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. 2019 Mar 11;8(3):340.
doi: 10.3390/jcm8030340.

"Can do" versus "do do": A Novel Concept to Better Understand Physical Functioning in Patients with Chronic Obstructive Pulmonary Disease

Eleonore H Koolen  1 , Hieronymus W van Hees  2 , Rob C van Lummel  3 , Richard Dekhuijzen  4 , Remco S Djamin  5 , Martijn A Spruit  6   7   8 , Alex J van 't Hul  9
Affiliations

"Can do" versus "do do": A Novel Concept to Better Understand Physical Functioning in Patients with Chronic Obstructive Pulmonary Disease

Eleonore H Koolen et al. J Clin Med. .

Abstract

Background: Physical capacity (PC) and physical activity (PA) represent associated but separate domains of physical function. It remains unknown whether this framework may support a better understanding of the impaired physical function in patients with chronic obstructive pulmonary disease (COPD). The current study had two aims: (1) to determine the distribution of patients with COPD over the PC-PA quadrants, and (2) to explore whether differences exist in clinical characteristics between these quadrants.

Methods: In this retrospective study, PC was measured using the six-minute walk distance (6MWD), and PA was assessed with an accelerometer. Moreover, patients' clinical characteristics were obtained. Patients were divided into the following quadrants: (I) low PC (6MWD <70% predicted), low PA, using a step-defined inactivity index (<5000 steps/day, "can't do, don't do" quadrant); (II) preserved PC, low PA ("can do, don't do" quadrant); (III) low PC, preserved PA ("can't do, do do" quadrant); and (IV) preserved PC, preserved PA ("can do, do do" quadrant).

Results: The distribution of the 662 COPD patients over the quadrants was as follows: "can't do, don't do": 34%; "can do, don't do": 14%; "can't do, do do": 21%; and "can do, do do": 31%. Statistically significant differences between quadrants were found for all clinical characteristics, except for educational levels.

Conclusions: This study proves the applicability of the PC-PA quadrant concept in COPD. This concept serves as a pragmatic clinical tool, that may be useful in the understanding of the impaired physical functioning in COPD patients and therefore, may improve the selection of appropriate interventions to improve physical function.

Keywords: chronic obstructive pulmonary disease; exercise; physical activity; physical function.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Graphical overview of the physical capacity-physical activity quadrant concept. 6MWD = six-minute walk distance; r = Pearson’s correlation coefficient; sample: n = 662 COPD patients.
See this image and copyright information in PMC

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