The study, “Cardiorespiratory Responses to Glittre ADL Test in Bronchiectasis: A Cross-Sectional Study,” was published in the Canadian Respiratory Journal.
Bronchiectasis is a chronic respiratory disease characterized by sputum (a mixture of saliva and mucus) production, fatigue, and dyspnea (difficulty breathing). Bronchiectasis patients often experience reduced exercise capacity, and a decrease in their ability to carry out activities of daily living, such as walking and dressing.
The functional capacity of an individual and the limitations they encounter in performing activities of daily living can be assessed through questionnaires and field tests. However, self-reported questionnaires can be influenced by a number of factors, and they often are subject to recall bias (in which the patient’s recollections may not be accurate).
That is why it is difficult for questionnaire-type tests to provide accurate functional and exercise capacity information.
One of the most widely used field tests to measure a patient’s functional status is the six-minute walk test, which assesses the distance that a patient can walk on a flat, hard surface in a period of six minutes. This test is particularly beneficial as it is easy to implement, low cost, and highly representative of everyday activities.
Unfortunately, the six-minute walk test assesses only the capacity of an individual to move using their legs, and ignores the role of arms in many activities of daily living.
So, in 2006, the Glittre ADL test was developed, which evaluates the functional status and capacity of patients with chronic obstructive pulmonary disease (COPD) to carry out activities of daily living.
The Glittre ADL test is composed of a standardized 10-meter (11-yard) circuit, in which the individual is instructed to go through a sequence of activities in the shortest time. These activities include sitting, standing, walking, climbing stairs, and shifting objects — providing a more complete picture of functional capacity compared to the walk test.
While several studies have investigated the use of the Glittre ADL test in COPD patients, there is a lack of studies assessing its use in patients with bronchiectasis.
So, researchers from the Kasturba Medical College, Manipal Academy of Higher Education, in India, conducted a study to investigate whether the Glittre ADL test can be used in patients with bronchiectasis to evaluate functional capacity.
Specifically, they investigated whether the test can differentiate the functional capacity of patients with bronchiectasis from those of healthy individuals using the six-minute walk test as the standard.
Thirty subjects were recruited for the study — 15 with bronchiectasis, and 15 age- and gender-matched healthy subjects.
All participants underwent the Glittre ADL and six-minute tests on two consecutive days. Researchers recorded various parameters before and after the tests, including total time, distance walked, heart rate, respiratory rate, SpO2 (an estimate of the amount of oxygen in the blood), and dyspnea.
Results indicated that the performance on the Glittre ADL test by patients with bronchiectasis was significantly worse compared to the healthy group. While patients took an average of 4.78 minutes to finish the test, healthy subjects took 3.94 minutes.
On the other hand, while the average distance walked in the six-minute walk test by patients with bronchiectasis was 400.33 meters (437 yards) compared to 442 meters (483 yards) by healthy subjects, the results (an almost 42 meter, or 46-yard, difference) were considered not significant.
The bronchiectasis group also had a significantly higher increase in dyspnea and respiratory rate, compared to controls, in both the Glittre ADL test and six-minute walk test. The variation in heart rate was not significant between the groups in both tests.
These observations suggested that, in general, the results from the Glittre ADL test correlated well with results from the six-minute walk test.
In contrast, SpO2 was significantly different between the two groups in the six-minute walk test, but not in the Glittre ADL.
Based on the results, the team concluded that “the Glittre ADL test can differentiate between bronchiectasis and healthy subjects,” and suggested that “the Glittre ADL test can be used as an assessment tool besides the six-minute walk test for the more complete evaluation of functional capacity and activities of daily living,” they wrote.