Questionnaire-Based Assessment of Physical Disability in COPD
Abstract
Purpose: Chronic Obstructive Pulmonary Disease (COPD) is characterized by a progressive limitation of exercise capacity and functional disability, induced by both airway obstruction, skeletal muscle dysfunction and comorbidities, contributing to the disease burden. The Health Assessment Questionnaire – Disability Index (HAQ-DI), a validated tool assessing functional disability in rheumatologic diseases, with higher scores reflecting more severe disability, may be of interest in COPD. This study aimed to assess functional disability in COPD using the HAQ-DI and its association with disease severity and burden. Patients and Methods: Mild to very severe COPD patients were included in the RINNOPARI prospective cohort (NCT02924818). Pulmonary function tests and 6-minute walking test (6MWT) results, HRCT emphysema quantification, and patient-reported outcomes, including mMRC, CAT, SGRQ, EQ-5D and SF-36, were recorded. Functional disability was assessed using the French version of the HAQ-DI. Results: A total of 117 patients were included, with a median HAQ-DI score of 0.38 [0.0–0.75]. HAQ-DI scores were significantly higher in COPD GOLD 3–4 (0.50 [0.13–0.75] vs 0.25 [0–0.63] in COPD GOLD 1–2, p = 0.015). HAQ-DI was associated with cardiovascular and depression comorbidities (p < 0.05), COPD clinical features (number of exacerbations, p = 0.015; mMRC dyspnea score, CAT score and 6MWT distance, all p < 0.001), and COPD burden as assessed by SF-36, SGRQ and HAD anxiety and depression scores, p < 0.001 for all. Multivariate analysis identified the 6MWT distance, CAT, SGRQ, and HAD-Depression scores as independent factors associated with HAQ-DI. We further identified a « High Functional Disability » (HFD) phenotype defined by HAQ-DI ≥ 1 (n = 20), and characterized by COPD poor prognosis markers and severe disease burden. Conclusion: The HAQ-DI is a feasible tool for screening functional disability in COPD. It allowed the identification of a « high-risk, high burden » phenotype, which could benefit from personalised management such as pulmonary rehabilitation and psychological support.
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BibTeX
@article{rogier2026questionnairebased,
title = {{Questionnaire-Based Assessment of Physical Disability in COPD}},
author = {Joffroy Rogier and Alexandre Vivien and Loïs Bolko and Sandra Dury and Jean-Hugues Salmon and Valérian Dormoy and Julien Ancel and Gaëtan Deslee and Jeanne-Marie Perotin},
journal = {International Journal of Chronic Obstructive Pulmonary Disease},
year = {2026},
month = sep,
doi = {10.2147/copd.s615741},
url = {https://univ-reims.hal.science/hal-05743319v1},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Questionnaire-Based Assessment of Physical Disability in COPD
AU - Joffroy Rogier
AU - Alexandre Vivien
AU - Loïs Bolko
AU - Sandra Dury
AU - Jean-Hugues Salmon
AU - Valérian Dormoy
AU - Julien Ancel
AU - Gaëtan Deslee
AU - Jeanne-Marie Perotin
PY - 2026
DA - 2026/09/09
JO - International Journal of Chronic Obstructive Pulmonary Disease
DO - 10.2147/copd.s615741
UR - https://univ-reims.hal.science/hal-05743319v1
AB - Purpose: Chronic Obstructive Pulmonary Disease (COPD) is characterized by a progressive limitation of exercise capacity and functional disability, induced by both airway obstruction, skeletal muscle dysfunction and comorbidities, contributing to the disease burden. The Health Assessment Questionnaire – Disability Index (HAQ-DI), a validated tool assessing functional disability in rheumatologic diseases, with higher scores reflecting more severe disability, may be of interest in COPD. This study aimed to assess functional disability in COPD using the HAQ-DI and its association with disease severity and burden. Patients and Methods: Mild to very severe COPD patients were included in the RINNOPARI prospective cohort (NCT02924818). Pulmonary function tests and 6-minute walking test (6MWT) results, HRCT emphysema quantification, and patient-reported outcomes, including mMRC, CAT, SGRQ, EQ-5D and SF-36, were recorded. Functional disability was assessed using the French version of the HAQ-DI. Results: A total of 117 patients were included, with a median HAQ-DI score of 0.38 [0.0–0.75]. HAQ-DI scores were significantly higher in COPD GOLD 3–4 (0.50 [0.13–0.75] vs 0.25 [0–0.63] in COPD GOLD 1–2, p = 0.015). HAQ-DI was associated with cardiovascular and depression comorbidities (p < 0.05), COPD clinical features (number of exacerbations, p = 0.015; mMRC dyspnea score, CAT score and 6MWT distance, all p < 0.001), and COPD burden as assessed by SF-36, SGRQ and HAD anxiety and depression scores, p < 0.001 for all. Multivariate analysis identified the 6MWT distance, CAT, SGRQ, and HAD-Depression scores as independent factors associated with HAQ-DI. We further identified a « High Functional Disability » (HFD) phenotype defined by HAQ-DI ≥ 1 (n = 20), and characterized by COPD poor prognosis markers and severe disease burden. Conclusion: The HAQ-DI is a feasible tool for screening functional disability in COPD. It allowed the identification of a « high-risk, high burden » phenotype, which could benefit from personalised management such as pulmonary rehabilitation and psychological support.
SN - 1176-9106
SN - 1178-2005
ER -