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Usefulness of the Human Activity Profile, a Functional Performance Measure, in People With Chronic Obstructive Pulmonary Disease

Nield, Margaret PhD, RN, CS; Hoo, Guy Soo MD, MPH; Roper, Janice PhD, RN; Santiago, Silverio MD; Dracup, Kathleen DNSc, RN, FNP, FAAN

Journal of Cardiopulmonary Rehabilitation: March-April 2005 - Volume 25 - Issue 2 - p 115–121

PURPOSE To further evaluate the usefulness of the Human Activity Profile (HAP) as a functional performance measure for those with chronic obstructive pulmonary disease (COPD).

METHODS Phase 1. The sample consisted of 53 outpatients (51 male) with stable COPD (forced expiratory volume in 1 second% predicted (FEV1% pred) = 38 ± 14 (mean ± standard deviation) at a university-affiliated veterans affairs medical center. Variables were functional performance (HAP Maximal Activity Score [MAS], HAP Adjusted Activity Score [AAS]), dyspnea (modified Borg category-ratio scale and Shortness of Breath Questionnaire [SOBQ]), and exercise capacity (6-minute walk distance [6MWD]). Phase 2. The HAP was administered pre-post pulmonary rehabilitation in 48 (14 male) outpatients with stable COPD (FEV1% pred = 35 ± 15) at an outpatient pulmonary rehabilitation program at a large private hospital.

RESULTS Phase 1. Scores for MAS and AAS were, respectively, 62 ± 12 and 44 ± 15. The 6MWD, modified Borg, and SOBQ were, respectively, 1055 ± 372 ft, 4.1 ± 1, and 64.4 ± 22 ft. Correlations of the 6MWD and dyspnea scores with the AAS were strong and explained 40% of the AAS variation. Phase 2. The baseline MAS and AAS scores were 55 ± 14 and 42 ± 15, respectively, with 29/48 (60%) classified as “low fitness” on the basis of the AAS. Post-rehabilitation, there was significant improvement in the AAS score (48 ± 13) and significant reduction for those classified as “low fitness.”

CONCLUSIONS The utility of the HAP as a measure of functional performance improvement in COPD is supported by its relationship with both 6MWD and dyspnea and its responsiveness to pulmonary rehabilitation.

VA Greater Los Angeles Healthcare System, West Los Angeles, Calif (Drs Nield, Soo Hoo, Roper, and Santiago); University of California, Los Angeles (Drs Soo Hoo, Santiago, and Dracup); and University of California, San Francisco (Dr Dracup).

Address for Correspondence: Margaret Nield, PhD, RN, CS, VA Greater Los Angeles Healthcare System, West Los Angeles, 11301 Wilshire Blvd (111Q), Los Angeles, CA 90073 (e-mail:

This study was funded in part by a Rehabilitation Research Career Development Award, Department of Veterans Affairs, and a Clinical Research Grant, American Lung Association.

© 2005 Lippincott Williams & Wilkins, Inc.