Viabilidad de la evaluación domiciliaria del estado funcional de pacientes con enfermedad pulmonar obstructiva crónica en fase de recuperación de una exacerbación

Introduction: The Glittre Activities of Daily Living Test (ADL-Test) is a reliable functional status measurement for stable chronic obstructive pulmonary disease (COPD) patients in a laboratory setting. We aimed to adapt the test to the home setting (mADL-Test) and to follow-up the functional status recovery of post-exacerbation COPD patients included in a home hospitalization (HH) program. Method: We assessed 17 exacerbated moderate-to-very-severe COPD patients in 3 home visits: at discharge to HH (V₀), 10 days (V_10post) and 1 month after discharge (V_30post). Patients completed the mADL-Test (laps, VO₂ and VE), COPD assessment test (CAT), London Chest ADL Test (LCADL), modified Medical Research Council (mMRC) and upper limb strength (handgrip). Results: The number of laps of the mADL-Test (4, 5 and 5, P < .05), CAT (19, 12 and 12, P < .01), mMRC (2, 1.5 and 1, P < .01) and the self-care domain of the LCADL (6, 5 and 5, P < .01) improved during follow-up (V₀, V_10post and V_30post, respectively). No significant changes were evidenced in VO₂, VE or handgrip. Conclusion: Our results suggest that the mADL-test can be performed in the home setting after a COPD exacerbation, and that functional status continues to improve 10 days after discharge to HH.