Short Physical Performance Battery: Response to Pulmonary Rehabilitation and Minimal Important Difference Estimates in Patients With Chronic Obstructive Pulmonary Disease.

Anouk A Stoffels, Jana De Brandt, Roy Meys, Hieronymus W van Hees, Anouk W Vaes, Peter Klijn, Chris Burtin, Frits M Franssen, Bram van den Borst, Maurice J Sillen, Daisy J Janssen, Martijn A Spruit

Journal: Archives of physical medicine and rehabilitation 2021;102(12):2377-2384.e5

PMID: 34175275

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Abstract

OBJECTIVE

To determine the response to a pulmonary rehabilitation (PR) program and minimal important differences (MIDs) for the Short Physical Performance Battery (SPPB) subtests and SPPB summary score in patients with chronic obstructive pulmonary disease (COPD).

DESIGN

Retrospective analysis using distribution- and anchor-based methods.

SETTING

PR center in the Netherlands including a comprehensive 40-session 8-week inpatient or 14-week outpatient program.

PARTICIPANTS

A total of 632 patients with COPD (age, 65±8y; 50% male; forced expiratory volume in the first second=43% [interquartile range, 30%-60%] predicted).

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURE

Baseline and post-PR results of the SPPB, consisting of 3 balance standing tests, 4-meter gait speed (4MGS), and 5-repetition sit-to-stand (5STS). The chosen anchors were the 6-Minute Walk Test and COPD Assessment Test. Patients were stratified according to their SPPB summary scores into low-performance, moderate-performance, and high-performance groups.

RESULTS

5STS (∆=-1.14 [-4.20 to -0.93]s) and SPPB summary score (∆=1 [0-2] points) improved after PR in patients with COPD. In patients with a low performance at baseline, balance tandem and 4MGS significantly increased as well. Based on distribution-based calculations, the MID estimates ranged between 2.19 and 6.33 seconds for 5STS and 0.83 to 0.96 points for SPPB summary score.

CONCLUSIONS

The 5STS and SPPB summary score are both responsive to PR in patients with COPD. The balance tandem test and 4MGS are only responsive to PR in patients with COPD with a low performance at baseline. Based on distribution-based calculations, an MID estimate of 1 point for the SPPB summary score is recommended in patients with COPD. Future research is needed to confirm MID estimates for SPPB in different centers.

Address: Department of Pulmonary Diseases, Dekkerswald Radboud University Medical Centre, Radboud Institute for Health Sciences, Nijmegen, the Netherlands; Department of Research and Development, CIRO, Horn, the Netherlands; Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), NUTRIM School of Nutrition and Translational Research in Metabolism, Faculty of Health, Medicine and Life Sciences, Maastricht, The Netherlands. Electronic address: [email protected].; REVAL-Rehabilitation Research Center, BIOMED-Biomedical Research Institute, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium.; Department of Research and Development, CIRO, Horn, the Netherlands; Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), NUTRIM School of Nutrition and Translational Research in Metabolism, Faculty of Health, Medicine and Life Sciences, Maastricht, The Netherlands.; Department of Pulmonary Diseases, Dekkerswald Radboud University Medical Centre, Radboud Institute for Health Sciences, Nijmegen, the Netherlands.; Department of Research and Development, CIRO, Horn, the Netherlands.; Department of Pulmonology, Merem Pulmonary Rehabilitation Centre, Hilversum, the Netherlands; Department of Pulmonary, Amsterdam University Medical Centre, Amsterdam, the Netherlands.; Department of Research and Development, CIRO, Horn, the Netherlands; Department of Health Services Research, Care and Public Health Research Institute, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands.; Department of Research and Development, CIRO, Horn, the Netherlands; Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), NUTRIM School of Nutrition and Translational Research in Metabolism, Faculty of Health, Medicine and Life Sciences, Maastricht, The Netherlands; REVAL-Rehabilitation Research Center, BIOMED-Biomedical Research Institute, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium.

DOI: 10.1016/j.apmr.2021.05.011