Harnessing Digital Health to Objectively Assess Functional Performance in Veterans with Chronic Obstructive Pulmonary...

Area of Science:

• Gerontology
• Rehabilitation Medicine
• Biomedical Engineering

Background:

• Early detection of functional decline is crucial for managing Chronic Obstructive Pulmonary Disease (COPD) symptoms.
• Conventional walking-based functional assessments are often impractical in limited clinic spaces.
• Alternative, space-efficient methods are needed to assess functional performance and frailty in COPD patients.

Purpose of the Study:

• To evaluate the feasibility and effectiveness of an upper-extremity frailty meter (FM) for assessing functional performance in COPD patients.
• To identify digital measures of functional performance using a wrist-worn sensor.
• To assess frailty levels in COPD patients using novel upper-extremity metrics.

Main Methods:

• Recruited 48 COPD patients and 49 controls.
• Participants performed a 20-second repetitive elbow flexion-extension test using a wrist-worn FM sensor.
• Compared FM metrics (speed, range of motion, power, exhaustion) with conventional functional assessments.

Main Results:

• COPD patients showed significantly poorer performance on both conventional assessments and all FM metrics compared to controls.
• FM metrics demonstrated significant agreement with established functional assessment tools.
• FM metrics effectively identified individuals with pre-frailty and frailty in the COPD cohort.

Conclusions:

• A 20-second elbow flexion-extension test with a wrist-worn sensor provides a feasible and practical method for evaluating functional performance in COPD.
• The FM offers a simple, low-risk alternative for assessing functional status, suitable for remote monitoring and space-constrained settings.
• Future research should utilize the FM for quantitative monitoring of functional decline and evaluating rehabilitation outcomes in COPD.