Physical Activity Characteristics across GOLD Quadrants Depend on the Questionnaire Used

BackgroundThe GOLD multidimensional classification of COPD severity combines the exacerbation risk with the symptom experience, for which 3 different questionnaires are permitted. This study investigated differences in physical activity (PA) in the different GOLD quadrants and patient’s distribution in relation to the questionnaire used.Methods136 COPD patients (58±21% FEV1 predicted, 34F/102M) completed COPD assessment test (CAT), clinical COPD questionnaire (CCQ) and modified Medical Research Council (mMRC) questionnaire. Exacerbation history, spirometry and 6MWD were collected. PA was objectively measured for 2 periods of 1 week, 6 months apart, in 5 European centres; to minimise seasonal and clinical variation the average of these two periods was used for analysis.ResultsGOLD quadrants C+D had reduced PA compared with A+B (3824 [2976] vs. 5508 [4671] steps.d-1, p-1, p ConclusionsUsing different questionnaires changes the patient distribution and results in different clinical characteristics. Therefore, standardization of the questionnaire used for classification is critical to allow comparison of different studies using this as an entry criterion.Clinical Trial RegistrationClinicalTrials.gov NCT01388218背景 慢性阻塞性肺疾病（Chronic Obstructive Pulmonary Disease, COPD）严重程度的全球慢性阻塞性肺疾病倡议（Global Initiative for Chronic Obstructive Lung Disease, GOLD）多维分级，将急性加重风险与症状表现相结合，该分级允许采用3种不同的问卷进行评估。本研究旨在探究不同GOLD象限分组患者的体力活动（Physical Activity, PA）差异，以及不同问卷使用情况下的患者分布情况。 方法 本研究纳入136例COPD患者[预测第1秒用力呼气容积（Forced Expiratory Volume in 1 second, FEV1）占预计值百分比为58±21%，其中女性34例、男性102例]，所有患者均完成了COPD评估测试（COPD Assessment Test, CAT）、临床COPD问卷（Clinical COPD Questionnaire, CCQ）以及改良版英国医学研究理事会（modified Medical Research Council, mMRC）问卷。研究收集了患者的急性加重病史、肺量测定结果以及6分钟步行距离（6-Minute Walk Distance, 6MWD）数据。在5家欧洲研究中心，采用客观监测手段对患者的体力活动进行了两次为期1周的测量，两次测量间隔6个月；为尽可能减少季节与临床状态波动带来的影响，本研究取两次测量的平均值用于后续分析。 结果 相较于GOLD象限A+B组，C+D组患者的体力活动水平更低[日均步数：3824（2976） vs. 5508（4671） 步数·日⁻¹，原文标注p-1, p]。 结论 采用不同的问卷进行评估会改变患者的分组分布，并导致临床特征分析结果出现差异。因此，对用于分级的问卷进行标准化，对于确保以该分级作为入组标准的不同研究之间具有可比性至关重要。 临床试验注册 临床试验.gov（ClinicalTrials.gov）注册号：NCT01388218