An Initial Assessment of the Decline With Age for the 6-minute Walk Test (6MWT) in Chinese Older Adults With Chronic Obstructive Pulmonary Disease (COPD).

Objective: To establish an initial assessment of the decline with age for the 6-minute walk test (6MWT) in patients with chronic obstructive pulmonary disease (COPD) in Chinese older adults. Design: It was an observational analytical study. Setting: The study was conducted in a local acute hospital. Participants: From January 2017 to January 2021, a total of 525 patients (431 men, 94 women; mean age 73.4±7.9; N=525) with COPD were studied. Main Outcome Measures: Information including sex, age, Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages, and 6-minute walk distance (6MWD) were collected. Results: The 6MWD was significantly decreased with increased age (P˂0.05). Mean 6MWD in the 61-65 years, 66-70 years, 71-75 years, 76-80 years, 81-85 years, and 86 years or above age groups were 301 m, 305 m, 274 m, 257 m, 260 m, and 215 m, respectively. The difference between the youngest and oldest age groups was 29%. The 6MWD was significantly lower in patients with more severe COPD (P˂0.05). The distance decreased from 317 m in GOLD 1, 306 m in GOLD 2, 259 m in GOLD 3 to 167 m in GOLD 4. The percentage dropped in 6MWD from GOLD 1 to GOLD 4 was 47%. Conclusion: An initial assessment of the decline with age for 6MWT in Chinese older adults with COPD has been established. 6MWD decreases as age (in groups 66-75, 81-85, and 86 or above) and COPD severity increases, primarily because of the increased severity of dyspnea, decline in exercise capacity, and muscle changes in aging. Health care professionals in Chinese community can use these values to evaluate these patients' functional capacity, assess treatment effect, and set treatment goals.

Adaptation and validation of the Chinese version of Dyspnoea-12 scale in individuals with chronic obstructive pulmonary disease.

INTRODUCTION: Dyspnoea-12 scale is a validated assessment tool, capturing the perception of dyspnoea and its physical and affective effects in individuals with chronic obstructive pulmonary disease (COPD). A validated version for the Chinese-speaking population has been unavailable. OBJECTIVE: To develop a Chinese version of D-12 (D-12-C) scale and evaluate its validity and reliability. METHODS: D-12 was translated from English to traditional Chinese in collaboration with a physician and a linguist. Back translation was adopted to ensure accuracy of the translation. A total of 155 COPD patients were recruited to test the reliability and validity of the D-12-C scale. Internal reliability and test-retest reliability were measured with Cronbach's alpha coefficient and intra-class correlation coefficient, respectively. Construct validity was assessed through exploratory factor analysis (EFA). Concurrent validity was assessed by the correlation of D-12-C total score and sub-scores and the Chinese version of Saint George's Respiratory Questionnaire (SGRQ), 36-Item Short Form Health Survey (SF-36), COPD Assessment Test (CAT) and Hospital Anxiety and Depression Scale (HADS) total score and sub-scores. RESULTS: The two-factor structure of D-12-C was confirmed by EFA. D-12-C and its sub-scores demonstrated high level of internal reliability (Cronbach's alpha = 0.88) and moderate level of test-retest reliability. D-12-C total score, physical and affective sub-scores were significantly correlated to SGRQ total score (rs  = 0.59, p < 0.001) and activity sub-score (rs  = 0.38, p = 0.006), SF-36 mental health sub-score (rs  = -0.36, p < 0.001), CAT (rs  = 0.56, p < 0.001), HADS anxiety (rs  = 0.51, p < 0.001) and depression sub-scores (rs  = 0.44, p < 0.001). CONCLUSION: D-12-C scale was developed, which demonstrated satisfactory reliability and validity in measuring dyspnoea among COPD patients.

A randomized controlled trial of auricular transcutaneous electrical nerve stimulation for managing posthysterectomy pain.

Background. A patient- and assessor-blinded randomized controlled trial was conducted to examine the effectiveness of auricular transcutaneous electrical nerve stimulation (TENS) in relieving posthysterectomy pain. Method. Forty-eight women who had undergone a total abdominal hysterectomy were randomly assigned into three groups (n = 16 each) to receive either (i) auricular TENS to therapeutic points (the true TENS group), (ii) auricular TENS to inappropriate points (the sham TENS group), or (iii) 20 minutes of bed rest with no stimulation (the control group). The intervention was delivered about 24 hours after the operation. A visual analogue scale was used to assess pain while resting (VAS-rest) and upon huffing (VAS-huff) and coughing (VAS-cough), and the peak expiratory flow rate (PEFR) was assessed before and at 0, 15, and 30 minutes after the intervention. Result. As compared to the baseline, only the true TENS group reported a significant reduction in VAS-rest (P = .001), VAS-huff (P = .004), and VAS-cough (P = .001), while no significant reduction in any of the VAS scores was seen in the sham TENS group (all P > .05). In contrast, a small rising trend was observed in the VAS-rest and VAS-huff scores of the control group, while the VAS-cough score remained largely unchanged during the period of the study. A between-group comparison revealed that all three VAS scores of the true TENS group were significantly lower than those of the control group at 15 and 30 minutes after the intervention (all P < .02). No significant between-group difference was observed in PEFR at any point in time. Conclusion. A single session of auricular TENS applied at specific therapeutic points significantly reduced resting (VAS-rest) and movement-evoked pain (VAS-huff, VAS-cough), and the effects lasted for at least 30 minutes after the stimulation. The analgesic effects of auricular TENS appeared to be point specific and could not be attributed to the placebo effect alone. However, auricular TENS did not produce any significant improvement in the performance of PEFR.