CHRONIC OBSTRUCTIVE PULMONARY DISEASE GROUP B AND C: ARE THEY REALLY THE OPPOSITE OF EACH OTHER REGARDING EXERCISE CAPACITY AND MUSCLE STRENGTH?

Year 2018, Volume: 29 Issue: 2, 18 - 23, 27.08.2018

İsmail Özsoy Serap Acar Sevgi Özalevli Atila Akkoçlu Sema Savcı

https://doi.org/10.21653/tjpr.351308

Abstract

Purpose: "Combined COPD
Assessment" in the classification of chronic obstructive pulmonary disease (COPD) was proposed as a new method
by The Global Initiative for Chronic Obstructive Pulmonary Disease (GOLD). The aim of this
study was to evaluate exercise capacity, and muscle strength (respiratory and peripheral
muscle strength) between two groups (Group B and C) of the new GOLD combined COPD assessment in this
study.

Methods: Patients were categorized into
group B (n=18) and C (n=18) according to the GOLD combined COPD assessment. Patients’
exercise capacity (the six-minute walk test [6MWT]) and the six-minute pegboard and ring test
[6PBRT]), respiratory muscle strength (maximal inspiratory pressure [MIP] and maximal expiratory
pressure [MEP]), and peripheral muscle strength (hand-grip and knee extensor strength) were assessed.

Results: The MEP value was significantly
higher in group B than in group C (p=0.024). Other values (6MWT distance, 6PBRT score, MIP values,
and peripheral muscle strength) were not significantly different between the two groups
(p>0.05).

Conclusion: This study shows that
comprehensive assessment is very important to evaluate patients with COPD. The GOLD spirometry
measures are not solely enough, symptoms and exacerbation
history must be evaluated.

Keywords

Chronic Obstructive Pulmonary Disease, Exercise Capacity, Muscle Strength

CHRONIC OBSTRUCTIVE PULMONARY DISEASE GROUP B AND C: ARE THEY REALLY THE OPPOSITE OF EACH OTHER REGARDING EXERCISE CAPACITY AND MUSCLE STRENGTH?

Abstract

Purpose: "Combined COPD Assessment" in the classification of chronic obstructive pulmonary disease (COPD) was proposed as a new method by The Global Initiative for Chronic Obstructive Pulmonary Disease (GOLD). The aim of this study was to evaluate exercise capacity, and muscle strength (respiratory and peripheral muscle strength) between two groups (Group B and C) of the new GOLD combined COPD assessment in this study.

Methods: Patients were categorized into group B (n=18) and C (n=18) according to the GOLD combined COPD assessment. Patients’ exercise capacity (the six-minute walk test [6MWT]) and the six-minute pegboard and ring test [6PBRT]), respiratory muscle strength (maximal inspiratory pressure [MIP] and maximal expiratory pressure [MEP]), and peripheral muscle strength (hand-grip and knee extensor strength) were assessed.

Results: The MEP value was significantly higher in group B than in group C (p=0.024). Other values (6MWT distance, 6PBRT score, MIP values, and peripheral muscle strength) were not significantly different between the two groups (p>0.05).

Conclusion: This study shows that comprehensive assessment is very important to evaluate patients with COPD. The GOLD spirometry measures are not solely enough, symptoms and exacerbation history must be evaluated.

Keywords

Chronic Obstructive Pulmonary Disease; Exercise Capacity; Muscle Strength.

References

• 1. Rosenberg SR, Kalhan R, Mannino DM. Epidemiology of Chronic Obstructive Pulmonary Disease: Prevalence, Morbidity, Mortality, and Risk Factors. Seminars in respiratory and critical care medicine. 2015 Aug;36(4):457-69.
• 2. The Global Initiative for Chronic Obstructive Lung Disease (GOLD). www.goldcopd.org [cited 10 November, 2017.].
• 3. ATS statement: guidelines for the six-minute walk test. American journal of respiratory and critical care medicine. 2002 Jul 01;166(1):111-7.
• 4. Spruit MA, Watkins ML, Edwards LD, Vestbo J, Calverley PM, Pinto-Plata V, et al. Determinants of poor 6-min walking distance in patients with COPD: the ECLIPSE cohort. Respiratory medicine. 2010 Jun;104(6):849-57.
• 5. Takeda K, Kawasaki Y, Yoshida K, Nishida Y, Harada T, Yamaguchi K, et al. The 6-minute pegboard and ring test is correlated with upper extremity activity of daily living in chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis. 2013;8:347-51.
• 6. Celli BR, Rassulo J, Make BJ. Dyssynchronous breathing during arm but not leg exercise in patients with chronic airflow obstruction. N Engl J Med. 1986 Jun 05;314(23):1485-90.
• 7. Zhan S, Cerny FJ, Gibbons WJ, Mador MJ, Wu YW. Development of an unsupported arm exercise test in patients with chronic obstructive pulmonary disease. J Cardiopulm Rehabil. 2006 May-Jun;26(3):180-7; discussion 8-90.
• 8. Marquis K, Debigaré R, Lacasse Y, LeBlanc P, Jobin J, Carrier G, et al. Midthigh muscle cross-sectional area is a better predictor of mortality than body mass index in patients with chronic obstructive pulmonary disease. American Journal of Respiratory and Critical Care Medicine. 2002;166(6):809-13.
• 9. Singer J, Yelin EH, Katz PP, Sanchez G, Iribarren C, Eisner MD, et al. Respiratory and skeletal muscle strength in chronic obstructive pulmonary disease: impact on exercise capacity and lower extremity function. J Cardiopulm Rehabil Prev. 2011 Mar-Apr;31(2):111-9.
• 10. Polkey MI, Kyroussis D, Hamnegard C-H, Mills GH, Green M, Moxham J. Diaphragm strength in chronic obstructive pulmonary disease. American journal of respiratory and critical care medicine. 1996;154(5):1310-7.
• 11. Levine S, Nguyen T, Kaiser LR, Rubinstein NA, Maislin G, Gregory C, et al. Human diaphragm remodeling associated with chronic obstructive pulmonary disease: clinical implications. American journal of respiratory and critical care medicine. 2003;168(6):706-13.
• 12. Sinderby C, Spahija J, Beck J, Kaminski D, Yan S, Comtois N, et al. Diaphragm activation during exercise in chronic obstructive pulmonary disease. American journal of respiratory and critical care medicine. 2001;163(7):1637-41.
• 13. Miller MR, Crapo R, Hankinson J, Brusasco V, Burgos F, Casaburi R, et al. General considerations for lung function testing. European Respiratory Journal. 2005;26(1):153-61.
• 14. Neder JA, Andreoni S, Lerario MC, Nery LE. Reference values for lung function tests. II. Maximal respiratory pressures and voluntary ventilation. Braz J Med Biol Res. 1999 Jun;32(6):719-27.
• 15. Andrews AW, Thomas MW, Bohannon RW. Normative values for isometric muscle force measurements obtained with hand-held dynamometers. Physical therapy. 1996;76(3):248-59.
• 16. Shechtman O, Gestewitz L, Kimble C. Reliability and validity of the DynEx dynamometer. J Hand Ther. 2005 Jul-Sep;18(3):339-47.
• 17. Annegarn J, Spruit MA, Savelberg HH, Willems PJ, van de Bool C, Schols AM, et al. Differences in walking pattern during 6-min walk test between patients with COPD and healthy subjects. PLoS One. 2012;7(5):e37329.
• 18. Hernandes NA, Wouters E, Meijer K, Annegarn J, Pitta F, Spruit M. Reproducibility of 6-minute walking test in patients with COPD. Eur Respir J. 2011;38(2):261-7.
• 19. Waatevik M, Johannessen A, Hardie JA, Bjordal JM, Aukrust P, Bakke PS, et al. Different COPD disease characteristics are related to different outcomes in the 6-minute walk test. COPD: Journal of Chronic Obstructive Pulmonary Disease. 2012;9(3):227-34.
• 20. KANAZAWA H. Association of six-minute walk distance (6MWD) with resting pulmonary function in patients with chronic obstructive pulmonary disease (COPD). Osaka City Med J. 2011;57:21-9.
• 21. Holland AE, Hill CJ, Nehez E, Ntoumenopoulos G. Does unsupported upper limb exercise training improve symptoms and quality of life for patients with chronic obstructive pulmonary disease? J Cardiopulm Rehabil. 2004 Nov-Dec;24(6):422-7.
• 22. Dolmage TE, Maestro L, Avendano MA, Goldstein RS. The ventilatory response to arm elevation of patients with chronic obstructive pulmonary disease. Chest. 1993 Oct;104(4):1097-100.
• 23. Pan L, Guo YZ, Yan JH, Zhang WX, Sun J, Li BW. Does upper extremity exercise improve dyspnea in patients with COPD? A meta-analysis. Respiratory medicine. 2012 Nov;106(11):1517-25.
• 24. Kim HC, Mofarrahi M, Hussain SN. Skeletal muscle dysfunction in patients with chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis. 2008;3(4):637-58.
• 25. Marquis K, Debigare R, Lacasse Y, LeBlanc P, Jobin J, Carrier G, et al. Midthigh muscle cross-sectional area is a better predictor of mortality than body mass index in patients with chronic obstructive pulmonary disease. American journal of respiratory and critical care medicine. 2002 Sep 15;166(6):809-13.
• 26. Mathur S, Brooks D, Carvalho CR. Structural alterations of skeletal muscle in copd. Frontiers in physiology. 2014;5:104.
• 27. Terzano C, Ceccarelli D, Conti V, Graziani E, Ricci A, Petroianni A. Maximal respiratory static pressures in patients with different stages of COPD severity. Respir Res. 2008 Jan 21;9:8.
• 28. Barreiro E, Gea J. Molecular and biological pathways of skeletal muscle dysfunction in chronic obstructive pulmonary disease. Chronic respiratory disease. 2016 Aug;13(3):297-311.
• 29. Barker BL, McKenna S, Mistry V, Pancholi M, Patel H, Haldar K, et al. Systemic and pulmonary inflammation is independent of skeletal muscle changes in patients with chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis. 2014;9:975-81.
• 30. Terzano C, Ceccarelli D, Conti V, Graziani E, Ricci A, Petroianni A. Maximal respiratory static pressures in patients with different stages of COPD severity. Respiratory research. 2008;9(1):8.