Browsing by Author "Leonardi, Naiara Tais"
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- Development of a performance-based toolkit of the treatable traits of functioning in hospitalised patients with exacerbation of COPD: a survey-based study protocolPublication . Leonardi, Naiara Tais; Kawakami, Débora Mayumi Oliveira; Cruz, Joana; Burtin, Chris; Borghi-Silva, Audrey; Mendes, Renata GonçalvesBackground The management of COPD has been based on the premise of identifying problems that guide personalised treatment based on a multidimensional assessment, known as treatable traits. Exacerbation of COPD (ECOPD) results in physical and functional impairments, limitation of daily activities and negative impact on patients’ quality of life and prognosis. In this context, identifying treatable traits in patients with ECOPD is essential to properly guide individualised patient care. There is a need to develop a performance-based toolkit to identify the main treatable traits of functioning in hospitalised patients with ECOPD. Methods and analysis This is a study protocol of a survey method observational study to develop a performance-based toolkit. The study will include the following steps: 1) definition of treatable traits by both physiotherapists who provide or have provided care to hospitalised patients with ECOPD on a regular basis, and patients who have experienced at least one ECOPD which required hospitalisation; 2) selection of the most appropriate measures (markers) for each treatable trait based on established criteria and a previous systematic review; and 3) implementation of the toolkit in a pilot/feasibility study with hospitalised patients with ECOPD. Conclusion The development of a feasible performance-based toolkit with the best markers for each key treatable trait of functioning in hospitalised patients with ECOPD will make it possible to create individualised patient care for the specific demands of these patients.
- Performance-based outcome measures to assess functionality in hospitalised patients with COPD exacerbations: a systematic review of the measurement propertiesPublication . Leonardi, Naiara Tais; Kawakami, Débora Mayumi Oliveira; Hurst, John R.; Cruz, Joana; Mendes, Renata GonçalvesIntroduction Hospitalised patients with exacerbations of COPD (ECOPD) may have physical and functional impairments that impact morbidity and readmission. Therefore, it is crucial to properly identify reduced functionality in these patients to support a personalised rehabilitation. The objective of this study is to summarise and compare the measurement properties of functionality performance-based outcome measures for hospitalised patients with ECOPD. Methods A systematic review based on the Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) was performed. The PubMed, Embase, PEDro and Cochrane databases were searched using terms related to functionality, hospitalised patients with ECOPD and measurement properties. Studies were selected and extracted by two researchers. The COSMIN Risk of Bias checklist was applied to assess the methodological quality of the studies and measurement property results were compared with the criteria for good measurement properties. Quality of evidence was graded using a modified Grades of Recommendation, Assessment, Development and Evaluation approach. Results 13 studies were included with nine outcome measures, namely the 6-min pegboard ring test, the de Morton mobility index, the incremental shuttle walk test (ISWT), the 6-min walk test (6MWT), maximum inspiratory pressure (MIP), the Berg balance scale, 4-m gait speed, handgrip strength and the 6-min stepper test. Construct validity was rated as sufficient, except for the ISWT. Responsiveness, assessed only for MIP, was considered insufficient and measurement errors for the ISWT and 6MWT were insufficient, with a very low quality of evidence for all measurement properties. Conclusion Measurement properties of performance-based outcome measures to assess functionality in patients hospitalised with ECOPD are still scarce, with very low evidence supporting validity and a lack of evidence of responsiveness and reliability. Further studies are needed to address this topic and guide assertive and personalised management.