COSMIN database

Functional Status Assessment of Patients With COPD: A Systematic Review of Performance-Based Measures and Patient-Reported Measures

Liu, Y., Li, H., Ding, N., Wang, N., and Wen, D.
Presently, there is no recommendation on how to assess functional status of chronic obstructive pulmonary disease (COPD) patients. This study aimed to summarize and systematically evaluate these measures.Studies on measures of COPD patients' functional status published before the end of January 2015 were included using a search filters in PubMed and Web of Science, screening reference lists of all included studies, and cross-checking against some relevant reviews. After title, abstract, and main text screening, the remaining was appraised using the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) 4-point checklist. All measures from these studies were rated according to best-evidence synthesis and the best-rated measures were selected.A total of 6447 records were found and 102 studies were reviewed, suggesting 44 performance-based measures and 14 patient-reported measures. The majority of the studies focused on internal consistency, reliability, and hypothesis testing, but only 21% of them employed good or excellent methodology. Their common weaknesses include lack of checks for unidimensionality, inadequate sample sizes, no prior hypotheses, and improper methods. On average, patient-reported measures perform better than performance-based measures. The best-rated patient-reported measures are functional performance inventory (FPI), functional performance inventory short form (FPI-SF), living with COPD questionnaire (LCOPD), COPD activity rating scale (CARS), University of Cincinnati dyspnea questionnaire (UCDQ), shortness of breath with daily activities (SOBDA), and short-form pulmonary functional status scale (PFSS-11), and the best-rated performance-based measures are exercise testing: 6-minute walk test (6MWT), endurance treadmill test, and usual 4-meter gait speed (usual 4MGS).Further research is needed to evaluate the reliability and validity of performance-based measures since present studies failed to provide convincing evidence. FPI, FPI-SF, LCOPD, CARS, UCDQ, SOBDA, PFSS-11, 6MWT, endurance treadmill test, and usual 4MGS performed well and are preferable to assess functional status of COPD patients.
Medicine (Baltimore)
1536-5964 (Electronic); 0025-7974 (Linking)
Publication year:
Functional status:
Cognitive/mental functioning
Physical functioning
Role functioning
Social functioning
Adults (18-65)
Seniors (65+)
Diseases of and symptoms related to the respiratory system
PRO / non-PRO:
Non-patient Reported Outcome
Patient Reported Outcome
Type of measurement instrument:
1 - Questionnaires
4 - Performance-based tests
6 - Clinical rating scales
12MinWT - 12 Minute Walk Test [alias; 12MWT]   
2MWT - 2-Minute Walk Test   
30MWT - 30-Meter Walk Test
3CRT - 3-minute Chair Rise Test
5-STS - Fives times Sit-to-Stand Test [Alias: 5RT - five-repetition sit-to-stand test]
6MST - 6-Minute Step Test
6MWT - 6-Minute Walk Test    | 
6PBRT - 6-min Pegboard and Ring Test
Accelerometry [alias: accelerometer]
Actiwatch Spectrum
ADL-D - Activity of Daily Living Dyspnea scale
AH - ActiHeart
CARS - COPD Activity Rating Scale
CAT - COPD Assessment Test   
CDLM - Capacity of Daily Living during the Morning questionnaire
CST - Chester Step Test
DASI - Duke Activity Status Index
DIRECT - Disability Related to COPD Tool
DynaPort ADL monitor
ECET - Endurance cycle ergometer test
ESWT - endurance shuttle walk test
ETT - Endurance treadmill test
FPI - Functional Performance Inventory
FPI-SF - Functional Performance Inventory—Short Form
Glittre ADL
GST - Grocery-Shelving Task
ICET - Incremental cycle ergometer test
ISWT - incremental shuttle walk test
ITT - Incremental treadmill test
LCADL - London Chest Activity of Daily Living Scale
LCOPD - Living with chronic obstructive pulmonary disease questionnaire
Lifecorder PLUS
M6MWT - Modified 6 Minute Walk Test
Maximal 10MGS - Maximal 10-Meter Gait Speed
Maximal 4MGS - Maximal 4-Meter Gait Speed
MRADLQ - Manchester Respiratory Activities of Daily Living Questionnaire
MSWT - Modified Shuttle Walk Test
PFSDQ-M - modified Pulmonary Functional Status & Dyspnea Questionnaire
PFSS-11 - Pulmonary Functional Status Scale—Short Version
PFSS - Pulmonary Function Status Scale
PW 610 - Power Walker 610
SAM - Step Activity Monitor
SCAM - Self-Contained Activity Monitor
SCPT - Stair Climb Power Test
Semipaced 3CRT
SenseWear Pro2 Armband
Sit-to-stand (test)
SOBDA - Shortness of Breath with Daily Activities
SRT - Steep Ramp Test   
UCDQ - Universitiy of Cincinnati Dyspnea Questionnaire
Usual 10MGS - Usual 10-Meter Gait Speed
Usual 4MGS - Usual 4-Meter Gait Speed
Usual and fast walking speeds
UULEX - Unsupported Upper-Limb Exercise Test;