Effectiveness of Energy Conservation Techniques in Patients with COPD.

BACKGROUND: Patients with chronic obstructive pulmonary disease (COPD) might suffer from severe dyspnea, which importantly impacts on the performance of activities of daily living (ADL). Patient training of energy conservation techniques (ECTs) might be useful to improve the tolerance and execution of these ADL, but objective studies evaluating the effect of teaching ECTs on the metabolic equivalent of task (MET) in patients with COPD are sparse. OBJECTIVES: The aim of this study was to test the hypothesis that practicing ECTs after a 2-week ECT teaching period would reduce the energy expenditure (MET) in performing an activity in patients with severe COPD. METHODS: Energy expenditure was assessed with a gas exchange system (OxyconTM Mobile) during one out of five standardized ADL before and after a 2-week intervention period in which ECTs were taught. These ECTs comprised a good breathing technique, an ergonomic way of performing the activity, and the use of assistive devices. RESULTS: Thirty-two patients with COPD (mean FEV1: 39 ± 14%; female: n = 18; age: 68 ± 7 years) were included. A significantly lower MET (2.3 ± 0.6 to 2.1 ± 0.5; p < 0.05) and less desaturation (89.7 ± 5.2 vs. 91.1 ± 5.5% HbO2; p < 0.05) were seen while performing the same activity after the intervention. However, there was no significant difference in the time spent on the task performed (6.0 ± 3.9 vs. 6.7 ± 4.0 min; p > 0.05). CONCLUSIONS: A 2-week educative program on ECTs successfully reduces the energy spent for performing ADL relevant to the patient without any significant increase in the time spent on the activity.

Test-retest of a Swedish version of the Pulmonary Functional Status & Dyspnea Questionnaire-modified.

The number of people suffering from chronic obstructive pulmonary disease (COPD) is increasing. From an occupational therapy perspective, it is important to estimate dyspnea, fatigue and activity performance in daily activities to be able to use the most effective interventions. In Sweden, there are several assessments for evaluating activities in daily living, but none of them are diagnosis specific for this group. The Pulmonary Functional Status & Dyspnea Questionnaire-Modified (PFSDQ-M) is a self-completion assessment, which takes a short time to complete. The aim of this study was to translate the PFSDQ-M into Swedish and test it twice on 30 people to make a test-retest assessment. The aim was also to evaluate the interviewees' experience of filling in the form. Agreement between the assessments was examined by percentage agreement (PA) and unweighted kappa value (k). The test-retest shows the complexity of evaluating the influence of dyspnea and fatigue in performing activities. It was easier to reach agreement in a five-point scale compared to an eleven-point scale. When it comes to screening people with COPD, the PFSDQ-M can be a valuable instrument for detecting individuals who require occupational therapy.