Do Physical Signs Reflect the Degree of Airflow Obstruction in Patients with Asthma or Chronic Obstructive Pulmonary Disease?

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Abstract
The aim of the study was to relate the physical signs of the chest to the degree of airflow obstruction in asthma and COPD. Methods: 113 patients with COPD and 76 patients with asthma were recruited from general practice. A standard physical examination of the chest was performed by trained medical students. Physical signs were related to the degree of airflow obstruction. Results: the signs correlating closely with the degree of airflow obstruction were: a prolonged expiratory phase, low-standing diaghragm, decreased expiratory breath sounds, noisy inspiratory sounds, and decreased diaphragmatic excursions. There was a fair correlation between the number of physical signs and the degree of airflow obstruction. This was especially the case in asthma (r=0.62), but it was less clear in COPD (r=0.45). Sensitivity of separate physical signs to detect airflow obstruction was less than 50%, but at least one of the signs was present in 70% of the patients with obstruction. Specificity of separate signs was more than 85%, apart from wheezing in asthma. Conclusion: the combination of physical signs can offer relevant information in monitoring the severity of airflow obstruction in asthma and COPD.