• Janneke Annegarn, Kenneth Meijer, Valeria Lima Passos, Katharina Stute, Jozé Wiechert, Hans H C M Savelberg, Annemie M W J Schols, Emiel F M Wouters, Martijn A Spruit, and Ciro+ Rehabilitation Network.
• Human Movement Science, NUTRIM School for Nutrition, Toxicology, and Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands. Janneke.annegarn@maastrichtuniversity.nl
• J Am Med Dir Assoc. 2012 Mar 1; 13 (3): 284-90.

BackgroundProblematic activities of daily life (ADLs) can be the main reason to refer patients with chronic obstructive pulmonary disease (COPD) for pulmonary rehabilitation. To date, information on problematic ADLs and their clinical correlates in COPD remain scarce. This retrospective chart review aimed to identify the most prevalent self-reported problematic ADLs in COPD patients, determine performance and satisfaction scores of these problematic ADLs, and explore the association between 13 clinical determinants and 4 problematic ADL domains.MethodsA total of 820 COPD patients entering pulmonary rehabilitation assessment were included in this retrospective study. Self-reported problematic ADLs were assessed using the Canadian Occupational Performance Measure, administered by occupational therapists in the form of a semistructured interview.ResultsCOPD patients (59% male, age 63.6 ± 9.3 years, FEV(1) (%pred): 46.4 ± 18.4) reported 2999 problematic ADLs. The most prevalent problematic ADLs were walking (68%), stair climbing (35%), and cycling (30%). Moreover, 30% of the patients reported "not able to do any of the scored problematic ADL" and 44% were "not satisfied at all with the performance of any of the scored problematic ADL." Significant but weak associations were found between clinical determinants (eg, physical and psychosocial) and problematic ADLs.ConclusionsThe lack of a strong association between problematic ADLs and clinical determinants emphasizes the need for individualized assessment of these ADLs to allow tailored intervention.Copyright © 2012 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.

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