Recent COPD exacerbations were associated with worse quality of life and a trend toward lower dual-task gait speed compared to stable COPD (66% vs 77%; p=0.10).
Cross-Sectional (n=33)
Yes
Patients with recent COPD exacerbations demonstrate worse health-related quality of life, activities of daily living, and slower single-task gait speed compared to stable COPD patients.
Absolute Event Rate: 66% vs 77%
p-value: p=0.10
Abstract Background/Rationale Exacerbations of chronic obstructive pulmonary disease (ECOPD) contribute to impaired cognitive and physical function and reduced health-related quality-of-life (HRQL) and activities of daily living (ADL). Concurrent cognitive and physical function can be evaluated using a dual-task paradigm (performing two-tasks simultaneously), and has not been examined post-ECOPD. We compared dual-task gait speed, respiratory symptoms, HRQL, ADL, and cognition in ECOPD versus stable COPD. Further, we evaluated whether there was a differential relationship of dual-task gait speed with cognition and patient-reported outcomes between COPD states. Methods A cross-sectional assessment of measures from an ongoing prospective, multi-centre cohort study of ECOPD patients (6 weeks post moderate-severe exacerbation) and stable COPD patients (no exacerbations for ≥6 months) was performed. Evaluations included: (1)single and dual-tasks comprised of a 20-meter gait speed test with or without cognitive task (auditory Stroop); (2) Medical Research Council (MRC) Dyspnea Scale; (3) COPD Assessment Test (CAT); (4) online neuropsychological battery (TestMyBrain); (5) London Chest ADL (LCADL) and (6) St. George’s Respiratory Questionnaire (SGRQ). Gait speed was expressed as percent predicted based on age-sex norms (Andrews AW 2023). The differences between ECOPD and stable COPD groups were compared using t-tests and tests of proportions. Spearman correlations assessed relationships between gait speed and cognitive and physical function measures. Results 33 participants (9 ECOPD, 24 stable COPD) with mean age 69±9 years, 57% female, and GOLD 2(46%)/ GOLD 3-4(54%) participated. Compared to stable COPD patients, ECOPD patients were younger (62±4 vs. 72±9 years, p=0.004) and a greater proportion required supplemental oxygen (78% vs. 29%, p=0.02). The ECOPD group had worse SGRQ scores and LCADL (Table), with MRC dyspnea and CAT scores being similar between groups. Single-task gait speed was slower in ECOPD compared to stable COPD (70±16% vs. 85±21%, p=0.04), with a trend towards a lower dual-task gait speed (66±16% vs. 77±16%, p=0.10). Several cognitive domains were reduced based on Z-normative population scores (Table), but no difference was seen between COPD groups. Dual-task gait speed in the ECOPD group demonstrated moderate-strong positive correlations with cognitive measures (range rho=0.53-0.81) whereas dual-task gait speed in the stable COPD group had moderate-strong inverse correlations with symptoms and HRQL (Table). Conclusion ECOPD patients demonstrated worse HRQL and ADL, with a trend towards lower dual-task gait speed compared to stable COPD patients. Cognitive function was more strongly correlated with dual-task gait speed in ECOPD suggesting that lower cognitive capacity may limit motor control during concurrent cognitive-physical tasks. This abstract is funded by: Canadian Institute of Health Research Project Grants (PJM 179846 and PJT 183640). Dmitry Rozenberg receives research support from the National Sanitarium Chair in Respiratory Rehabilitation Research West Park (UHN).
Rozenberg et al. (Fri,) conducted a cross-sectional in Chronic Obstructive Pulmonary Disease (COPD) (n=33). Recent COPD exacerbation (ECOPD) vs. Stable COPD was evaluated on Dual-task gait speed (% predicted) (p=0.10). Recent COPD exacerbations were associated with worse quality of life and a trend toward lower dual-task gait speed compared to stable COPD (66% vs 77%; p=0.10).