If you have COPD you may be familiar with the BODE index, what is stands for and what it is used for.
If you are not familiar with the terminology, this article will break down important information about COPD, the BODE Index, and the tests to determine the current BODE Index stage.
The BODE index stands for body mass, obstruction of airflow, dyspnea and exercise capacity. This index is measured by the six-minute walk test, or any other test the doctor may use to test the patients breathing.
The Index is ranged from a scale of 1-10 (after all 4 things have been totaled together), 10 being the worst.
Points are given based on 4 things FEV1 (forced expiratory volume in 1 second), exercise (most likely one listed below), dyspnea scale, and body mass.
The FEV1 test ranges from 0-3 points, 3 being the patient has expelled less than 35% of forced air.
Normally the six-minute walk test, the exercise required of a patient can also be ranked from 0-3. 3 will be given if the patient cannot walk more than 149 meters without being exhausted.
The dyspnea scale is also 0-3, 3 being the patient cannot leave their home and they get exhausted from dressing and undressing.
Lastly, the body mass index is on a scale on 0-1, 0 points being given if their body mass index is smaller than 21, 1 point given if their BMI is higher than or equal to 21.
This index is used to determine the severity of COPD and can help figure out the best treatment path for the patient.
Some of Pulmonary Function Tests (PFT) used for BODE index testing include: spirometry, body plethysmography, gas diffusion test and the 6 minute walk test.
Pulmonary Function Testing is a broad term for a handful of tests that mainly measure the amount of air the patient is inhaling and exhaling.
Airway resistance (RAW) is a measure of airway obstruction and indicates to the doctor that the alveolar pressure is not what is needed to establish a flow rate.
RAW is the difference between mouth and alveoli, divided by airflow. This gives doctors a number to see if there is any need for additional oxygen or other medications.
Spirometry is the process of a doctor using a device called a spirometer, which is connected to a machine that reads out how much and how often the patient inhales and exhales.
There is a small mouthpiece the patient will wear when doing the test, and it will be the small device that measures your breath.
While getting a spirometry done, the patient will have their nose plugged so that the device can measure an accurate number of what the patient is breathing in a certain time frame.
A spirometry may be based on how deep and quick the patient can breathe in and out, depending on what the doctor wants to test.
Sometimes, spirometry may also have medication to help open up their lungs and then measure any change the medication may have on their lung function.
Lung Plethysmography is the process of sitting in an airtight room, that measures pressure, flow and volume changes in the room.
This test also measures the amount of gas in the patients lungs (their lung volume).
Doctors use this test to those who currently have a lung disease and see if there is a decrease in total lung capacity (TLC). TLC is based on the amount of air in the patients lungs after a very deep breath.
Gas Diffusion Tests measure the amount of oxygen and carbon dioxide in their bloodstream. This test is used to see if there is any issue getting oxygen from their lungs to their body.
When they breathe they take in oxygen, which goes to the alveoli and into the bloodstream. This test also measures the speed of carbon dioxide from the blood to the lungs.
This test is used by doctors to assess current lung disease patients or diagnose lung diseases.
When the patient goes in for a diffusion test, they should expect a mouthpiece to be placed in their mouth and a plugged nose.
From there, they will breathe in air, hold it for a few seconds and then exhale quickly.
This air will be analyzed by the doctor to look at how much oxygen and carbon dioxide are hanging around in the lungs.
The 6 minute walk test is used to see if the patient can walk for 6 minutes on a flat, hard surface, similar to a concrete floor, no more than 100-ft long. During this time, the doctor or nurse may take additional tests as they are walking.
This test will see the maximum capacity that the patient can handle, both in physically exercise, as well as oxygen intake.
Conclusion
If you are the patient, or family and friends, learning more about the BODE Index and how the scores are achieved can give a better understanding to COPD.
There are a lot of different tests used to determine the BODE score, and different exercises may be used as well.
Your doctor will customize your testing based on your needs and capabilities, they most likely won't require you to do the 6 minute walk test if you require a wheelchair or walker.