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Original Research: COPD |

Measurement of Activities of Daily Living in Patients With COPDActivities of Daily Living Measures in COPD: A Systematic Review

Tania Janaudis-Ferreira, PhD; Marla K. Beauchamp, PhD, PT; Priscila Games Robles, MSc; Roger S. Goldstein, MD, FCCP; Dina Brooks, PhD, PT
Author and Funding Information

From the Department of Respiratory Medicine (Drs Janaudis-Ferreira, Beauchamp, Goldstein, and Brooks and Ms Robles), West Park Healthcare Centre; the St. John’s Rehabilitation Program (Dr Janaudis-Ferreira), Sunnybrook Research Institute, Sunnybrook Health Sciences Centre; and the Department of Physical Therapy (Drs Janaudis-Ferreira, Goldstein, and Brooks), and the Department of Medicine (Dr Goldstein), University of Toronto, Toronto, ON, Canada.

Correspondence to: Tania Janaudis-Ferreira, PhD, Respiratory Medicine, W Park Healthcare Centre, 82 Buttonwood Ave, Toronto, ON, M6M 2J5, Canada; e-mail: taniajanaudis.ferreira@westpark.org


For editorial comment see page 200

*References 16, 21, 23, 25, 27, 30‐32, 35, 44, 47, 48, 50, 51, 56, 57, 63, 66‐68, 71, 77‐79, 82, 87, 91, 95‐97.

References 51, 54, 62, 69, 74, 82, 85, 92‐94, 97, 101, 102, 105‐107, 110, 111, 129, 130, 132.

Funding/Support: This study was supported by the Ontario Respiratory Care Society and the Canadian Respiratory Health Professionals.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2014;145(2):253-271. doi:10.1378/chest.13-0016
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Background:  The objectives of this systematic review were to synthesize the literature on measures of activities of daily living (ADLs) that have been used in individuals with COPD and to provide an overview of the psychometric properties of the identified measures and describe the relationship of the disease-specific instruments with other relevant outcome measures for individuals with COPD and health-care use.

Methods:  Studies that included a measure of ADLs in individuals with COPD were identified using electronic and hand searches. Two investigators performed the literature search. One investigator reviewed the study title, abstract, and full text of the articles to determine study eligibility and performed the data extraction and tabulation. In cases of uncertainty, a second reviewer was consulted.

Results:  A total of 679 articles were identified. Of those, 116 met the inclusion criteria. Twenty-seven ADLs instruments were identified, of which 11 instruments were respiratory disease-specific, whereas 16 were generic. Most instruments combined instrumental ADLs (IADLs) with basic ADLs (BADLs). The majority of the instruments were self-reported; only three instruments were performance based. Twenty-one studies assessed psychometric properties of 16 ADLs instruments in patients with COPD.

Conclusions:  Although several ADLs instruments were identified, psychometric properties have only been reported in a few. Selection of the most appropriate measure should focus on the target construct (BADLs or IADLs or both), type of test (disease-specific vs generic and self-reported vs performance-based), depth of information obtained, and psychometric properties of the instruments. Given the relevance of ADLs to the lives of patients with COPD, its assessment should be more frequently incorporated as a clinical outcome in their management.

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