30-s Chair stand test and 30 meter walk test – related to acute visits due to respiratory problems in COPD patients Results from the TIE-study Regina Bendrik 1,2, Andrei Malinovschi 3, Marieann Högman3, Karin Lisspers1, Björn Ställberg1, Kristina Bröms1,2, TIE-study-group ¹Dept. of Public Health and Caring Sciences Medicine, Uppsala University, Uppsala, Sweden ²Centre for Research & Development, Uppsala University/Region Gävleborg, Sweden ³Dept. of Medical Sciences, Uppsala University, Uppsala, Sweden TIE= tools identification exacerbations

TIE-study Multicenterstudy in primary- and secondary care Counties in Mid-Sweden: Gävleborg, Dalarna, Uppsala TIE is a prospectiv cohort study. We are still including patients. The goal is to include 600 patients. At baseline there are multiple tests for example physical tests, answering a questionnaire and spirometry. Follow-ups at one and two years after baseline. I will present baselinedata today.

Aim Investigate if 30-meter walk-test or 30-second Chair stand test are related to acute visits due to respiratory problems and exacerbations

Method COPD-diagnosis - physician and spirometry verified Lung function - GOLD-stage 1-4 Age 69 years (range 47-87 years) 299 patients (58% women) No history of stroke/TIA

Method Physical capacity Time to walk 30 meters at maximal velocity Number of repetitions of 30-s Chair stand test  Acute visits due to respiratory problems and exacerbations during last year were assessed by questionnaire Exacerbation is defined as acute visit due to respiratory problems and treated with antibiotica or oral steroids.

Result A trend to longer time to walk 30m and fewer repetitions in Chair-stand test with more severe GOLD-stage GOLD stage % 30m walk test (s) Chair stand 30-s (times) 1 (n=22) 7 20.8 11.9 2 (n=162) 54 19.0 11.7 3 (n=86) 29 21.8 10.5 4 (n=29) 10 24.6 9.8 P<0.001

Results Acute visits last year were related to longer time to walk 30m and fewer repetitions of sit to stand 30m walk test Acute visits (n=109) No acute visits (n=187) 21.5 19.8 P=0.03 30-s Chair stand test Acute visits (n=109) No acute visits (n=187) 10.5 11.6 P =0.003

Results A history of COPD exacerbations last year were related to fewer repetitions of sit to stand 30m walk test Exacerbations (n=87) No exacerbations (n=204) 21.2 19.9 P=0.10 30s Chair stand test Exacerbations (n=85) No exacerbations (n=201) 10.4 11.5 P=0.008

Results 30-s Chair stand test Fewer repetitions of sit-to stand related to acute visits (p=0.008) exacerbations (p=0.04) (adjusted for lung function, gender, age and current smoking)

Conclusion Data suggest a relation between 30-s Chair stand test and a history of acute visits due to respiratory problems and exacerbations in patients with COPD Further studies should look at the prospective value of the test as well as its’ additive value to lung function measurements

Thank you! TIE-study group regina.bendrik@regiongavleborg.se Marieann Högman Professor Dept. of Medical Sciences, Uppsala University, Uppsala, Sweden; Centre for Research & Development, Uppsala University/Region Gävleborg Andrei Malinovschi MD, Associate Professor, Dept. of Medical Sciences, Uppsala University, Uppsala Björn Ställberg MD, PhD, Dept. of Public Health and Caring Science, Family Medicine and Preventive Medicine, Uppsala University Karin Lisspers MD, PhD, Dept. of Public Health and Caring Science, Family Medicine and Preventive Medicine, Uppsala University Kristina Bröms MD, PhD, Centre for Research & Development, Uppsala University/Region Gävleborg, Sweden; Dept. of Public Health and Caring Sciences, Uppsala University Christer Janson MD, Professor, Dept. of Medical Sciences, Uppsala University, Uppsala Hans Hedenström MD, Associate Professor, Dept. of Medical Sciences, Uppsala University Hirsh Koyi MD, PhD, Centre for Research & Development, Uppsala University/Region Gävleborg Eva Brandén MD, PhD, Centre for Research & Development, Uppsala University/Region Gävleborg Jonas Lundkvist Health Economist, PhD, Dept of Pharmacy, Uppsala University, Sweden PhD students Alexandra Thornadtsson PhD student, Centre for Research & Development, Uppsala University/Region Gävleborg, Dept. of Medical Sciences, Uppsala University, Uppsala Margareta Gonzaléz Lindh SLP, PhD student, Centre for Research & Development, Uppsala University/Region Gävleborg, Dept. of Neuro Science, Uppsala University Jens Ellingsen MD, PhD student, Dept. of Medical Sciences, Uppsala University Johanna Sulku Clin. Pharmacist, PhD student, Centre for Research & Development, Uppsala University/Region Gävleborg, Dept. of Pharmaceutical Biosciences, Uppsala University Regina Bendrik Physiotherapist, PhD student, Centre for Research & Development, Uppsala University/Region Gävleborg, Dept. of Public Health and Caring Sciences, Uppsala University regina.bendrik@regiongavleborg.se