Assessing the exertion required to induce breathlessness in a population with advanced cancer: matching measures to the level of physical function
Abstract Background The aim of the study was to assess four evidence-based assessments utilising exercise challenges that induce breathlessness, each with progressively less demanding levels of exertion, which can be tailored to people with a range of functional capabilities in the setting of advanc...
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| Format: | Article |
| Language: | English |
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BMC
2019-01-01
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| Series: | BMC Palliative Care |
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| Online Access: | http://link.springer.com/article/10.1186/s12904-018-0386-1 |
| _version_ | 1818448048569712640 |
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| author | Kahren M. White Meera R. Agar David C. Currow |
| author_facet | Kahren M. White Meera R. Agar David C. Currow |
| author_sort | Kahren M. White |
| collection | DOAJ |
| description | Abstract Background The aim of the study was to assess four evidence-based assessments utilising exercise challenges that induce breathlessness, each with progressively less demanding levels of exertion, which can be tailored to people with a range of functional capabilities in the setting of advanced cancer for research studies. Functional cut off points for these assessments have not previously been defined. Methods A cross sectional study of four exercise tests attempted by all participants: 6 min walk test (6MWT); (derived) 2 min walk test (2MWT); arm exercises; and reading numbers aloud. Performance status (Australia-modified Karnofsky Performance Status (AKPS)), baseline breathlessness using the modified Medical Research Council (mMRC) breathlessness scale, and a visual analogue scale of intensity and unpleasantness of breathlessness were measured. Co-morbidity was codified using the Charlson Co-morbidity Index. Percentage of people completing each test by AKPS level of function and baseline mMRC breathlessness scores were quantified. Results In the 68 participants, poorer function decreased the proportion of people able to complete the exercise tests. For completion rates ≥80%, of 6MWT and 2MWT, only people with an AKPS 70–90 had completion. For arm exercises, this included people with an AKPS as low as ≥50; and for reading numbers, it included people with an AKPS of 40 but not below. Conclusions Walking tests have poor utility in people with high levels of functional impairment. For people with high levels of dependence, reading numbers should be used in evaluating exercise-induced breathlessness in research studies. These data also suggest that people’s exertional limitations have been under-estimated as cancer progresses. |
| first_indexed | 2024-12-14T20:13:19Z |
| format | Article |
| id | doaj.art-86e22d00565c4c89ad307cf0ac5b50a5 |
| institution | Directory Open Access Journal |
| issn | 1472-684X |
| language | English |
| last_indexed | 2024-12-14T20:13:19Z |
| publishDate | 2019-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Palliative Care |
| spelling | doaj.art-86e22d00565c4c89ad307cf0ac5b50a52022-12-21T22:48:54ZengBMCBMC Palliative Care1472-684X2019-01-011811610.1186/s12904-018-0386-1Assessing the exertion required to induce breathlessness in a population with advanced cancer: matching measures to the level of physical functionKahren M. White0Meera R. Agar1David C. Currow2Occupational Therapist, Private PracticeIMPACCT, Faculty of Health, University of Technology SydneyIMPACCT, Faculty of Health, University of Technology SydneyAbstract Background The aim of the study was to assess four evidence-based assessments utilising exercise challenges that induce breathlessness, each with progressively less demanding levels of exertion, which can be tailored to people with a range of functional capabilities in the setting of advanced cancer for research studies. Functional cut off points for these assessments have not previously been defined. Methods A cross sectional study of four exercise tests attempted by all participants: 6 min walk test (6MWT); (derived) 2 min walk test (2MWT); arm exercises; and reading numbers aloud. Performance status (Australia-modified Karnofsky Performance Status (AKPS)), baseline breathlessness using the modified Medical Research Council (mMRC) breathlessness scale, and a visual analogue scale of intensity and unpleasantness of breathlessness were measured. Co-morbidity was codified using the Charlson Co-morbidity Index. Percentage of people completing each test by AKPS level of function and baseline mMRC breathlessness scores were quantified. Results In the 68 participants, poorer function decreased the proportion of people able to complete the exercise tests. For completion rates ≥80%, of 6MWT and 2MWT, only people with an AKPS 70–90 had completion. For arm exercises, this included people with an AKPS as low as ≥50; and for reading numbers, it included people with an AKPS of 40 but not below. Conclusions Walking tests have poor utility in people with high levels of functional impairment. For people with high levels of dependence, reading numbers should be used in evaluating exercise-induced breathlessness in research studies. These data also suggest that people’s exertional limitations have been under-estimated as cancer progresses.http://link.springer.com/article/10.1186/s12904-018-0386-1Exercise-induced breathlessnessClinical research toolsSix minute walk testArm exercisesCohort study |
| spellingShingle | Kahren M. White Meera R. Agar David C. Currow Assessing the exertion required to induce breathlessness in a population with advanced cancer: matching measures to the level of physical function BMC Palliative Care Exercise-induced breathlessness Clinical research tools Six minute walk test Arm exercises Cohort study |
| title | Assessing the exertion required to induce breathlessness in a population with advanced cancer: matching measures to the level of physical function |
| title_full | Assessing the exertion required to induce breathlessness in a population with advanced cancer: matching measures to the level of physical function |
| title_fullStr | Assessing the exertion required to induce breathlessness in a population with advanced cancer: matching measures to the level of physical function |
| title_full_unstemmed | Assessing the exertion required to induce breathlessness in a population with advanced cancer: matching measures to the level of physical function |
| title_short | Assessing the exertion required to induce breathlessness in a population with advanced cancer: matching measures to the level of physical function |
| title_sort | assessing the exertion required to induce breathlessness in a population with advanced cancer matching measures to the level of physical function |
| topic | Exercise-induced breathlessness Clinical research tools Six minute walk test Arm exercises Cohort study |
| url | http://link.springer.com/article/10.1186/s12904-018-0386-1 |
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