Abstract Objectives To systematically review the instruments used to assess postural control and fear of falling in people with chronic obstructive pulmonary disease (COPD), and to synthesize and ...evaluate their breadth of content and measurement properties. Data Sources MEDLINE, EMBASE, Web of Science, CINAHL, CENTRAL, PsycINFO, PEDro, and OTSeeker databases searched in September 2012. Study Selection Two independent reviewers performed the selection of articles, the ICF linking process and quality assessment. Only quantitative studies were included, irrespective of language or publication date. Data Extraction This systematic review comprised two phases. Phase 1 aimed to identify the commonly used instruments to assess postural control and fear of falling in the COPD literature. The breadth of content of each instrument was examined based on the International Classification of Functioning, Disability and Health (ICF). In phase 2, a measurement property search filter was adopted and used in four electronic databases to retrieve properties reported in the COPD population. The COSMIN checklist was used to assess the methodological quality of each measurement property reported. Data Synthesis Seventeen out of 401 publications were eligible in phase 1. Seventeen instruments were identified including 15 for postural control and 2 for fear of falling assessment. The Berg Balance Scale, the Short Physical Performance Battery, and the Activities-specific Balance Confidence (ABC) scale were the most frequently used instruments to assess postural control and fear of falling respectively. The ICF categories covered varied considerably among instruments. The Balance Evaluation Systems test and ABC presented the greatest breadth of content. Measurement properties reported included criterion predictive validity (4 instruments), construct validity (11 instruments) and responsiveness (1 instrument), with inconsistent findings based on ‘fair’ and ‘poor’ quality studies. Conclusions Different instruments with heterogeneous content have been used to assess postural control and fear of falling outcomes. Standardized assessment methods and best evidence on measurement properties is required in the COPD literature.
Introduction. Physical activity (PA) is important in lung cancer. Objectives. To investigate PA levels and health-related quality of life (HRQoL) of patients with lung cancer in China and compare ...this to a similar cohort in Australia. Methods. Prospective cohort study. 71 patients from China (group CH) and 90 patients from Australia (group AU) with newly diagnosed lung cancer. Questionnaires assessed self-reported PA levels and HRQoL at baseline (diagnosis) and 8 weeks. Results. At baseline, group CH were engaged in less overall PA than group AU (Physical Activity Scale for the Elderly PASE total score: median IQR group CH, 56 32-59; group AU, 66 38-116; P < .005), and less occupational and household activity (P < .005). However, at baseline, group CH reported significantly more walking time than group AU (median IQR: group CH, 210 150-315 min/wk; group AU, 550-210 min/wk; P < .0005). Global HRQoL scores were similar between groups (P = .038). Over 8 weeks, group CH increased their overall PA levels (P < .005) and walking time (P = .008), and HRQoL remained unchanged. The comparison group AU experienced a reduction in PA levels (P = .02) and HRQoL (P < .005). Conclusions. A diagnosis, patients in China were less physically active than those in Australia. Following diagnosis, patients in China increased their PA levels, whereas those in Australia reduced their PA levels. Research is required to explore potential reasons behind differences, and this may inform research/clinical services to facilitate patients with lung cancer to be more active.
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