Phenotypic characteristics associated with slow gait speed in idiopathic pulmonary fibrosis
Corresponding Author
Claire M. Nolan
Harefield Pulmonary Rehabilitation and Muscle Research Group, Royal Brompton and Harefield NHS Foundation Trust, London, UK
National Heart and Lung Institute, Imperial College London, London, UK
Correspondence: Claire M. Nolan, Harefield Pulmonary Rehabilitation and Muscle Research Group, Royal Brompton and Harefield NHS Foundation Trust, Harefield Hospital, Middlesex UB9 6JH, UK. Email: [email protected]
Search for more papers by this authorMatthew Maddocks
Division of Palliative Care, Policy and Rehabilitation, King’s College London, Cicely Saunders Institute, London, UK
Search for more papers by this authorToby M. Maher
Interstitial Lung Disease Unit, Royal Brompton and Harefield NHS Foundation Trust, London, UK
Fibrosis Research Group, National Heart and Lung Institute, Imperial College London, London, UK
Search for more papers by this authorJane L. Canavan
Harefield Pulmonary Rehabilitation and Muscle Research Group, Royal Brompton and Harefield NHS Foundation Trust, London, UK
Search for more papers by this authorSarah E. Jones
Harefield Pulmonary Rehabilitation and Muscle Research Group, Royal Brompton and Harefield NHS Foundation Trust, London, UK
National Heart and Lung Institute, Imperial College London, London, UK
Search for more papers by this authorRuth E. Barker
Harefield Pulmonary Rehabilitation and Muscle Research Group, Royal Brompton and Harefield NHS Foundation Trust, London, UK
Search for more papers by this authorSuhani Patel
Harefield Pulmonary Rehabilitation and Muscle Research Group, Royal Brompton and Harefield NHS Foundation Trust, London, UK
Search for more papers by this authorJoseph Jacob
Fibrosis Research Group, National Heart and Lung Institute, Imperial College London, London, UK
Search for more papers by this authorPaul Cullinan
Department of Occupational and Environmental Medicine, Imperial College London, London, UK
Search for more papers by this authorWilliam D.-C. Man
Harefield Pulmonary Rehabilitation and Muscle Research Group, Royal Brompton and Harefield NHS Foundation Trust, London, UK
National Heart and Lung Institute, Imperial College London, London, UK
Search for more papers by this authorCorresponding Author
Claire M. Nolan
Harefield Pulmonary Rehabilitation and Muscle Research Group, Royal Brompton and Harefield NHS Foundation Trust, London, UK
National Heart and Lung Institute, Imperial College London, London, UK
Correspondence: Claire M. Nolan, Harefield Pulmonary Rehabilitation and Muscle Research Group, Royal Brompton and Harefield NHS Foundation Trust, Harefield Hospital, Middlesex UB9 6JH, UK. Email: [email protected]
Search for more papers by this authorMatthew Maddocks
Division of Palliative Care, Policy and Rehabilitation, King’s College London, Cicely Saunders Institute, London, UK
Search for more papers by this authorToby M. Maher
Interstitial Lung Disease Unit, Royal Brompton and Harefield NHS Foundation Trust, London, UK
Fibrosis Research Group, National Heart and Lung Institute, Imperial College London, London, UK
Search for more papers by this authorJane L. Canavan
Harefield Pulmonary Rehabilitation and Muscle Research Group, Royal Brompton and Harefield NHS Foundation Trust, London, UK
Search for more papers by this authorSarah E. Jones
Harefield Pulmonary Rehabilitation and Muscle Research Group, Royal Brompton and Harefield NHS Foundation Trust, London, UK
National Heart and Lung Institute, Imperial College London, London, UK
Search for more papers by this authorRuth E. Barker
Harefield Pulmonary Rehabilitation and Muscle Research Group, Royal Brompton and Harefield NHS Foundation Trust, London, UK
Search for more papers by this authorSuhani Patel
Harefield Pulmonary Rehabilitation and Muscle Research Group, Royal Brompton and Harefield NHS Foundation Trust, London, UK
Search for more papers by this authorJoseph Jacob
Fibrosis Research Group, National Heart and Lung Institute, Imperial College London, London, UK
Search for more papers by this authorPaul Cullinan
Department of Occupational and Environmental Medicine, Imperial College London, London, UK
Search for more papers by this authorWilliam D.-C. Man
Harefield Pulmonary Rehabilitation and Muscle Research Group, Royal Brompton and Harefield NHS Foundation Trust, London, UK
National Heart and Lung Institute, Imperial College London, London, UK
Search for more papers by this authorABSTRACT
Background and objective
Usual gait speed over 4 m (4MGS) is an established functional performance measure in older adults that consistently predicts adverse health outcomes, but few data exist in idiopathic pulmonary fibrosis (IPF). We assessed the reliability of 4MGS, its relationship with established outcome measures and its responsiveness to pulmonary rehabilitation.
Methods
In four prospective IPF cohorts, 4MGS inter-observer (n = 46) and test–retest (n = 46) reliability, concurrent validity (n = 65 and n = 62) and responsiveness (n = 60) were determined. The phenotypic characteristics of all patients stratified according to slow 4MGS (<0.8 m/s) were compared, including lung function parameters, HRCT of the chest, 6-min walking distance (6MWD), Medical Respiratory Council (MRC) dyspnoea score, King’s Brief Interstitial Lung Disease (KBILD) questionnaire and Gender, Age and lung Physiology (GAP) prognostic index.
Results
Intra-class correlation coefficients for inter-observer and test–retest reliability were 0.996 and 0.983, respectively. There was a strong association between 4MGS and 6MWD (r = 0.76; P < 0.0001) and moderate correlations with MRC (r = −0.56), KBILD (r = 0.44) and GAP index (r = −0.41); all P < 0.005. 4MGS improved significantly with pulmonary rehabilitation (mean (95% CI) change: 0.16 (0.12–0.20) m/s), effect size 0.65. Patients with slow 4MGS had significantly worse exercise performance (6MWD: −167 (−220 to −133) m), dyspnoea, health status and prognosis index than those with preserved 4MGS, despite similar lung function and HRCT parameters.
Conclusion
4MGS is a simple, reliable, valid and responsive tool that may detect a patient phenotype with worse exercise performance, dyspnoea, health status and prognosis index in stable IPF.
Supporting Information
| Filename | Description |
|---|---|
| resp13213-sup-0001-AppendixS1-S3.docWord document, 150 KB |
Appendix S1 Measurement of 4 m gait speed. Appendix S2 Study flow diagrams. Appendix S3 Power calculation. |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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