Patients with Chronic Obstructive Pulmonary Disease Can Accurately Perform Home-Based Measurements of Inspiratory Capacity and Dynamic Hyperinflation

Abstract

Home-based lung function measurements can be used to capture day-to-day variations in symptoms in patients with chronic obstructive pulmonary disease (COPD). Although dynamic hyperinflation (DH) is clinically relevant, existing home-based measurements do not include its assessment. DH can be measured through inspiratory capacity (IC) measurements before and after metronome-paced tachypnea test (MPT). The goal of this study is to determine the accuracy of unsupervised home-based IC and DH measurements in COPD.Sixteen COPD patients performed IC and DH measurements during 4 home visits. Visit 1 was considered a training session. During all visits supervised and unsupervised IC at rest (IC_REST) and after MPT (IC_MPT) were measured. DH was calculated as the difference between IC_REST and IC_MPT, and as a percentage of IC_REST. Bland-Altman analyses and ANOVA tests were performed to determine the effect of supervision and repeated measures over time.The biases between supervised and unsupervised IC_REST, IC_MPT, ΔIC and ΔIC% were 0.007 L, 0.007 L, 0 mL and -0.09% in the last visit, respectively. Limits of agreement of IC_REST and ΔIC% decreased from ±0.261 mL to ±0.201 mL, and from ±13.84% to ±10.81% between visit 1 and 4, respectively. No significant effect of supervision or over time was found.After a robust training and a learning phase, COPD patients are able to perform IC measurements in an accurate manner in both rest and after MPT. This yield accurate assessment of DH, in an unsupervised home-based setting.

Keywords: Chronic obstructive pulmonary disease; accuracy; home-based; inspiratory capacity; metronome paced tachypnea; unsupervised.