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  • 1.
    Johansson Strandkvist, Viktor
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab. Umeå University, Department of Public Health and Clinical Medicine, Division of Occupational and Environmental Medicine, The OLIN unit.
    Backman, Helena
    Umeå University, Department of Public Health and Clinical Medicine, Division of Occupational and Environmental Medicine, The OLIN unit.
    Andersson, Mikael
    Uppsala University, Department of Neuroscience.
    Larsson, Agneta
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Stridsman, Caroline
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Lindberg, Anne
    Department of Public Health and Clinical Medicine, Division of Medicine/the OLIN unit, Umeå University.
    Hand grip strength is associated with fatigue in COPD2017Conference paper (Refereed)
  • 2.
    Johansson Strandkvist, Viktor
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Backman, Helena
    Division of Occupational and Environmental Medicine, Department of Public Health and Clinical Medicine, The Obstructive Lung disease in Northern Sweden Unit, Umeå University.
    Röding, Jenny
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Stridsman, Caroline
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Lindberg, Anne
    Division of Medicine, Department of Public Health and Clinical Medicine, Umeå University.
    Hand grip strength is associated with forced expiratory volume in 1 second among subjects with COPD: report from a population-based cohort study.2016In: The International Journal of Chronic Obstructive Pulmonary Disease, ISSN 1176-9106, E-ISSN 1178-2005, Vol. 11, no 1, p. 2527-2534Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Cardiovascular diseases and skeletal muscle dysfunction are common comorbidities in COPD. Hand grip strength (HGS) is related to general muscle strength and is associated with cardiovascular disease and all-cause mortality, while the results from small selected COPD populations are contradictory. The aim of this population-based study was to compare HGS among the subjects with and without COPD, to evaluate HGS in relation to COPD severity, and to evaluate the impact of heart disease.

    SUBJECTS AND METHODS: Data were collected from the Obstructive Lung disease in Northern Sweden COPD study, where the subjects with and without COPD have been invited to annual examinations since 2005. In 2009-2010, 441 subjects with COPD (postbronchodilator forced expiratory volume in 1 second [FEV1]/vital capacity <0.70) and 570 without COPD participated in structured interviews, spirometry, and measurements of HGS.

    RESULTS: The mean HGS was similar when comparing subjects with and without COPD, but those with heart disease had lower HGS than those without. When compared by Global Initiative for Chronic Obstructive Lung Disease (GOLD) grades, the subjects with GOLD 3-4 had lower HGS than those without COPD in both sexes (females 21.4 kg vs 26.9 kg, P=0.010; males 41.5 kg vs 46.3 kg, P=0.038), and the difference persisted also when adjusted for confounders. Among the subjects with COPD, HGS was associated with FEV1% of predicted value but not heart disease when adjusted for height, age, sex, and smoking habits, and the pattern was similar among males and females.

    CONCLUSION: In this population-based study, the subjects with GOLD 3-4 had lower HGS than the subjects without COPD. Among those with COPD, HGS was associated with FEV1% of predicted value but not heart disease, and the pattern was similar in both sexes.

  • 3.
    Johansson Strandkvist, Viktor
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation. OLIN-studierna.
    Backman, Helena
    Department of Public Health and Clinical Medicine, Division of Occupational and Environmental Medicine, The OLIN Unit, Umeå University.
    Röding, Jenny
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Stridsman, Caroline
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Lindberg, Anne
    Department of Public Health and Clinical Medicine, Division of Medicine/the OLIN unit, Umeå University.
    Impact of heart disease on hand grip strength in COPD: epidemiological data2016Conference paper (Refereed)
    Abstract [en]

    Background: Hand grip strength (HGS) and heart disease (HD) are related to mortality. Peripheral muscle dysfunction and HD are both frequently observed among subjects with COPD, but the relationship between HGS and HD in COPD is unclear.

    Aim: To evaluate HGS and the impact of HD among subjects with and without COPD.Methods: Data was collected from the OLIN (Obstructive Lung Disease in Northern Sweden) COPD study, where subjects with COPD have been invited to annual examinations since 2005 together with age- and sex-matched subjects without COPD. During 2009, 441 subjects with COPD and 570 without COPD participated in examinations including structured interviews, spirometry and measurements of HGS. COPD was defined as post-bronchodilator FEV1/VC<0.70.

    Results: Both among subjects with and without COPD, and in both sexes, those with HD had significantly lower HGS. The proportion of subjects below estimated normal value for HGS was similar in subjects with and without COPD and in both sexes; among women (35.4 vs. 33.4%, p=0.714) and men (19.1 vs 15.9%, p=0.315). In a linear regression model among subjects with COPD only, HGS was significantly associated with age, beta coefficient (B) = -0.46 (p<0.001), sex, B=19.85 (p<0.001) and FEV1 % of predicted normal value, B=0.06 (p=0.007), but not with HD or smoking habits. When a similar model was estimated among subjects without COPD, HGS was only associated with age and sex.

    Conclusions: In this population-based study, subjects with heart disease had lower hand grip strength regardless if they had COPD or not. Among COPD subjects, hand grip strength was associated with age, sex and FEV1, but not with heart disease.

  • 4.
    Johansson Strandkvist, Viktor
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Nyberg, Lars
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Larsson, Agneta
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Röijezon, Ulrik
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Stridsman, Caroline
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Lindberg, Anne
    OLIN studierna Norrbottens läns landsting , Sverige.
    Project: Physical function and postural control among subjects with Chronic Obstructive Pulmonary Disease – epidemiological and laboratory studies2016Other (Other (popular science, discussion, etc.))
  • 5.
    Lindberg, Anne
    et al.
    Department of Public Health and Clinical Medicine, Division of Medicine, Umeå University, Umeå.
    Linder, Robert
    Department of Public Health and Clinical Medicine, Division of Medicine, Umeå University, Umeå.
    Backman, Helena
    Department of Public Health and Clinical Medicine, Division of Occupational and Environmental Medicine, Umeå University, Umeå.
    Eriksson Ström, Jonas
    Department of Public Health and Clinical Medicine, Division of Medicine, Umeå University, Umeå.
    Frølich, Andreas
    Department of Public Health and Clinical Medicine, Division of Medicine, Umeå University, Umeå.
    Nilsson, Ulf
    Department of Public Health and Clinical Medicine, Division of Medicine, Umeå University, Umeå.
    Rönmark, Eva
    Department of Public Health and Clinical Medicine, Division of Occupational and Environmental Medicine, Umeå University, Umeå.
    Johansson Strandkvist, Viktor
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Behndig, Annelie F
    Department of Public Health and Clinical Medicine, Division of Medicine, Umeå University, Umeå.
    Blomberg, Anders
    Department of Public Health and Clinical Medicine, Division of Medicine, Umeå University, Umeå.
    From COPD epidemiology to studies of pathophysiological disease mechanisms: challenges with regard to study design and recruitment process2017In: European Clinical Respiratory Journal, ISSN 2001-8525, Vol. 4, no 1, article id 1415095Article in journal (Refereed)
    Abstract [en]

    Background: Chronic obstructive pulmonary disease (COPD) is a largely underdiagnosed disease including several phenotypes. In this report, the design of a study intending to evaluate the pathophysiological mechanism in COPD in relation to the specific phenotypes non-rapid and rapid decline in lung function is described together with the recruitment process of the study population derived from a population based study. Method: The OLIN COPD study includes a population-based COPD cohort and referents without COPD identified in 2002-04 (n = 1986), and thereafter followed annually since 2005. Lung function decline was estimated from baseline in 2002-2004 to 2010 (first recruitment phase) or to 2012/2013 (second recruitment phase). Individuals who met the predefined criteria for the following four groups were identified; group A) COPD grade 2-3 with rapid decline in FEV1 and group B) COPD grade 2-3 without rapid decline in FEV1 (≥60 and ≤30 ml/year, respectively), group C) ever-smokers, and group D) non-smokers with normal lung function. Groups A-C included ever-smokers with >10 pack years. The intention was to recruit 15 subjects in each of the groups A-D. Results: From the database groups A-D were identified; group A n = 37, group B n = 29, group C n = 41, and group D n = 55. Fifteen subjects were recruited from groups C and D, while this goal was not reached in the groups A (n = 12) and B (n = 10). The most common reasons for excluding individuals identified as A or B were comorbidities contraindicating bronchoscopy, or inflammatory diseases/immune suppressive medication expected to affect the outcome. Conclusion: The study is expected to generate important results regarding pathophysiological mechanisms associated with rate of decline in lung function among subjects with COPD and the in-detail described recruitment process, including reasons for non-participation, is a strength when interpreting the results in forthcoming studies.

  • 6.
    Pauelsen, Mascha
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Vikman, Irene
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Johansson, Viktor
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Larsson, Agneta
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Röijezon, Ulrik
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Decline in sensorimotor systems explains reduced falls self-efficacy2018In: Journal of Electromyography & Kinesiology, ISSN 1050-6411, E-ISSN 1873-5711, Vol. 42, p. 104-110Article in journal (Refereed)
    Abstract [en]

    Physical performance including balance tasks is one of the main factors explaining the variance in falls self-efficacy in older adults. Balance performance is often measured by use of gross assessment scales, which assess the result of integration of all systems involved in postural control. We aimed to investigate which measurements of postural control correlate to falls self-efficacy scores as measured by the FES-I instrument, and which sensory and motor systems best explain them. A cross sectional study was designed, in which 45 older adults performed quiet stance and limits of stability trials during which their center of pressure (CoP) excursion was recorded. Falls self-efficacy was measured using the Falls Efficacy Scale - International. Eyesight, vestibular function, proprioception, reaction time and strength were also measured. Hierarchical orthogonal projection of latent structures was used to model FES-I with the CoP trials and then with the sensory and muscle function data. Fes-I could be explained to 39%, with the eyes open trials and the limits of stability trials loading the heaviest. The base model could be explained to 40% using the sensory and muscle function data, with lower limb strength, leg proprioception, neck proprioception, reaction time and eyesight loading the heaviest.

  • 7.
    Qvist, Linnea
    et al.
    Institute of Environmental Medicine, Karolinska Institutet.
    Nilsson, Ulf
    Department of Public Health and Clinical Medicine, Division of Medicine, Umeå University.
    Johansson, Viktor
    Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, The OLIN Unit, Umeå University.
    Larsson, Kjell
    Institute of Environmental Medicine, Karolinska Institutet.
    Rönmark, Eva
    Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, The OLIN Unit, Umeå University.
    Langrish, Jeremy
    BHF Centre for Cardiovascular Science, University of Edinburgh.
    Blomberg, Anders
    Department of Public Health and Clinical Medicine, Division of Medicine, Umeå University.
    Lindberg, Anne
    Department of Public Health and Clinical Medicine, Division of Medicine, Umeå University.
    Central arterial stiffness is increased among subjects with severe and very severe COPD: report from a population-based cohort study2015In: European Clinical Respiratory Journal, ISSN 2001-8525, Vol. 2, article id 27023Article in journal (Refereed)
    Abstract [en]

    ReferencesFootnoteAbout the AuthorsArticle MetricsRelated ContentDownload Article PDF EPUB XML Download ArticleCite Article Share Keywordsallergic rhinitis allergy asthma bacteria bronchoscopy cancer chronic obstructive pulmonary disease computed tomography copd eib endothelin endotypes epidemiology exercise-induced asthma genetic epidemiology idiopathic pulmonary fibrosis interstitial lung disease mortality respiratory failure sports vegf +Article ToolsPublish with UsSubmit a Manuscript Author Benefits Sign Up for eAlertsSearch Journal ContentRelated Tweets ORIGINAL RESEARCH ARTICLECentral arterial stiffness is increased among subjects with severe and very severe COPD: report from a population-based cohort studyLinnea Qvist1†, Ulf Nilsson2†, Viktor Johansson3, Kjell Larsson1, Eva Rönmark3, Jeremy Langrish4, Anders Blomberg2 and Anne Lindberg2*1Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; 2Department of Public Health and Clinical Medicine, Division of Medicine, Umeå University, Umeå, Sweden; 3OLIN Unit, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, Umeå, Sweden; 4BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United KingdomAbstractIntroduction: Cardiovascular disease (CVD) is common in chronic obstructive pulmonary disease (COPD) and is, as productive cough, related to poorer prognosis in COPD. Central arterial stiffness is a marker of early atherosclerosis, but the association between COPD, productive cough, and arterial stiffness as a possible indicator of CVD is unclear.Objectives: To compare both arterial stiffness among subjects with and without COPD and the impact of productive cough in a population-based cohort.Methods: A population-based cohort, including 993 COPD and 993 non-COPD subjects, has been invited to annual examination since 2005. In 2010, 947 subjects, of which 416 had COPD (according to the GOLD spirometric criteria), participated in examinations including structured interview, spirometry, and measurements of central arterial stiffness as pulse wave velocity (PWV).Results: PWV was higher in GOLD 3–4 compared to non-COPD (10.52 vs. 9.13 m/s, p=0.042). CVD and age ≥60 were both associated with significantly higher PWV in COPD as well as in non-COPD. In COPD, those with productive cough had higher PWV than those without, significantly so in GOLD 1 (9.59 vs. 8.92 m/s, p=0.024). In a multivariate model, GOLD 3–4 but not productive cough was associated with higher PWV, when adjusted for sex, age group, smoking habits, blood pressure, CVD, and pulse rate.Conclusions: GOLD 3–4, age ≥60, and CVD were associated with increased arterial stiffness, and also increased in COPD subjects with productive cough compared to those without. Of importance, GOLD 3–4 but not productive cough remained associated with increased central arterial stiffness when adjusted for confounders.

  • 8.
    Strandkvist, Viktor
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation. Norrbotten County Council.
    Hand grip strength and postural control among individuals with and without Chronic Obstructive Pulmonary Disease: Epidemiological and motion laboratory studies2019Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Background

    Chronic obstructive pulmonary disease (COPD) is estimated to affect approximately 8%–10% of all adults. The disease is considered to be a heterogenic syndrome with systemic effects, in which comorbidities including cardiovascular diseases, muscle dysfunction and fatigue are common. The majority of all individuals with COPD have mild to moderate disease (Global Initiative for Chronic Obstructive Lung Disease (GOLD) 1-2), and only a third are identified by health care, and this under-diagnosis contributes to a lack of knowledge of COPD in the population. COPD is related to skeletal muscle dysfunction, where muscle weakness, frequently assessed with hand grip strength (HGS), is one of the components. Evidence of postural control limitations among individuals with severe or very severe COPD has been emerging during the last decade. These limitations are partly related to muscle weakness, however, research of the other underlying systems of postural control is scarce, and an increased knowledge is of importance for the prevention of falls.

    Aim

    The main objective of the thesis was to increase the population-based knowledge about muscle strength, assessed as hand grip strength, and also postural control among individuals with and without COPD. Another objective was to investigate the value of hand grip strength measurements in relation to lower limb muscle strength and postural control among community-dwelling older adults.

    Methods

    Paper I and II are based on the population-based Obstructive Lung disease in Northern Sweden (OLIN) COPD study. All individuals with obstructive lung function impairment (n=993) and an age- and sex-matched group without (n=993) (COPD and non-COPD) were identified after re-examination of population based cohorts during 2002-04. They (n=1,986) have been invited to recurrent examinations including structured interviews and spirometry. Paper I (n=1011) and II (n=831) include data from examinations during 2009-2010 and 2014, respectively, where measurements of HGS (Paper I & II) as well as assessment of fatigue and physical activity (Paper II) were included. Paper III and IV are based on the population-based Balancing Human and Robot (BAHRT) study. Randomly selected individuals over 70 years of age were invited to participate in a study of postural control aspects, in their homes and at the 2 Human Health and Performance Lab- Movement Science, at Luleå University of Technology. The examinations included a structured interview as well as measurements of postural control and sensory and motor systems including HGS, lower limb strength, proprioception, pressure sensitivity, visual acuity, vestibular function and reaction time. Participants in Paper III consisted of communitydwelling individuals over 70 years of age (n=45). Paper IV consisted of individuals with COPD recruited from both the OLIN COPD study as well as the BAHRT-study (n=22), as well as a control group without airway obstruction from the BAHRT-study (n=34).

    Results

    In Paper I, there was no differences in mean HGS between the groups with and without COPD. However, HGS was related to disease severity; HGS was lower among those with severe to very severe COPD (GOLD 3-4) compared to nonCOPD, and HGS was associated with forced expiratory volume during 1 second % of predicted value (FEV1 % predicted) in regression models. Five years later, in Paper II, mean HGS was lower in COPD compared to non-COPD. Further, individuals with COPD and clinically relevant fatigue had lower HGS than those without clinically relevant fatigue, significantly so among men and close to among women. There was no clear association between HGS and level of physical activity. In Paper III, there was a strong and valid model showing association between HGS and lower limb strength, where all tested muscle groups were significantly correlated to hand grip strength. The regression model with HGS and postural control was significant, however, the model was weak. In Paper IV, individuals with COPD had worse postural control than those without COPD, significantly so regarding mediolateral amplitude in quiet stance with eyes open on soft/unstable surface, as well as anteroposterior limits of stability. In the COPD group, mediolateral amplitude was related to eye sight and the burden of tobacco smoking assessed as pack-years. Further, muscle strength associated with anteroposterior amplitude in the limits of stability test.

    Conclusions

    In the population-based OLIN COPD study in 2009-2010, mean HGS was significantly lower among individuals with severe to very severe COPD (GOLD 3-4) than those without COPD. Five years later, mean HGS was lower among all individuals with COPD (GOLD 1-4) compared to those without COPD, which may indicate altered aging process in COPD. HGS was associated to fatigue among individuals with COPD, while there were no associations between HGS and physical activity. HGS is a valid tool for the estimation of lower limb muscle strength among community-dwelling older adults, however, HGS is not 3 appropriate to use as an estimation of postural control. Postural control was impaired among individuals with COPD and different postural control assessments had different demands on the sensory and motor systems. The burden of tobacco smoking and visual acuity might be important for quiet stance trials with visual input, while muscle strength might be important for the more dynamic limits of stability test. Further research regarding the longitudinal aspects of muscle weakness and postural control among individuals with COPD is needed to gain knowledge for appropriate preventive or rehabilitative interventions.

  • 9.
    Strandkvist, Viktor
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation. Department of Public Health and Clinical Medicine, The OLIN Unit, Division of Occupational and Environmental Medicine , Umea University.
    Andersson, Mikael
    Department of Neuroscience, Physiotherapy, Uppsala University , Uppsala.
    Backman, Helena
    Department of Public Health and Clinical Medicine, The OLIN Unit, Division of Occupational and Environmental Medicine , Umeå University , Umeå.
    Larsson, Agneta
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Stridsman, Caroline
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Lindberg, Anne
    Department of Public Health and Clinical Medicine, Division of Medicine , Umeå University , Umeå.
    Hand grip strength is associated with fatigue among men with COPD: epidemiological data from northern Sweden2018In: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to investigate if hand grip strength (HGS) is associated with: 1) fatigue, and specifically clinically relevant fatigue (CRF); 2) low physical activity; and 3) fatigue independent of physical activity level, among individuals with and without COPD. Data were collected from the Obstructive Lung Disease in Northern Sweden (OLIN) COPD-study in 2014. HGS was measured with a hand-grip dynamometer, fatigue and physical activity were assessed by questionnaires; FACIT-Fatigue respectively IPAQ. Among individuals with COPD (n = 389), but not without COPD (n = 442), HGS was lower among those with CRF than those without CRF, significantly so among men (p = 0.001) and close to among women (p = 0.051). HGS was not associated with physical activity levels within any of the groups. HGS was associated with fatigue among men, but not women, with COPD independent of physical activity level, age, height, and smoking habits (Beta = 0.190, 95% CI 0.061-0.319, respectively Beta = 0.048, 95% CI-0.056-0.152), while there were no corresponding significant findings among individuals without COPD. In summary, HGS was associated with CRF among individuals with COPD in this population-based study. Among men with COPD, HGS was associated with fatigue independent of physical activity level and common confounders.

  • 10.
    Strandkvist, Viktor
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation. Norrbotten County Council.
    Lindberg, Anne
    Umeå University.
    Larsson, Agneta
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Pauelsen, Mascha
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Stridsman, Caroline
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Nyberg, Lars
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Backman, Helena
    Umeå University.
    Röijezon, Ulrik
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Postural control among individuals with and without chronic obstructive pulmonary disease: A study of motor and sensory systems.Manuscript (preprint) (Other academic)
  • 11.
    Strandkvist, Viktor
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation. Norrbotten County Council.
    Pauelsen, Mascha
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Larsson, Agneta
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Nyberg, Lars
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Vikman, Irene
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Lindberg, Anne
    Umeå University.
    Gustafsson, Thomas
    Luleå University of Technology, Department of Computer Science, Electrical and Space Engineering, Signals and Systems.
    Röijezon, Ulrik
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Hand grip strength is strongly associated with lower limb strength but only weakly with postural control in community-dwelling older adultsManuscript (preprint) (Other academic)
  • 12.
    Stridsman, Caroline
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care. The OLIN Studies.
    Svensson, My
    Department of Public Health and Clinical Medicine, The OLIN Unit/Division of Medicine, Umeå University.
    Johansson Strandkvist, Viktor
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Hedman, Linnea
    Luleå University of Technology, Department of Health Sciences, Nursing Care. Department of Public Health and Clinical Medicine, The OLIN Unit/Division of Occupational and Environmental Medicine, Umeå University.
    Backman, Helena
    Department of Public Health and Clinical Medicine, The OLIN Unit/Division of Occupational and Environmental Medicine, Umeå University.
    Lindberg, Anne
    Department of Public Health and Clinical Medicine, The OLIN Unit/Division of Medicine, Umeå University.
    The COPD Assessment Test (CAT) can screen for fatigue among patients with COPD2018In: Therapeutic advances in respiratory disease, ISSN 1753-4658, Vol. 12, article id 1753466618787380Article in journal (Refereed)
    Abstract [en]

    Background:

    Fatigue is one of the most common symptoms among subjects with chronic obstructive pulmonary disease (COPD), but is rarely identified in clinical practice. The aim of this study was to evaluate the association between fatigue and health-related quality of life (HRQoL) assessed with clinically useful instruments, both among subjects with and without COPD. Further, to investigate the association between fatigue and the COPD Assessment Test (CAT)-energy question.

    Methods:

    Data were collected in 2014 within the population-based OLIN COPD study. Subjects with (n = 367) and without (n = 428) COPD participated in clinical examinations including spirometry and completed questionnaires about fatigue (FACIT-Fatigue, clinically relevant fatigue ⩽43), and HRQoL (EQ-5D-VAS, lower score = worse health; CAT, lower score = fewer symptoms/better health).

    Results:

    Subjects with clinically relevant fatigue had worse HRQoL measured with EQ-5D-VAS, regardless of having COPD or not. Decreasing EQ-5D-VAS scores, any respiratory symptoms and anxiety/depression were associated with clinically relevant fatigue also when adjusted for confounders. Among subjects with COPD, clinically relevant fatigue was associated with increasing total CAT score, and CAT score ⩾10. The proportion of subjects with clinically relevant fatigue increased significantly, with a higher score on the CAT-energy question, and nearly 50% of those with a score of 2, and 70% of those with a score of ⩾3, had clinically relevant fatigue.

    Conclusions:

    Fatigue was associated with respiratory symptoms, anxiety/depression and worse HRQoL when using the clinically useful instruments EQ-5D-VAS and CAT. The CAT-energy question can be used to screen for fatigue in clinical practice, using a cut-off of ⩾2.

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