Functional Measures in Non-COPD Chronic Respiratory Diseases: A Systematic Review

Area of Science:

• Pulmonary Medicine
• Rehabilitation Science
• Clinical Measurement

Background:

• Selecting appropriate functional performance (FP) instruments for chronic respiratory diseases (CRD) beyond COPD is difficult due to the wide variety available.
• A systematic review is needed to consolidate information on FP instruments, their measurement properties, and clinical utility in non-COPD CRD.

Purpose of the Study:

• To systematically review and summarize FP instruments used in non-COPD CRD.
• To evaluate the measurement properties and minimum clinically important differences of these instruments.
• To explore associations between FP measures and CRD course-related events or prognosis.

Main Methods:

• Systematic literature search across PubMed, PEDro, Embase, and Cochrane Library databases.
• Inclusion of studies assessing FP in non-COPD CRD using patient-reported or performance-based instruments.
• Exclusion of COPD-exclusive studies and solely exercise capacity tests; risk of bias assessment using established checklists.

Main Results:

• 216 studies across seven CRD categories (e.g., asthma, ILD, PAH) were included, identifying 33 FP instruments.
• The SF-36 physical function domain was the most common patient-reported tool; the 1 min sit-to-stand test was the most studied performance-based measure.
• Associations with clinical events were infrequent, mainly linking mortality in ILD and PAH.

Conclusions:

• Limited data exists on the measurement properties and clinical implications of many FP instruments used in non-COPD CRD.
• This review provides a consolidated evidence summary to guide the selection of FP tools for non-COPD CRD.
• Improved understanding of FP instrument properties can enhance clinical decision-making and patient management.