Farklı Fenotipteki Kronik Obstrüktif Akciğer Hastalarında Fonksiyonel Statünün Karşılaştırılması

Abstract

Chronic obstructive pulmonary disease (COPD) is one of the major causes of morbidity and mortality. Besides its effects on lung, there are also systemic effects on exercise capacity and daily living activities. The purpose of this study was to evaluate and compare functional status in COPD patients with different phenotype. Sixty-five patients with COPD participated in this study. COPD phenotypes were determined according to risk classification GOLD (Global Initiative for Chronic Obstruction Lung Disease) classification and the number of exacerbation in the previous one year, classification of symptoms CAT (COPD Assessment Questionnaire). Sixteen phenotype A, 21 phenotype B, 2 phenotype C, and 26 phenotype D patients were included in the study. Physical and demographic characteristics of the subjects were recorded. Pulmonary function testing, inspiratory and expiratory muscle strength (MIP and MEP) measurement, peripheral muscle strength measurement, six-minute walk test (6MWT), Glittre Activities of Daily Living (ADL) testing were used. Modified Medical Research Council (MMRC) dyspnea scale to determine the dyspnea perception, London Chest Activities of Daily Living Questionnaire (LCADL) to assess ADL, Clinical COPD Questionnaire (CCQ) to measure functional status and symptoms were used. As a result, MMRC score, CCQ score, physical, recreation and total scores of LCADL in group A was significantly lower than group B and D (p<0.05). The PFT parameters and dominant hand grip strength of group D were significantly lower than those of the other two groups (p<0.05). The MIP and %MIP values of group D were significantly less than the values of group B (p<0.05). The 6MWT distance and %6MWT distance were statistically lower and LCADL-personal care score of group D patients was statistically higher than those of the patients with group A (p<0.05). There were no statistically significant differences among groups in MEP, %MEP, quadriceps muscle strength, Glittre ADL test duration, and LCADL-household score (p>0.05). In conclusion, it has been shown that different phenotypes of COPD patients have different functional status. Comprehensive evaluation of the patients with different phenotypes of COPD, a systemic disease, will contribute to program planning in pulmonary rehabilitation according to patients? needs.