Respiratory Muscle Strength in Patients With Chronic Obstructive Pulmonary Disease
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Objective To compare the respiratory muscle strength between patients with stable and acutely exacerbated (AE) chronic obstructive pulmonary disease (COPD) at various stages.Methods A retrospective medical record review was conducted on patients with COPD from March 2014 to May 2016. Patients were subdivided into COPD stages 1–4 according to the Global Initiative for Chronic Obstructive Lung Disease guidelines: mild, moderate, severe, and very severe. A rehabilitation physician reviewed their medical records and initial assessment, including spirometry, maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP), COPD Assessment Test, and modified Medical Research Council scale. We then compared the initial parameters in patients with a stable condition and those at AE status.Results The AE group (n=94) had significantly lower MIP (AE, 55.93±20.57; stable, 67.88±24.96; p=0.006) and MIP% (AE, 82.82±27.92; stable, 96.64±30.46; p=0.015) than the stable patient group (n=36). MIP, but not MEP, was proportional to disease severity in patients with AE and stable COPD.Conclusion The strength of the inspiratory muscles may better reflect severity of disease when compared to that of expiratory muscles.
Abstract
Objective To compare the respiratory muscle strength between patients with stable and acutely exacerbated (AE) chronic obstructive pulmonary disease (COPD) at various stages.Methods A retrospective medical record review was conducted on patients with COPD from March 2014 to May 2016. Patients were subdivided into COPD stages 1–4 according to the Global Initiative for Chronic Obstructive Lung Disease guidelines: mild, moderate, severe, and very severe. A rehabilitation physician reviewed their medical records and initial assessment, including spirometry, maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP), COPD Assessment Test, and modified Medical Research Council scale. We then compared the initial parameters in patients with a stable condition and those at AE status.Results The AE group (n=94) had significantly lower MIP (AE, 55.93±20.57; stable, 67.88±24.96; p=0.006) and MIP% (AE, 82.82±27.92; stable, 96.64±30.46; p=0.015) than the stable patient group (n=36). MIP, but not MEP, was proportional to disease severity in patients with AE and stable COPD.Conclusion The strength of the inspiratory muscles may better reflect severity of disease when compared to that of expiratory muscles.
참고문헌 (33)
- Marciniuk DD, "Optimizing pulmonary rehabilitation in chronic obstructive pulmonary disease:practical issues: a Canadian Thoracic Society Clinical Practice Guideline", Can Respir J, 17, pp.159~168 (2010)
- Rabe KF, "Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary", Am J Respir Crit Care Med, 176, pp.532~555 (2007)
- Spruit MA, "An official American Thoracic Society", European Respiratory Society statement: key concepts and advances in pulmonary rehabilitation, 2013, pp.188, e13~64
- Debigare R, "The major limitation to exercise performance in COPD is lower limb muscle dysfunction", J Appl Physiol (1985), 105, pp.751~753 (2008)
- Hyatt RE, "Expiratory flow limitation", J Appl Physiol, 55, pp.1~7 (1983)
- O’Donnell DE, "Dynamic hyperinflation and exercise intolerance in chronic obstructive pulmonary disease", Am J Respir Crit Care Med, 164, pp.770~777 (2001)
- Gosselink R, "Peripheral muscle weakness contributes to exercise limitation in COPD", Am J Respir Crit Care Med, 153, pp.976~980 (1996)
- Troosters T, "Resistance training prevents deterioration in quadriceps muscle function during acute exacerbations of chronic obstructive pulmonary disease", Am J Respir Crit Care Med, 181, pp.1072~1077 (2010)
- Casaburi R, "Reductions in exercise lactic acidosis and ventilation as a result of exercise training in patients with obstructive lung disease", Am Rev Respir Dis, 143, pp.9~18 (1991)
- Maltais F, "Oxidative capacity of the skeletal muscle and lactic acid kinetics during exercise in normal subjects and in patients with COPD", Am J Respir Crit Care Med, 153, pp.288~293 (1996)
- Gea J, "Pathophysiology of muscle dysfunction in COPD", J Appl Physiol (1985), 114, pp.1222~1234 (2013)
- Levine S, "Cellular adaptations in the diaphragm in chronic obstructive pulmonary disease", N Engl J Med, 337, pp.1799~1806 (1997)
- Seemungal TA, "Time course and recovery of exacerbations in patients with chronic obstructive pulmonary disease", Am J Respir Crit Care Med, 161, pp.1608~1613 (2000)
- Pitta F, "Physical activity and hospitalization for exacerbation of COPD", Chest, 129, pp.536~544 (2006)
- Schmier JK, "The quality of life impact of acute exacerbations of chronic bronchitis (AECB): a literature review", Qual Life Res, 14, pp.329~347 (2005)
- Puhan MA, "Pulmonary rehabilitation following exacerbations of chronic obstructive pulmonary disease", Cochrane Database Syst Rev, pp.CD005305~ (2011)
- Gosselink R, "Impact of inspiratory muscle training in patients with COPD: what is the evidence?", Eur Respir J, 37, pp.416~425 (2011)
- Thomas MJ, "The impact of home-based physiotherapy interventions on breathlessness during activities of daily living in severe COPD: a systematic review", Physiotherapy, 96, pp.108~119 (2010)
- Geddes EL, "Inspiratory muscle training in adults with chronic obstructive pulmonary disease: an update of a systematic review", Respir Med, 102, pp.1715~1729 (2008)
- Terzano C, "Maximal respiratory static pressures in patients with different stages of COPD severity", Respir Res, 9, pp.8~ (2008)
- Burge S, "COPD exacerbations: definitions and classifications", Eur Respir J Suppl, 41, pp.46s~53s (2003)
- Wilson SH, "Predicted normal values for maximal respiratory pressures in Caucasian adults and children", Thorax, 39, pp.535~538 (1984)
- Miller MR, "Standardisation of spirometry", Eur Respir J, 26, pp.319~338 (2005)
- Morris JF, "Spirometric standards for healthy nonsmoking adults", Am Rev Respir Dis, 103, pp.57~67 (1971)
- Jones PW, "Development and first validation of the COPD Assessment Test", Eur Respir J, 34, pp.648~654 (2009)
- Bestall JC, "Usefulness of the Medical Research Council (MRC) dyspnoea scale as a measure of disability in patients with chronic obstructive pulmonary disease", Thorax, 54, pp.581~586 (1999)
- Rochester DF, "Determinants of maximal inspiratory pressure in chronic obstructive pulmonary disease", Am Rev Respir Dis, 132, pp.42~47 (1985)
- Butler C, "Diaphragmatic changes in emphysema", Am Rev Respir Dis, 114, pp.155~159 (1976)
- Breslin EH, "Correlations between dyspnea, diaphragm and sternomastoid recruitment during inspiratory resistance breathing in normal subjects", Chest, 98, pp.298~302 (1990)
- Mador MJ, "Skeletal muscle dysfunction in chronic obstructive pulmonary disease", Respir Res, 2, pp.216~224 (2001)
- O’Donnell DE, "Expiratory resistive loading in patients with severe chronic air-flow limitation: an evaluation of ventilatory mechanics and compensatory responses", Am Rev Respir Dis, 136, pp.102~107 (1987)
- Gorini M, "Abdominal muscle recruitment and PEEPi during bronchoconstriction in chronic obstructive pulmonary disease", Thorax, 52, pp.355~361 (1997)
- Ramirez-Sarmiento A, "Expiratory muscle endurance in chronic obstructive pulmonary disease", Thorax, 57, pp.132~136 (2002)