Evaluate the patient’s physical capacities

An individual evaluation of the patient's physical capacity is necessary for every patient who is referred to a pulmonary rehabilitation program.

The patient's capacity to do physical exercise should be part of the initial evaluation of any patient who wishes to participate in a pulmonary rehabilitation program. In order to evaluate the patient, the evaluation of the latter's physical capacity will have to be repeated at the end of the program.

Different evaluation methods 

There are several different ways to evaluate a patient's physical capacity. Certain methods are more complex than others, or require more equipment, while still others require the patient to have more dexterity.

Questionnaires and tests

Questionnaires and tests are a simple way to verify a patient's physical capacity. Although the questionnaires remain subjective, they do help us observe the impact upon daily living.

• MRC shortness of breath scale
• Questionnaires on quality of life: CAT (COPD Assessment Test); SF-36;
  CRQ (Chronic Respiratory Disease Questionnaire;
  St. George's Hospital Respiratory Questionnaire;
  Hospital Anxiety and Depression (HAD) Scale
• Questionnaires on physical activity (FR)

The six-minute walk test

This test is widely used in Canada, since it is simple and easily administered by the patient. However, this test has a few drawbacks and should not be favoured as an instrument to measure the progress of the patient's physical capacity as they proceed through the program. It is thus a good prognostic tool, but is not the best assessment tool due to the test's weak sensitivity to change.

The Incremental Maximal Exercise Test (Jones test)

This test provides detailed physiological data that can be useful in evaluating the patient's exercise limits and prescribing the appropriate exercises. It is generally done on a treadmill or a stationary bicycle. This test is more sensitive to changes in the patient's physical capacity following a rehabilitation program. However, it is far more complex than the six-minute walk test. In addition, it requires technical equipment, is more costly and is usually only done in more specialized centres.

The Shuttle Walk Distance Test 

This walk test is actually an endurance test. It was developed to stimulate cardiovascular exertion during a walk test. The patient begins the test by walking slowly, but must increase their pace as the test progresses. The patient has to walk until they are either too out of breath or can't keep up the pace that is required. At that time, the test ends. The results of such a test are influenced less by a patient's motivation, provide better data on the physical capacity of patients with chronic pulmonary diseases, and can be a more sensitive indicator of the changes that occur during a pulmonary rehabilitation program. This test is very useful for more precisely prescribing the intensity of the walking exercise portion of the exercise program.

For more information about these tests and other measurement instruments, please click here