Reliability and validity of the online application of London Chest Activity of Daily Living scale in assessing dyspnea-related functional impairment in individuals after hospitalization for COVID-19.

PURPOSE: To investigate the test-retest reliability and construct validity of the LCADL scale applied via online form in individuals after hospitalization for COVID-19. METHODS: Methodological study. After hospitalization for COVID-19 individuals completed the LCADL via online form at two separate times. They also answered the post-COVID-19 Functional Status Scale (PCFS), dyspnea, fatigue, and health perception scales, modified Medical Research Council (MRCm), Short Form Health Survey 36 (SF-36). Hospitalization data were collected from the individual's medical record. RESULTS: 104 individuals participated in the study (57 men, 45.2 ± 11.9 years). The LCADL showed moderately to high test-retest reliability (ICC: 0.73-0.86; p < 0.001), there was no difference in scores between test and retest (p > 0.05), the mean difference between the applications was smaller than the standard error of measurement and the internal consistency was adequate (Cronbach's α = 0.70-0.94). In addition, it demonstrated adequate construct validity, showing correlations with PCFS, dyspnea perception, fatigue and health scales, mMRC, SF-36, and length of stay in the Intensive Care Unit (p < 0.05). The LCADL as percentage of the total score presented a significant floor effect (25%). CONCLUSION: The LCADL applied online was reliable and valid for assessing limitations due to dyspnea in ADL in individuals after hospitalization for COVID-19.

The London Chest Activity of Daily Living Scale applied online is a method of evaluation of dyspnea-related ADL limitations that is valid and reliable after hospitalization for COVID-19 and can be used both in the telerehabilitation environment and in-person rehabilitation;The online form provides a more sustainable means of data storage, since no paper is needed, and saves time during in-person rehabilitation.

Reproducibility of the 6-Min Step Test in Subjects With COPD.

BACKGROUND: Test-retest reproducibility of the 6-min step test (6MST) is controversial in patients with COPD because the decision to perform a second test is influenced by interruptions, physiological overload, and the patient's exercise tolerance. The aim of this study was to analyze the reproducibility of performance on the 6MST (ie, number of steps climbed and interruptions) and physiological variables in subjects with COPD, with and without poor exercise tolerance, and with and without interruptions during the test. METHODS: Subjects performed 2 6MST (6MST1, 6MST2) with a minimum of 30 min rest between tests. Physiological variables were assessed with a gas analyzer. Subjects who performed ≤ 78 steps in the 6MST1 and ≤ 86 steps in the test with the higher number of steps performed (6MSTBEST) were considered to have poor exercise tolerance. Subjects were also stratified according to those who interrupted the 6MSTBEST and those who did not interrupt the 6MSTBEST. RESULTS: 40 subjects (31 men; FEV1 percent of predicted = 50.4 ± 13.5) participated in the study. The number of steps, interruptions, and physiological variables showed moderate to high reliability (intraclass correlation coefficient: 0.70-0.99, P < .001). Thirty-one (77.5%) subjects had a better performance during 6MST2 than 6MST1 (mean difference: 4.65 ± 5.59, P < .001). Although the number of times subjects were interrupted was similar between the 2 tests (P = .66), the duration of these interruptions was shorter during 6MST2 (mean difference: -0.12 ± 0.39 s, P = .040). The difference in the number of steps (6MST2 - 6MST1) did not differ between subjects who performed ≤78 steps (mean difference: 5.64 ± 5.32 steps; 10.3%; P < 0.001) and ≥ 79 steps (3.00 ± 5.82 steps; 6.13%; P = 0.08) on the 6MST1 (P = 0.15) and between subjects who performed ≤ 86 steps (5.39 ± 5.14 steps; 9.39%; P < 0.001) and ≥ 87 steps (2.92 ± 6.43 steps; 2.74%; P = 0.14) steps on the 6MSTBEST (P = 0.20). CONCLUSIONS: Performance and physiological variables in the 6MST were reproducible, and a second test did not impose greater physiological overload. Two tests were essential for patients with poor exercise tolerance.

Reliability of the five-repetition sit-to-stand test in patients with chronic obstructive pulmonary disease on domiciliary oxygen therapy.

Objectives: To evaluate the reliability and learning effect of the five-repetition sit-to-stand test (5STSt) in severe and very severe chronic obstructive pulmonary disease (COPD) patients on domiciliary oxygen therapy compare the results with those of COPD patients not on such therapy. Methods: Twenty-eight COPD patients were included in the domiciliary oxygen therapy group (DOTG) and 17 in the control group (CG). The participants of the groups were paired by age, sex, body mass index, and lung function. The groups performed two 5STSt (5STSt1 and 5STSt2). Results: In total, 96% of the patients in the DOTG performed better on the second 5STSt (5STSt2) (17.1 ± 4.63s), with an average reduction of 3.87 ± 3.50 s (p < 0.001) and a learning effect of 18.4%. In the CG, 82.3% of patients had better performance on the 5STSt2 (15.06 ± 3.45 s), with an average reduction of 1.38 ± 2.51 s (p = 0.035) and a learning effect of 8.39%. The 5STSt had an ICC of 0.79 (95%CI: 0.02-0.93; p < 0.001) in the DOTG and of 0.89 (95%CI: 0.65-0.96; p < 0.001) in the CG. Conclusion: The 5STSt is reliable in patients with severe and very severe COPD on domiciliary oxygen therapy, with learning effect of nearly 18% in the DOTG. Thus, performing two tests is recommended to achieve the patient´s best performance in this population.