Masters Degrees (Physiotherapy)

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Browsing Masters Degrees (Physiotherapy) by Author "Cason, Katherine Mary"

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    Measuring exercise capacity in chronic obstructive pulmonary disease (COPD) patients
    (Stellenbosch : Stellenbosch University, 2022-04) Cason, Katherine Mary; Lupton-Smith, Alison; Hanekom, Susan; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Health and Rehabilitation Sciences. Physiotherapy.
    ENGLISH SUMMARY: Background: Pulmonary rehabilitation (PR) is recommended to be essential in the management of Chronic Obstructive Pulmonary Disease (COPD) patients. PR consists of a multidisciplinary approach including various components with patient- tailored exercise training as the cornerstone for effective results. Measuring exercise capacity is necessary to identify exercise limitations and personalise the prescription of exercise training. Cardiopulmonary exercise testing (CPET) identifies limitations but is expensive and often inaccessible in clinical settings. Field tests are increasingly being used to measure functional exercise capacity and their parameters could inform exercise training prescription. The aims of this thesis were to 1.) identify which field tests are being used to assess exercise capacity of COPD patients and to describe if and how the test data is used to inform exercise prescription, 2.) design a validation study in which we can compare the physiological responses evoked when completing a simple field test to those of the CPET in the COPD population. Methods: A scoping review according to the JBI methodology was undertaken to identify studies reporting on field tests measuring exercise capacity in the COPD population. After a two-reviewer screening process, the studies’ characteristics, participants information, field tests methods, clinical utility, and possible prescription ability were extracted (Chapter 2). Subsequently, the findings from the scoping review were used to inform the design of a randomised cross-over study. This study design aim is to compare the Three Minute Sit-to-Stand Test (3M-STST) to CPET and to identify comparable or associated parameters for exercise limitation identification and informing exercise training prescription (Chapter 3). Results: The scoping review search returned 3269 citations with 93 final full text studies eligible for inclusion. Papers were predominantly from high income economy countries and included samples presenting with moderate to severe COPD stages. A total of 28 different tests were identified as measuring exercise capacity and categorised according to five main descriptors: Upper Limb, Combined Function, Sit-To-Stand, Step or Walk tests. Normative values for these tests are not commonly reported and was mainly identified in Walk tests. Only five of the 28 tests were used to suggest prescribing exercise training. The study designed was planned according to the research guidelines of Stellenbosch University, was approved by the health research ethics committee, and obtained funding from the Harry Crossley Foundation. Conclusion: This thesis identified numerous different clinical field tests developed to measure exercise capacity in COPD. While some of the tests can be used to predict outcome or physical activity levels, only a small number of tests are used for exercise prescription. To address the gap in the literature we designed a study to compare the physiological responses elicited by 3M-STST with the gold standard CPET. The outcome of the study will identify the parameters which can be used to facilitate patient targeted exercise prescription. Clinicians and researchers can now use the information summarised in this thesis to identify a field test aligned with their specific needs and context. There is a need to standardise terminology, procedures, and exercise prescription in the COPD population for future use.