Assessment of Pulmonary Functions and Peripheral Muscle Strength of COPD Patients in Different GOLD Stages

Begüm Ünlü; Ufuk Yurdalan; İpek Özmen

doi:10.31067/acusaglik.898530

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Assessment of Pulmonary Functions and Peripheral Muscle Strength of COPD Patients in Different GOLD Stages

Year 2022, Volume: 13 Issue: 1, 140 - 149, 01.01.2022

Begüm Ünlü , Ufuk Yurdalan , İpek Özmen

https://doi.org/10.31067/acusaglik.898530

Abstract

Purpose: The purpose of this research was to examine the respiratory functions, respiratory muscle strength and peripheral muscle strength of COPD patients with different GOLD stages and to evaluate their correlation with the duration and prognosis of the disease in COPD.
Methods: Patient’s demographic information, clinical status, COPD Assessment Test score, mMRC Dyspnea Scale score, emergency and hospital admissions numbers in the last 3 months, number of exacerbation and hospitalizations in the last one year were recorded. Maximal mouth pressures were used for respiratory muscle strength. Peripheral muscle strength was evaluated with handgrip in the upper extremity. In the lower extremity knee extension and flexion strength were evaluated with a hand-held dynamometer. The findings of PFT performed during the regular hospital controls were obtained. GOLD stages of patients were determined according to GOLD combined assessment.
Results: Total of 31 COPD cases (5 females, 26 males, age 64.80 ± 7.71 years), including nine in Group B, five in Group C and 17 in Group D, were included in our study. There were statistically significant, negative, moderate correlations between all patients' respiratory functions and disease duration (p <0.05; for FVC% r: -0.410; for FEV1% r: -0.569; for MEF25-75% r: -0.451). There was a statistically significant, moderate, negative correlation between knee extension strength and numbers of exacerbations and hospitalizations over the last 1 year (p <0.05).
Conclusion: The results of the study suggest that non-respiratory symptoms and GOLD stages should also be considered in the planning of COPD follow-up and pulmonary rehabilitation programs.
Clinical trial registration number (NCT04803656), 09.03.2021 (retrospectively registered).

Keywords

COPD, pulmonary functions, peripheral muscle strength

Supporting Institution

Marmara University Scientific Research Projects Coordination Unit

Project Number

SAG-C-YLP-131217-0652

References

1. Kocabaş A, Atış S, Çöplü L, et al. Kronik obstrüktif akciğer hastaliği (KOAH) koruma, tani ve tedavi raporu 2014. Turk Thorac J 2014; 15.
2. Global Strategy For The Diagnosis, Management, And Prevention Of Chronic Obstructive Pulmonary Disease 2021 Report, available on the GOLD website: www.goldcopd.org access date 24.01.2021.
3. de Sá RB, Pessoa MF, Cavalcanti AGL, et al. Immediate effects of respiratory muscle stretching on chest wall kinematics and electromyography in COPD patients. Resp Physiol Neurobi 2017; 242: 1-7. DOI: 10.1016/j.resp.2017.03.002
4. Gea J, Agustí A, Roca J. Pathophysiology of muscle dysfunction in COPD. J Appl Physiol 2013; 114 (9): 1222-34. DOI: 10.1152/japplphysiol.00981.2012
5. Vilaró J, Ramirez-Sarmiento A, Martínez-Llorens JM, et al. Global muscle dysfunction as a risk factor of readmission to hospital due to COPD exacerbations. Respir Med 2010; 104: 1896 –1902. DOI: 10.1016/j.rmed.2010.05.001
6. Agusti A, Morla M, Sauleda J, et al. NF-κB activation and iNOS upregulation in skeletal muscle of patients with COPD and low body weight. Thorax 2004; 59 (6): 483-7. DOI: 10.1136/thx.2003.017640
7. Huertas A, Palange P. COPD: a multifactorial systemic disease. Ther Adv Respir Dis 2011; 5 (3): 217-24. DOI: 10.1177/1753465811400490
8. Rausch-Osthoff A-K, Kohler M, Sievi NA, et al. Association between peripheral muscle strength, exercise performance, and physical activity in daily life in patients with Chronic Obstructive Pulmonary Disease. Multidiscip Resp Med 2014; 9 (1): 37. DOI: 10.1186/2049-6958-9-37
9. Silva ALGD, Garmatz E, Goulart CDL, et al. Handgrip and functional capacity in Chronic Obstructive Pulmonary Disease patients. Fisioter Mov 2017; 30 (3): 501-7.
10. Celli BR, Cote CG, Marin JM, et al. The body-mass index, airflow obstruction, dyspnea, and exercise capacity index in chronic obstructive pulmonary disease. New Engl J Med 2004; 350 (10): 1005-12. DOI: 10.1056/NEJMoa021322
11. Yorgancioğlu A, Polatli M, Aydemir Ö, et al. KOAH değerlendirme testinin Türkçe geçerlilik ve güvenilirliği. Tuberk Toraks 2012; 60 (4): 314-20.
12. Graham BL, Steenbruggen I, Miller MR, et al. Standardization of spirometry 2019 update. An official American thoracic society and European respiratory society technical statement. Am J Resp Crit Care 2019; 200(8): 70-88. DOI: 10.1164/rccm.201908-1590ST.
13. Troosters T, Gosselink R, Decramer M. Respiratory muscle assessment. In: Gosselink R, Stam H, eds. Lung Function Testing. Wakefiels: European Respiratory Society Journals Ltd; 2005. p. 57-71.
14. Laveneziana P, Albuquerque, A, Aliverti A, et al. ERS statement on respiratory muscle testing at rest and during exercise. Eur Respir J 2019; 53(6): 1-34. DOI: 10.1183/13993003.01214-2018.
15. Haidar S, Kumar D, Bassi R, Deshmukh S. Average versus maximum grip strength: which is more consistent? J Hand Surg 2004; 29 (1): 82-4. DOI: 10.1016/j.jhsb.2003.09.012
16. Aslan Telci E, Baş Aslan Ü, Cavlak U. Sağlıklı quadriseps femoris kasında handheld dinamometrenin intrarater ve interrater güvenirliği: Kas kuvvetinin etkisi. Clin Exp Health Sci 2011; 1(2): 124-128.
17. Jackson H, Hubbard R. Detecting chronic obstructive pulmonary disease using peak flow rate: cross sectional survey. BMJ 2003; 327 (7416): 653-4. DOI: 10.1136/bmj.327.7416.653
18. Miller MR, Hankinson J, Brusasco V, et al. Standardisation of spirometry. Eur Respir J 2005; 26 (2): 319-38.
19. Pellegrino R, Viegi G, Brusasco V, et al. Interpretative strategies for lung function tests. Eur Respir J 2005; 26 (5): 948-68. DOI: 10.1183/09031936.05.00034805
20. Terzano C, Ceccarelli D, Conti V, et al. Maximal respiratory static pressures in patients with different stages of COPD severity. Respir Res 2008; 9 (1): 1-7. DOI: 10.1186/1465-9921-9-8
21. Gea J, Casadevall C, Pascual S, et al. Respiratory diseases and muscle dysfunction. Expert Rev Respir Med 2012; 6: 75–90. DOI: 10.1586/ers.11.81
22. Tudorache V, Oancea C, Mlădinescu OF. Clinical relevance of maximal inspiratory pressure: determination in COPD exacerbation. Int J Chronic Obst 2010; 5: 119-23.
23. Gosselink R, Troosters T, Decramer M. Peripheral muscle weakness contributes to exercise limitation in COPD. Am J Respir Crit Care Med 1996; 153: 976 –80. DOI: 10.1164/ajrccm.153.3.8630582
24. Swallow EB, Reyes D, Hopkinson NS, et al. Quadriceps strength predicts mortality in patients with moderate to severe chronic obstructive pulmonary disease. Thorax 2007; 62: 115–120. DOI: 10.1136/thx.2006.062026
25. Hopkinson NS, Tennant RC, Dayer MJ, Swallow EB, Hansel TT, Moxham J, et al. A prospective study of decline in fat free mass and skeletal muscle strength in chronic obstructive pulmonary disease. Respir Res 2007; 8 (1): 1-8. DOI: 10.1186/1465-9921-8-25
26. Jeong M, Kang HK, Song P, et al. Hand grip strength in patients with chronic obstructive pulmonary disease. Int J Chronic Obst. 2017; 12: 2385-90. DOI: 10.2147/COPD.S140915
27. Gayan-Ramirez G, Decramer M. Mechanisms of striated muscle dysfunction during acute exacerbations of COPD. J Appl Physiol 2013; 114 (9): 1291-9. DOI: 10.1152/japplphysiol.00847.2012
28. Bernard S, Leblanc P, Whittom F, Et al. Peripheral muscle weakness in patients with chronic obstructive pulmonary disease. Am J Resp Crit Care 1998; 158 (2): 629-34. DOI: 10.1164/ajrccm.158.2.9711023
29. Hamilton AL, Killian KJ, Summers E, Jones NL. Muscle strength, symptom intensity, and exercise capacity in patients with cardiorespiratory disorders. Am J Resp Crit Care 1995; 152 (6): 2021-31. DOI: 10.1164/ajrccm.152.6.8520771
30. Crul T, Spruit M, Gayan‐Ramirez G, et al. Markers of inflammation and disuse in vastus lateralis of chronic obstructive pulmonary disease patients. Eur J Clin Invest 2007; 37 (11): 897-904. DOI: 10.1111/j.1365-2362.2007.01867.x
31. Spruit M, Gosselink R, Troosters T, et al. Muscle force during an acute exacerbation in hospitalised patients with COPD and its relationship with CXCL8 and IGF-I. Thorax 2003; 58 (9): 752-6. DOI: 10.1136/thorax.58.9.752
32. Pitta F, Troosters T, Probst VS, et al. Physical activity and hospitalization for exacerbation of COPD. Chest 2006; 129 (3): 536-44. DOI: 10.1378/chest.129.3.536