Factors Influencing Activities of Daily Living in Subjects With COPD

Respir Care. 2019 Feb;64(2):189-195. doi: 10.4187/respcare.05938. Epub 2018 Nov 6.


Background: Activities of daily living (ADL) are important for an independent life. As COPD progresses, the ability to complete ADL is usually reduced. Knowing the possible factors that influence the ability to perform ADL may allow better targeting of appropriate rehabilitation programs to increase the independence levels and/or to prevent further decreases in patients with COPD. Therefore, the aim of this study was to investigate ADL performance as measured by the London Chest Activity of Daily Living scale, which is a commonly used measure in patients with COPD.

Methods: This cross-sectional study included 44 clinically stable subjects who were not taking antibiotics and had not made any changes in their medications for at least three weeks with a COPD diagnosis based on Global Initiative for Chronic Obstructive Lung Disease. Demographic characteristics, pulmonary function, ADL measured by the London Chest Activity of Daily Living scale, functional exercise capacity via the 6-min walk distance, disease-related symptoms measured by the COPD Assessment Test, and peripheral and respiratory muscle strength were evaluated. A multiple linear regression (stepwise) analysis was used to determine the variables that have the greatest influence on ADL (ie, the London Chest Activity of Daily Living scale score).

Results: The London Chest Activity of Daily Living scale score had moderate correlations with the COPD Assessment Test score (r = 0.31, P = .041), maximum expiratory pressure value (r = -0.37, P = .01), 6-min walk distance (r = -0.48, P = .001), knee extensor muscle strength (r = -0.47, P = .001), handgrip strength (r = -0.44, P = .003). The 6-min walk distance, COPD Assessment Test score and maximal expiratory pressure values were significant and independent determinants of the London Chest Activity of Daily Living scale, with 40.1% of the variance in subjects with COPD.

Conclusions: Functional exercise capacity, disease-related symptoms, and expiratory muscle strength have the greatest influence on ADL in the subjects with COPD. The level of independence to perform ADL can be increased by improving functional exercise capacity, reducing symptoms, and increasing expiratory muscle strength in subjects with COPD.

Keywords: ADL; COPD; activities of daily living; disease-related symptoms; functional exercise capacity; muscle strength.

Publication types

  • Evaluation Study

MeSH terms

  • Activities of Daily Living*
  • Aged
  • Cross-Sectional Studies
  • Disability Evaluation*
  • Exercise Test
  • Exercise Tolerance / physiology
  • Female
  • Forced Expiratory Volume
  • Hand Strength
  • Humans
  • Male
  • Middle Aged
  • Muscle Strength
  • Physical Functional Performance
  • Pulmonary Disease, Chronic Obstructive / physiopathology*
  • Respiratory Muscles / physiopathology
  • Severity of Illness Index*
  • Spirometry / statistics & numerical data
  • Walk Test