do" versus "do do" : A Novel Concept to Better Understand Physical Functioning in Patients with Chronic Obstructive Pulmonary Disease. In: Journal of Clinical Medicine. 2019 ; Vol. 8, No. 3. pp. 1-10.
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title = "{"}Can do{"} versus {"}do do{"}: A Novel Concept to Better Understand Physical Functioning in Patients with Chronic Obstructive Pulmonary Disease",
abstract = "Background: Physical capacity (PC) and physical activity (PA) represent associated but separate domains of physical function. It remains unknown whether this framework may support a better understanding of the impaired physical function in patients with chronic obstructive pulmonary disease (COPD). The current study had two aims: (1) to determine the distribution of patients with COPD over the PC-PA quadrants, and (2) to explore whether differences exist in clinical characteristics between these quadrants. Methods: In this retrospective study, PC was measured using the six-minute walk distance (6MWD), and PA was assessed with an accelerometer. Moreover, patients’ clinical characteristics were obtained. Patients were divided into the following quadrants: (I) low PC (6MWD <70{\%} predicted), low PA, using a step-defined inactivity index (<5000 steps/day, ”can’t do, don’t do” quadrant); (II) preserved PC, low PA (“can do, don’t do” quadrant); (III) low PC, preserved PA (“can’t do, do do” quadrant); and (IV) preserved PC, preserved PA (“can do, do do” quadrant). Results: The distribution of the 662 COPD patients over the quadrants was as follows: “can’t do, don’t do”: 34{\%}; “can do, don’t do”: 14{\%}; “can’t do, do do”: 21{\%}; and “can do, do do”: 31{\%}. Statistically significant differences between quadrants were found for all clinical characteristics, except for educational levels. Conclusions: This study proves the applicability of the PC-PA quadrant concept in COPD. This concept serves as a pragmatic clinical tool, that may be useful in the understanding of the impaired physical functioning in COPD patients and therefore, may improve the selection of appropriate interventions to improve physical function.",
keywords = "chronic obstructive pulmonary disease, exercise, physical function, physical activity, RESPIRATORY SOCIETY STATEMENT, FIELD WALKING TESTS, COPD, REHABILITATION, EXERCISE, EXACERBATION, INTERVENTION, DETERMINANTS, BARRIERS, ENABLERS",
author = "Koolen, {Eleonore H.} and {van Hees}, {Hieronymus W.} and {van Lummel}, {Rob C.} and Richard Dekhuijzen and Djamin, {Remco S.} and Spruit, {Martijn A.} and {van't Hul}, {Alex J.}",
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"Can do" versus "do do" : A Novel Concept to Better Understand Physical Functioning in Patients with Chronic Obstructive Pulmonary Disease. / Koolen, Eleonore H.; van Hees, Hieronymus W.; van Lummel, Rob C.; Dekhuijzen, Richard; Djamin, Remco S.; Spruit, Martijn A.; van't Hul, Alex J.

In: Journal of Clinical Medicine, Vol. 8, No. 3, 340, 11.03.2019, p. 1-10.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - "Can do" versus "do do"

T2 - A Novel Concept to Better Understand Physical Functioning in Patients with Chronic Obstructive Pulmonary Disease

AU - Koolen, Eleonore H.

AU - van Hees, Hieronymus W.

AU - van Lummel, Rob C.

AU - Dekhuijzen, Richard

AU - Djamin, Remco S.

AU - Spruit, Martijn A.

AU - van't Hul, Alex J.

PY - 2019/3/11

Y1 - 2019/3/11

N2 - Background: Physical capacity (PC) and physical activity (PA) represent associated but separate domains of physical function. It remains unknown whether this framework may support a better understanding of the impaired physical function in patients with chronic obstructive pulmonary disease (COPD). The current study had two aims: (1) to determine the distribution of patients with COPD over the PC-PA quadrants, and (2) to explore whether differences exist in clinical characteristics between these quadrants. Methods: In this retrospective study, PC was measured using the six-minute walk distance (6MWD), and PA was assessed with an accelerometer. Moreover, patients’ clinical characteristics were obtained. Patients were divided into the following quadrants: (I) low PC (6MWD <70% predicted), low PA, using a step-defined inactivity index (<5000 steps/day, ”can’t do, don’t do” quadrant); (II) preserved PC, low PA (“can do, don’t do” quadrant); (III) low PC, preserved PA (“can’t do, do do” quadrant); and (IV) preserved PC, preserved PA (“can do, do do” quadrant). Results: The distribution of the 662 COPD patients over the quadrants was as follows: “can’t do, don’t do”: 34%; “can do, don’t do”: 14%; “can’t do, do do”: 21%; and “can do, do do”: 31%. Statistically significant differences between quadrants were found for all clinical characteristics, except for educational levels. Conclusions: This study proves the applicability of the PC-PA quadrant concept in COPD. This concept serves as a pragmatic clinical tool, that may be useful in the understanding of the impaired physical functioning in COPD patients and therefore, may improve the selection of appropriate interventions to improve physical function.

AB - Background: Physical capacity (PC) and physical activity (PA) represent associated but separate domains of physical function. It remains unknown whether this framework may support a better understanding of the impaired physical function in patients with chronic obstructive pulmonary disease (COPD). The current study had two aims: (1) to determine the distribution of patients with COPD over the PC-PA quadrants, and (2) to explore whether differences exist in clinical characteristics between these quadrants. Methods: In this retrospective study, PC was measured using the six-minute walk distance (6MWD), and PA was assessed with an accelerometer. Moreover, patients’ clinical characteristics were obtained. Patients were divided into the following quadrants: (I) low PC (6MWD <70% predicted), low PA, using a step-defined inactivity index (<5000 steps/day, ”can’t do, don’t do” quadrant); (II) preserved PC, low PA (“can do, don’t do” quadrant); (III) low PC, preserved PA (“can’t do, do do” quadrant); and (IV) preserved PC, preserved PA (“can do, do do” quadrant). Results: The distribution of the 662 COPD patients over the quadrants was as follows: “can’t do, don’t do”: 34%; “can do, don’t do”: 14%; “can’t do, do do”: 21%; and “can do, do do”: 31%. Statistically significant differences between quadrants were found for all clinical characteristics, except for educational levels. Conclusions: This study proves the applicability of the PC-PA quadrant concept in COPD. This concept serves as a pragmatic clinical tool, that may be useful in the understanding of the impaired physical functioning in COPD patients and therefore, may improve the selection of appropriate interventions to improve physical function.

KW - chronic obstructive pulmonary disease

KW - exercise

KW - physical function

KW - physical activity

KW - RESPIRATORY SOCIETY STATEMENT

KW - FIELD WALKING TESTS

KW - COPD

KW - REHABILITATION

KW - EXERCISE

KW - EXACERBATION

KW - INTERVENTION

KW - DETERMINANTS

KW - BARRIERS

KW - ENABLERS

U2 - 10.3390/jcm8030340

DO - 10.3390/jcm8030340

M3 - Article

VL - 8

SP - 1

EP - 10

JO - Journal of Clinical Medicine

JF - Journal of Clinical Medicine

SN - 2077-0383

IS - 3

M1 - 340

ER -