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The Relationship of Exercise Capacity with Peripheral Muscle Strength and Lung Functıons in Lung Transplantion Candidates

Yıl 2019, Cilt: 10 Sayı: 38, 77 - 81, 15.12.2019
https://doi.org/10.17944/mkutfd.538403

Öz

Aim: We aimed to investigate the relationship between functional exercise capacity level and muscle strength and lung functions in the lung transplantation (LTx) candidates.

Materials and Methods: Twenty-five patients who were referred to our hospital for the pre-transplantation pulmonary rehabilitation program were included in the study. Patients were divided into 2 groups according to the 6-min walk test walking distance (Group1: 6MWD<350m; n:14, Group2: 6DWD≥350m, n=11).The percentage of muscle and fat masses, peripheral muscle forces were compared and the relationship between the muscle mass, muscle strength, lung functions and the exercise capacity level were examined. 

Results: The groups have similar demographic characteristics (age, body mass index). Muscle masses (p=.956), lean tissue (p=.956), fat masses (p=.827), fat percentages (p = .701) were similar. When the peripheral muscle strengths were compared, the knee extension, elbow flexion and hand grip strengths were similar, and the dorsiflexion muscle strength (p=.039) and FEV1% (p = 0.030) values of group 1 were found to be statistically low. The correlation between 6MWD and other outcome measures, there were moderate correlation with elbow flexion (r =.483; p=.015), dorsiflexion (r =.518; p=.008) and %FEV1 (r =.514; p=.009) and high level correlation with %FVC (r=.605; p=.001).

Conclusion: In our study, the exercise capacities of LTx candidates are independent of muscle and fat mass and are influenced by muscle strength and lung functions. This suggests that exercise capacity is related to primary lung pathology in this patient group. In order to obtain more meaningful results, post-rehabilitation changes should be examined.

Kaynakça

  • Kugler C, Gottlieb J, Warnecke G, et al. Health-related quality of life after solid organ transplantation: a prospective, multiorgan cohort study. Transplantation 2013; 96:316-323
  • Spruit MA, Singh SJ, Garvey C, et al. An official American Thoracic Society/European Respiratory Society statement: key concepts and advances in pulmonary rehabilitation. Am J Respir Crit Care Med 2013; 188:e13-64
  • Mathur S, Hornblower E, Levy RD. Exercise training before and after lung transplantation. Phys Sportsmed 2009; 37:78-87
  • van Adrichem EJ, Reinsma GD, van den Berg S, et al. Predicting 6-minute walking distance in recipients of lung transplantation: longitudinal study of 108 patients. Phys Ther 2015; 95:720-729
  • Reinsma GD, ten Hacken NH, Grevink RG, et al. Limiting factors of exercise performance 1 year after lung transplantation. J Heart Lung Transplant 2006; 25:1310-1316
  • Falque L, Gheerbrant H, Saint-Raymond C, et al. [Selection of lung transplant candidates in France in 2019]. Rev Mal Respir 2019; 36:508-518
  • Pirard L, Marchand E. Reassessing the BODE score as a criterion for listing COPD patients for lung transplantation. Int J Chron Obstruct Pulmon Dis 2018; 13:3963-3970
  • Mathur S, Reid WD, Levy RD. Exercise limitation in recipients of lung transplants. Phys Ther 2004; 84:1178-1187
  • Maury G, Langer D, Verleden G, et al. Skeletal muscle force and functional exercise tolerance before and after lung transplantation: a cohort study. Am J Transplant 2008; 8:1275-1281
  • Dudley KA, El-Chemaly S. Cardiopulmonary exercise testing in lung transplantation: a review. Pulm Med 2012; 2012:237852
  • Walsh JR, Chambers DC, Davis RJ, et al. Impaired exercise capacity after lung transplantation is related to delayed recovery of muscle strength. Clin Transplant 2013; 27:E504-511
  • Rasekaba T, Lee AL, Naughton MT, et al. The six-minute walk test: a useful metric for the cardiopulmonary patient. Intern Med J 2009; 39:495-501
  • Pehlivan E, Balci A, Kilic L, et al. Preoperative Pulmonary Rehabilitation for Lung Transplant: Effects on Pulmonary Function, Exercise Capacity, and Quality of Life; First Results in Turkey. Exp Clin Transplant 2018; 16:455-460
  • 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
  • Decramer M, Gosselink R, Troosters T, et al. Muscle weakness is related to utilization of health care resources in COPD patients. Eur Respir J 1997; 10:417-423
  • Machado FVC, Schneider LP, Fonseca J, et al. Clinical impact of body composition phenotypes in patients with COPD: a retrospective analysis. Eur J Clin Nutr 2019
  • Oshima A, Nishimura A, Chen-Yoshikawa TF, et al. Nutrition-related factors associated with waiting list mortality in patients with interstitial lung disease: A retrospective cohort study. Clin Transplant 2019:e13566
  • Nytroen K, Rustad LA, Gude E, et al. Muscular exercise capacity and body fat predict VO(2peak) in heart transplant recipients. Eur J Prev Cardiol 2014; 21:21-29
  • Van Der Woude BT, Kropmans TJ, Douma KW, et al. Peripheral muscle force and exercise capacity in lung transplant candidates. Int J Rehabil Res 2002; 25:351-355
  • Pradon D, Roche N, Enette L, et al. Relationship between lower limb muscle strength and 6-minute walk test performance in stroke patients. J Rehabil Med 2013; 45:105-108

Akciğer Nakil Adaylarında Egzersiz Kapasitesinin Periferik Kas Kuvveti Ve Solunum Fonksiyonları İle İlişkisi

Yıl 2019, Cilt: 10 Sayı: 38, 77 - 81, 15.12.2019
https://doi.org/10.17944/mkutfd.538403

Öz

Amaç: Çalışmamızda akciğer nakil adaylarında fonksiyonel egzersiz kapasitesi seviyesinin, periferik kas gücü ve solunum fonksiyonları ile olan ilişkisini incelemeyi amaçladık.

Gereç ve Yöntem: Hastanemiz pulmoner rehabilitasyon merkezinde, akciğer nakli öncesi rehabilitasyon programına alınması için refere edilen 25 hasta çalışmaya dahil edildi. Hastalar 6 -dakika yürüyüş testi yürüme mesafelerine (6DYM) göre 2 gruba ayrıldı (Grup1: 6DYM<350m, n:14; Grup2: 6DYM≥350m, n=11). Grupların kas ve yağ kütle ve yüzdeleri, periferik kas kuvvetleri karşılaştırıldı, egzersiz kapasitesi seviyesinin kas kütlesi ve solunum fonksiyonları ile olan ilişkisi incelendi. 

Bulgular: Gruplar benzer demografik özelliklere sahipti (yaş, beden kitle indeksi). Kas kütleleri (p=,956), yağsız doku yüzdeleri (p=,956), yağ kütleleri (p=,827) ve vücut yağ yüzdeleri (p=,701) benzerdi. Periferik kas kuvvetleri karşılaştırıldığında diz ekstansiyonu, dirsek fleksiyonu ve el kavrama kuvvetleri benzer olup, Grup1’in dorsifleksiyon kas kuvvetinin (p=,039) ve FEV1% (p=0,033) değerlerinin istatistiksel olarak daha düşük olduğu tespit edildi. 6DYM ile diğer sonuç ölçümleri arasında yapılan ilişki analizinde dirsek fleksiyonu (r=,483; p=,015), dorsifleksiyon (r=,518; p=,008) kas kuvveti ve FEV1% (r=,514; p=,009) ile orta, FVC% (r=,605; p=,001)  ile ise yüksek seviyede korelasyon tespit edildi.

Sonuç: Çalışmamızdaki akciğer nakil adayı olan hastaların egzersiz kapasiteleri, kas ve yağ kütlesinden bağımsız olup, kas kuvvetinden ve solunum fonksiyonlarından etkilenmektedir. Bu durum, bu hasta grubunda egzersiz kapasitesindeki azalmanın daha ziyade primer akciğer patolojisine bağlı olduğunu düşündürmektedir. Daha anlamlı sonuçların elde edilebilmesi için, rehabilitasyon sonrası değişimler incelenmelidir.

Kaynakça

  • Kugler C, Gottlieb J, Warnecke G, et al. Health-related quality of life after solid organ transplantation: a prospective, multiorgan cohort study. Transplantation 2013; 96:316-323
  • Spruit MA, Singh SJ, Garvey C, et al. An official American Thoracic Society/European Respiratory Society statement: key concepts and advances in pulmonary rehabilitation. Am J Respir Crit Care Med 2013; 188:e13-64
  • Mathur S, Hornblower E, Levy RD. Exercise training before and after lung transplantation. Phys Sportsmed 2009; 37:78-87
  • van Adrichem EJ, Reinsma GD, van den Berg S, et al. Predicting 6-minute walking distance in recipients of lung transplantation: longitudinal study of 108 patients. Phys Ther 2015; 95:720-729
  • Reinsma GD, ten Hacken NH, Grevink RG, et al. Limiting factors of exercise performance 1 year after lung transplantation. J Heart Lung Transplant 2006; 25:1310-1316
  • Falque L, Gheerbrant H, Saint-Raymond C, et al. [Selection of lung transplant candidates in France in 2019]. Rev Mal Respir 2019; 36:508-518
  • Pirard L, Marchand E. Reassessing the BODE score as a criterion for listing COPD patients for lung transplantation. Int J Chron Obstruct Pulmon Dis 2018; 13:3963-3970
  • Mathur S, Reid WD, Levy RD. Exercise limitation in recipients of lung transplants. Phys Ther 2004; 84:1178-1187
  • Maury G, Langer D, Verleden G, et al. Skeletal muscle force and functional exercise tolerance before and after lung transplantation: a cohort study. Am J Transplant 2008; 8:1275-1281
  • Dudley KA, El-Chemaly S. Cardiopulmonary exercise testing in lung transplantation: a review. Pulm Med 2012; 2012:237852
  • Walsh JR, Chambers DC, Davis RJ, et al. Impaired exercise capacity after lung transplantation is related to delayed recovery of muscle strength. Clin Transplant 2013; 27:E504-511
  • Rasekaba T, Lee AL, Naughton MT, et al. The six-minute walk test: a useful metric for the cardiopulmonary patient. Intern Med J 2009; 39:495-501
  • Pehlivan E, Balci A, Kilic L, et al. Preoperative Pulmonary Rehabilitation for Lung Transplant: Effects on Pulmonary Function, Exercise Capacity, and Quality of Life; First Results in Turkey. Exp Clin Transplant 2018; 16:455-460
  • 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
  • Decramer M, Gosselink R, Troosters T, et al. Muscle weakness is related to utilization of health care resources in COPD patients. Eur Respir J 1997; 10:417-423
  • Machado FVC, Schneider LP, Fonseca J, et al. Clinical impact of body composition phenotypes in patients with COPD: a retrospective analysis. Eur J Clin Nutr 2019
  • Oshima A, Nishimura A, Chen-Yoshikawa TF, et al. Nutrition-related factors associated with waiting list mortality in patients with interstitial lung disease: A retrospective cohort study. Clin Transplant 2019:e13566
  • Nytroen K, Rustad LA, Gude E, et al. Muscular exercise capacity and body fat predict VO(2peak) in heart transplant recipients. Eur J Prev Cardiol 2014; 21:21-29
  • Van Der Woude BT, Kropmans TJ, Douma KW, et al. Peripheral muscle force and exercise capacity in lung transplant candidates. Int J Rehabil Res 2002; 25:351-355
  • Pradon D, Roche N, Enette L, et al. Relationship between lower limb muscle strength and 6-minute walk test performance in stroke patients. J Rehabil Med 2013; 45:105-108
Toplam 20 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm Original Articles
Yazarlar

Esra Pehlivan 0000-0002-1791-5392

Sevda Kalafat Bu kişi benim 0000-0002-5010-7469

Arif Balcı Bu kişi benim 0000-0002-4052-3506

Lütfiye Kılıç Bu kişi benim 0000-0002-5609-0522

Yayımlanma Tarihi 15 Aralık 2019
Gönderilme Tarihi 11 Mart 2019
Kabul Tarihi 5 Ağustos 2019
Yayımlandığı Sayı Yıl 2019 Cilt: 10 Sayı: 38

Kaynak Göster

Vancouver Pehlivan E, Kalafat S, Balcı A, Kılıç L. Akciğer Nakil Adaylarında Egzersiz Kapasitesinin Periferik Kas Kuvveti Ve Solunum Fonksiyonları İle İlişkisi. mkutfd. 2019;10(38):77-81.