Performance-based outcome measures for assessing physical capacity in patients with pulmonary embolism: A scoping review

Thrombosis Research, vol. 235, pp. 52–67

Abstract

INTRODUCTION: Up to 50 % of patients surviving a pulmonary embolism (PE) report persisting shortness of breath, reduced physical capacity and psychological distress. As the PE population is heterogeneous compared to other cardiovascular patient groups, outcome measures for assessing physical capacity traditionally used in cardiac populations may not be reliable for the PE population as a whole. This scoping review aims to 1) map performance-based outcome measures (PBOMs) used for assessing physical capacity in PE research, and 2) to report the psychometric properties of the identified PBOMs in a PE population. METHODS: The review was conducted according to the Joanna Briggs Institute framework for scoping reviews and reported according to the PRISMA-Extension for Scoping Reviews guideline. RESULTS: The systematic search of five databases identified 4585 studies, of which 243 studies met the inclusion criteria. Of these, 185 studies focused on a subgroup of patients with chronic thromboembolic pulmonary hypertension. Ten different PBOMs were identified in the included studies. The 6-minute walk test (6MWT) and cardiopulmonary exercise test (CPET) were the most commonly used, followed by the (Modified) Bruce protocol and Incremental Shuttle Walk test. No studies reported psychometric properties of any of the identified PBOMs in a PE population. CONCLUSIONS: Publication of studies measuring physical capacity within PE populations has increased significantly over the past 5-10 years. Still, not one study was identified, reporting the validity, reliability, or responsiveness for any of the identified PBOMs in a PE population. This should be a priority for future research in the field.

Authors 7

1. Christina Krogner Caspersen

   Aarhus University Hospital

   Affiliation as printed

   Department of Physiotherapy and Occupational Therapy, Aarhus University Hospital, Denmark

2. Stian Ingemann-Molden

   Aalborg University Hospital

   Affiliation as printed

   Department of Physiotherapy and Occupational Therapy, Aalborg University Hospital, Denmark

3. Erik Lerkevang Grove

   Aarhus University · Aarhus University Hospital

   Affiliation as printed

   Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark

   Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark

   Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark

4. Anette Arbjerg Højen

   Aalborg University Hospital · Aalborg University

   Affiliation as printed

   Department of Health Science and Technology, Aalborg University, Denmark; Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark

   Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark

   Department of Health Science and Technology, Aalborg University, Denmark

5. Jane Andreasen

   Aalborg University Hospital · Aalborg University

   Affiliation as printed

   Department of Physiotherapy and Occupational Therapy, Aalborg University Hospital, Denmark; Department of Health Science and Technology, Aalborg University, Denmark; Aalborg Health and Rehabilitation Centre, Aalborg Municipality, Denmark

   Aalborg Health and Rehabilitation Centre, Aalborg Municipality, Denmark

   Department of Health Science and Technology, Aalborg University, Denmark

   Department of Physiotherapy and Occupational Therapy, Aalborg University Hospital, Denmark

6. Frederikus Albertus Klok Aachen Dept of Medicine - Thrombosis and Hemostasis

   Leiden University Medical Center

   Affiliation as printed

   Department of Medicine - Thrombosis and Hemostasis, Leiden University Medical Center, the Netherlands

   Department of Medicine – Thrombosis and Hemostasis, Leiden University Medical Center, the Netherlands

7. Nanna Rolving corresponding

   Aarhus University · Aarhus University Hospital

   Affiliation as printed

   Department of Physiotherapy and Occupational Therapy, Aarhus University Hospital, Denmark; Department of Public Health, Aarhus University, Denmark. Electronic address: Nanna.Rolving@rm.dk

   Department of Physiotherapy and Occupational Therapy, Aarhus University Hospital, Denmark

   Department of Public Health, Aarhus University, Denmark