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Chronic obstructive pulmonary disease is a major cause of morbidity and mortality worldwide and an important cause of disability. A thorough patient-centered outcome assessment, including not only measures of lung function, exercise capacity, and health-related quality of life, but also functional capacity and performance in activities of daily life, is imperative for a comprehensive management of chronic obstructive pulmonary disease. This American Thoracic Society Seminar Series is devoted to help clinicians substantiate their choice of functional outcome measures in this population. In Part 1 of this two-part seminar series, we describe the various domains of functional status to elucidate terms and key concepts intertwined with functioning and to demonstrate the clinical relevance of assessing functional capacity in the context of activities of daily living in agreement with the International Classification of Functioning, Disability, and Health. We hope that a better understanding of the various defining components of functional status will be instrumental to healthcare providers to optimize chronic obstructive pulmonary disease evaluation and management, ultimately leading to improved quality of life of patients afflicted by this condition. This first article also serves as an introduction to Part 2 of this seminar series, in which the main functional tests available to assess upper and lower body functional capacity of these patients are discussed. [ABSTRACT FROM AUTHOR]

Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality worldwide and an important cause of disability and handicap. For a thorough patient-centered outcome assessment and comprehensive management of the disease, measures of lung function, exercise capacity, and health-related quality of life, but also of functional capacity in activities of daily life, are necessary. In Part 2 of this seminar series, we discuss the main functional tests to assess upper and lower body functional capacity in patients with COPD to help clinicians substantiate their choice of functional outcome measures in COPD. In agreement with the International Classification of Functioning, Disability and Health to assess functional capacity representative of daily life activities, this review focuses on functional tests that include components such as changing and maintaining body positions, walking, moving, and climbing, as well as carrying, moving, and handling objects. We review the validity, reliability, and responsiveness of these tests. With 11 links to the International Classification of Functioning, Disability and Health framework addressing several upper and lower body components of functional activities, the Glittre Activities of Daily Life test seems to be the most promising and comprehensive test to evaluate functional capacity in activities of daily life. The links between functional capacity tests and real participation in daily life, as well as with important clinical outcomes such as morbidity and mortality, need further investigation. More studies are also recommended to document minimal detectable changes, minimal clinically important differences, and normative values for these functional tests. [ABSTRACT FROM AUTHOR]