Pulmonary rehabilitation (PR) has traditionally focused on improving patient endurance and strength, in which outcomes are easily measured. However, documenting objective improvement in an individual’s ability to perform activities of daily living (ADL) following PR has not been well established, despite the obvious utility of such a demonstration. We developed an observational functional assessment tool with three progressively more difficult levels of ADL tasks to evaluate ADL performance in patients with chronic lung disease. The purpose of this study was to determine if improvements found in ADL performance following PR coincided with concurrent improvements in physical performance.
A retrospective chart review was performed for PR participants from 2003-2004. Thirty six patients who had participated in either a land or water-based PR program and in whom data was completely available were included in this study. Charts were reviewed for data on physical performance and observed ADL performance. The data was analyzed with repeated measures, MANOVA, univariate analysis and a Wilcoxin Signed Ranks test.
Both land and water-based exercise PR participants demonstrated similar improvements in physical performance as measured by changes in six minute walk test distance and six repetition maximum strength tests for the shoulder, knee, and hip (p<.05). These improvements were mirrored by significant increases in observed ADL task performance measured across all three levels of tasks (p<.05).
The assessment tool developed at our facility was found to be effective in measuring changes in patient ADL performance following PR. Both physical and ADL performance can now be demonstrated to improve after PR.
Usually, ADL function is obtained through self-reporting patient questionnaires. The ADL assessment tool developed by our facility provides an objective measurement of ADL performance.
Mary Hart, None.