chronic obstructive, functional performance, pulmonary disease



  1. Nield, Margaret PhD, RN, CS
  2. Hoo, Guy Soo MD, MPH
  3. Roper, Janice PhD, RN
  4. Santiago, Silverio MD
  5. Dracup, Kathleen DNSc, RN, FNP, FAAN


PURPOSE: To further evaluate the usefulness of the Human Activity Profile (HAP) as a functional performance measure for those with chronic obstructive pulmonary disease (COPD).


METHODS: Phase 1. The sample consisted of 53 outpatients (51 male) with stable COPD (forced expiratory volume in 1 second% predicted (FEV1% pred) = 38 +/- 14 (mean +/- standard deviation) at a university-affiliated veterans affairs medical center. Variables were functional performance (HAP Maximal Activity Score [MAS], HAP Adjusted Activity Score [AAS]), dyspnea (modified Borg category-ratio scale and Shortness of Breath Questionnaire [SOBQ]), and exercise capacity (6-minute walk distance [6MWD]). Phase 2. The HAP was administered pre-post pulmonary rehabilitation in 48 (14 male) outpatients with stable COPD (FEV1% pred = 35 +/- 15) at an outpatient pulmonary rehabilitation program at a large private hospital.


RESULTS: Phase 1. Scores for MAS and AAS were, respectively, 62 +/- 12 and 44 +/- 15. The 6MWD, modified Borg, and SOBQ were, respectively, 1055 +/- 372 ft, 4.1 +/- 1, and 64.4 +/- 22 ft. Correlations of the 6MWD and dyspnea scores with the AAS were strong and explained 40% of the AAS variation. Phase 2. The baseline MAS and AAS scores were 55 +/- 14 and 42 +/- 15, respectively, with 29/48 (60%) classified as "low fitness" on the basis of the AAS. Post-rehabilitation, there was significant improvement in the AAS score (48 +/- 13) and significant reduction for those classified as "low fitness."


CONCLUSIONS: The utility of the HAP as a measure of functional performance improvement in COPD is supported by its relationship with both 6MWD and dyspnea and its responsiveness to pulmonary rehabilitation.