scholarly journals The impact of muscle strength on exercise capacity and symptoms

2020 ◽  
Vol 6 (4) ◽  
pp. 00089-2020
Author(s):  
Mohammed Abdul Malik Farooqi ◽  
Kieran Killian ◽  
Imran Satia
Keyword(s):  
Muscle Strength ◽  
Exercise Capacity ◽  
Functional Limitation ◽  
Cardiopulmonary Exercise Testing ◽  
Multiple Linear Regression Model ◽  
Quadriceps Strength ◽  
Exercise Intolerance ◽  
Maximal Power Output ◽  
Peripheral Muscle ◽  
The Impact

The capacity to exercise is a major contributor to functional limitation and is accompanied by increased morbidity and mortality. What are the most important physiological contributors to exercise capacity?Cross-sectional data from consecutive patients referred to the McMaster University Medical Centre exercise laboratory for incremental cardiopulmonary exercise testing from 1988 to 2012 were analysed. Exercise capacity was determined by maximal power output (MPO) in kpm·min−1. The contributions of quadriceps strength (maximal peak force in kg using maximal dynamic voluntary contractions against hydraulic resistance), inspiratory muscle strength (determined using maximal inspiratory pressure (MIP)), maximal breathing capacity (MBC) and gas exchange (carbon monoxide transfer coefficient (KCO)) were determined using regression coefficients in a multiple linear regression model. Dyspnoea and leg fatigue were measured using the modified Borg scale. Contributors to dyspnoea and leg fatigue were assessed using nonlinear regression.A total of 36 389 patients were included (60% male, mean±sd age 53±18 years). Mean±sd MPO, quadriceps strength and MIP achieved were 792±333 kpm·min−1, 46±18 kg and 75±31 cmH2O, respectively. MIP and quadriceps strength accounted for over half the variation in MPO (R2=0.57). Quadriceps strength was a stronger predictor of MPO (standardised regression coefficient, β±se 0.37±0.005) than MBC (β±se 0.16±0.005) and KCO (β±se 0.16±0.004), when adjusted for age, sex, height and weight. The effort required to cycle and breathe at any given power intensified systematically as both respiratory and peripheral muscle strength declined.Muscle weakness causes exercise intolerance and should be routinely assessed in patients presenting with fatigue and dyspnoea, and those with functional limitation both in the presence or absence of disease.

scholarly journals The clinical value of cardiopulmonary exercise testing in the modern era

2021 ◽  
Vol 30 (159) ◽  
pp. 200187
Author(s):  
Pierantonio Laveneziana ◽  
Marcello Di Paolo ◽  
Paolo Palange
Keyword(s):  
Gas Exchange ◽  
Exercise Testing ◽  
Respiratory Mechanics ◽  
Cardiopulmonary Exercise Testing ◽  
Pulmonary Gas Exchange ◽  
Exercise Intolerance ◽  
Cardiopulmonary Exercise ◽  
Peripheral Muscle ◽  
Metabolic Systems ◽  
The Impact

Cardiopulmonary exercise testing (CPET) has long been used as diagnostic tool for cardiac diseases. During recent years CPET has been proven to be additionally useful for 1) distinguishing between normal and abnormal responses to exercise; 2) determining peak oxygen uptake and level of disability; 3) identifying factors contributing to dyspnoea and exercise limitation; 4) differentiating between ventilatory (respiratory mechanics and pulmonary gas exchange), cardiovascular, metabolic and peripheral muscle causes of exercise intolerance; 5) identifying anomalies of ventilatory (respiratory mechanics and pulmonary gas exchange), cardiovascular and metabolic systems, as well as peripheral muscle and psychological disorders; 6) screening for coexistent ischaemic heart disease, peripheral vascular disease and arterial hypoxaemia; 7) assisting in planning individualised exercise training; 8) generating prognostic information; and 9) objectively evaluating the impact of therapeutic interventions. As such, CPET is an essential part of patients' clinical assessment. This article belongs to the special series on the “Ventilatory efficiency and its clinical prognostic value in cardiorespiratory disorders”, addressed to clinicians, physiologists and researchers, and aims at encouraging them to get acquainted with CPET in order to help and orient the clinical decision concerning individual patients.

P296 Association of peripheral muscle strength with exercise capacity and use of antibiotics in patients with cystic fibrosis

2020 ◽  
Vol 19 ◽  
pp. S139
Author(s):  
N. Evangelista Campos ◽  
F.M. Vendrusculo ◽  
M.F. Gheller ◽  
I. Silveira de Almeida ◽  
N. Acosta Becker ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Muscle Strength ◽  
Exercise Capacity ◽  
Peripheral Muscle

scholarly journals Composite Uremic Load and Physical Performance in Hemodialysis Patients: A Cross-Sectional Study

Toxins ◽  
2020 ◽  
Vol 12 (2) ◽  
pp. 135
Author(s):  
Karsten Vanden Wyngaert ◽  
Amaryllis H. Van Craenenbroeck ◽  
Els Holvoet ◽  
Patrick Calders ◽  
Wim Van Biesen ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Exercise Capacity ◽  
Physical Performance ◽  
Ridge Regression ◽  
Handgrip Strength ◽  
Cross Sectional Study ◽  
Uremic Toxins ◽  
Sectional Study ◽  
Cross Sectional ◽  
The Impact

Impaired physical performance is common in patients on hemodialysis (HD) and is associated with poor prognosis. A patient relevant marker of adequacy of dialysis is lacking. Previous studies evaluated uremic toxicity by assessing the impact of different uremic toxins separately. However, such an approach is most likely not reflective of true uremic toxicity. Therefore, this cross-sectional study aimed to examine if the uremic syndrome, estimated as one composite of different uremic toxins (facilitated by ridge regression method) to reflect the kinetic behavior during dialysis, is associated with physical performance in patients on HD. Levels of p-cresyl glucuronide and sulfate, indole-acetic acid, indoxyl sulfate, uric acid, hippuric acid, and 3-carboxy-4-methyl-5-propyl-2-furanpropionic acid were assessed and associated by ridge regression to muscle strength, functional exercise capacity, and measures of balance and coordination. 75 HD patients were included (mean age 68 years, 57% male). The composite of different uremic toxins (i.e., uremic load) explained 22% of the variance in handgrip strength. Although there was an association between full body muscle strength and the composite uremic load independent of nutritional status, age and gender, the predictive power of composite uremic load for muscle weakness is limited. Single uremic toxins as well as composite uremic load were not associated with exercise capacity, coordination, and balance, indicating that the degree of uremia does not predict physical performance in patients on HD.

scholarly journals The Impact of Pulmonary Arterial Pressure on Exercise Capacity in Mild-to-Moderate Cystic Fibrosis: A Case Control Study

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Katerina Manika ◽  
Georgia G. Pitsiou ◽  
Afroditi K. Boutou ◽  
Vassilis Tsaoussis ◽  
Nikolaos Chavouzis ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Arterial Pressure ◽  
Exercise Capacity ◽  
Case Control Study ◽  
Pulmonary Arterial Pressure ◽  
Cardiopulmonary Exercise Testing ◽  
Case Control ◽  
Pulmonary Arterial ◽  
The Impact ◽  
Control Study

Background. Pulmonary hypertension (PH) is an often complication of severe cystic fibrosis (CF); however, data on the presence and impact of pulmonary vasculopathy in adult CF patients with milder disease, is very limited.Aim. To investigate, for the first time, the impact of systolic pulmonary arterial pressure (PASP) on maximal exercise capacity in adults with mild-to-moderate cystic fibrosis, without PH at rest.Methods. This is a Case Control study. Seventeen adults with mild-to-moderate CF, without PH at rest (cases) and 10 healthy, nonsmoking, age, and height matched controls were studied. All subjects underwent maximal cardiopulmonary exercise testing and echocardiography before and within 1 minute after stopping exercise.Results. Exercise ventilation parameters were similar in the two groups; however, cases, compared to controls, had higher postexercise PASP and decreased exercise capacity, established with lower peak work rate, peak O2uptake, anaerobic threshold, and peak O2pulse. Furthermore, the change in PASP values before and after exercise was strongly correlated to the parameters of exercise capacity among cases but not among controls.Conclusions. CF adults with mild-to-moderate disease should be screened for the presence of pulmonary vasculopathy, since the elevation of PASP during exercise might contribute to impaired exercise capacity.

scholarly journals Is the peripheral muscle weakness a limitation to exercise on chronic kidney disease?

2020 ◽  
Vol 33 ◽  
Author(s):  
Davi de Souza Francisco ◽  
Ana Karla Vieira Brüggemann ◽  
Tarcila Dal Pont ◽  
Mariana Nunes Lúcio ◽  
Elaine Paulin
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Muscle Strength ◽  
Exercise Capacity ◽  
Muscle Weakness ◽  
Lower Limb ◽  
Public Health Problem ◽  
Healthy Individuals ◽  
Peripheral Muscle ◽  
Left Limb

Abstract Introduction: Chronic kidney disease (CKD) is a global public health problem with systemic repercussions, compromising muscle function and making patients less exercise tolerant. Objective: To verify the contribution of peripheral muscle strength in the exercise capacity of patients in hemodialysis (HD), as well as to compare peripheral muscle strength and exercise capacity between renal patients and healthy individuals. Method: 50 patients with chronic kidney disease (CKD) who performed HD and 13 healthy subjects underwent anthropometric evaluation, evaluation of peripheral muscle strength, pulmonary function test and exercise capacity assessment. Results: Simple linear regression indicated that the peripheral muscle strength contributed 41.4% to the distance walked in the six-minute walk test (R2 0.414; p < 0.001), showing that for every 1 Kgf reduced in the right lower limb the patient it stops walking 0.5m while for every 1 Kgf reduced in the lower left limb the patient stops walking 0.8m. In addition, it was observed that patients with CKD had a reduction in right lower limb muscle strength (129.44 ± 48.05 vs. 169.36 ± 44.30, p = 0.002), left (136.12 ± 52, 08 vs 168.40 ± 43.35, p = 0.01) and exercise capacity (421.20 ± 98.07 vs. 611.28 ± 80.91, p < 0.001) when compared to healthy pairs. Conclusion: Peripheral muscle weakness is an important limiting factor for exercise in CKD and patients on HD experience a decline in peripheral muscle strength and exercise capacity when compared to healthy individuals.

Specific contribution of quadriceps muscle strength, endurance, and power to functional exercise capacity in people with chronic obstructive pulmonary disease: a multicenter study

2021 ◽  
Author(s):  
Sarah Gephine ◽  
Erik Frykholm ◽  
Andre Nyberg ◽  
Patrick Mucci ◽  
Hieronymus W H Van Hees ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Exercise Capacity ◽  
Muscle Power ◽  
Quadriceps Muscle ◽  
Quadriceps Strength ◽  
Muscle Properties ◽  
Sit To Stand ◽  
Functional Exercise ◽  
Functional Exercise Capacity ◽  
Muscle Property

Abstract Objective Various functional muscle properties affect different aspects of functional exercise capacity in people with COPD. The purpose of this study was to investigate the contribution of quadriceps muscle strength, endurance, and power to the 6-minute walking distance (6MWD) and the 1-minute sit-to-stand test (1STS) performance in people with COPD. Methods The study was a prospective, multicenter cross-sectional study. Anthropometrics, Medical Research Council (MRC) dyspnea scale, lung function, 6MWD and the 1STS number of repetitions were assessed. Isometric quadriceps strength (Strength-ISOM) and endurance (Endurance-ISOM), isotonic quadriceps endurance (Endurance-ISOT), isokinetic quadriceps strength (Strength-ISOKIN), and power (Power-ISOKIN) were assessed on a computerized dynamometer while functional quadriceps power was determined during 5 sit-to-stand repetitions (Power-5STS). Univariate and multivariate analyses were performed to determine the contribution of functional muscle properties on the 6MWD and the 1STS number of repetitions. Results The study included 70 people with COPD (mean % predicted FEV1 = 58.9 [SD = 18.2]). The 6MWD correlated with each functional muscle property, except the Endurance-ISOM. The number of repetitions during the 1STS correlated with each functional muscle property except isometric measurements. Multivariate models explained respectively 60% and 39% of the variance in the 6MWD and 1STS number of repetitions, with Power-5STS being the muscle functional property with the strongest contribution to the models. Conclusion Except for isometric endurance, quadriceps strength, endurance, and power were associated with functional exercise capacity in people with moderate COPD. Among these functional muscle properties, muscle power contributed the most to the 6MWD and 1STS number of repetitions, suggesting that muscle power is more relevant to functional exercise capacity than muscle strength or endurance in people with COPD. Impact Understanding the individual contribution of muscle properties to functional status is important to designing interventions. This study provides the guidance that muscle power may be more important to functional exercise capacity than muscle strength or endurance in people with COPD.

scholarly journals Peripheral Muscle Microcirculation Dynamics During Strength Exercise in Heart Failure Patients: A Cross-Sectional Study

2021 ◽  
Author(s):  
Amanda Vale-Lira ◽  
Natália Turri-Silva ◽  
Kenneth Verboven ◽  
João Luiz Quagliotti Durigan ◽  
Gaspar R. Chiappa ◽  
...  
Keyword(s):  
Heart Failure ◽  
Muscle Strength ◽  
Cross Sectional Study ◽  
Exercise Intolerance ◽  
Strength Exercise ◽  
Sectional Study ◽  
Cross Sectional ◽  
Heart Failure Patients ◽  
Peripheral Muscle ◽  
Class C

Abstract This cross-sectional study aimed to compare the muscle microcirculation dynamics via near-infrared spectroscopy (NIRS) response during an isokinetic muscle strength test and ultrasound-derived parameters in heart failure patients with preserved or reduced ejection fraction phenotypes (HFpEF and HFrEF, respectively) and different functional severities (Weber Class A, B, and C). Twenty-eight aged-matched patients with HFpEF (n = 16) and HFrEF (n = 12) were assessed. Within HFpEF, Weber Class C patients presented a worse capability to reach a greater oxygen extraction during exercise than Classes A and B. Among those with Weber C severity, while HFrEF patients reached lower oxyhemoglobin (O2Hb, µM) (-10.9 ± 3.8 vs. -23.7 ± 5.7, p = 0.029) during exercise, HFpEF kept a lower O2Hb during the recovery period (-3.0 ± 3.4 vs. 5.9 ± 2.8, p = 0.007). Among the ultrasound-derived variables, HFpEF, Weber Class C, also presented a higher echo intensity than HFrEF patients (29.7 ± 8.4 vs. 15.1 ± 6.8, p = 0.017). Our study reveals more pronounced impairments in local microcirculatory dynamics in HFpEF vs. HFrEF patients during muscle strength exercise, combined with muscle-skeletal abnormalities detected via ultrasound imaging, which may help to explain the commonly observed exercise intolerance in HFpEF patients.

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