scholarly journals The use of ultrasonography as a tool to evaluate the quadriceps muscle in patients with chronic obstructive pulmonary disease: a systematic review

2022 ◽  
Vol 11 (1) ◽  
pp. e19911124728
Author(s):  
Thais Angélica Bobalo dos Santos ◽  
Paula Motta dos Santos ◽  
Talita Wassmuth ◽  
Débora Melo Mazzo ◽  
Bruno Margueritte Costa ◽  
...  
Keyword(s):  
Low Cost ◽  
Maximum Voluntary Contraction ◽  
Quadriceps Muscle ◽  
Voluntary Contraction ◽  
Chronic Obstructive ◽  
Inclusion Criteria ◽  
Obstructive Pulmonary Disease ◽  
Peripheral Muscle ◽  
Section Area ◽  
Potential Clinical Utility

Abstract: The aim of this review is to understand the feasibility and potential clinical utility of US in measurements of the quadriceps muscles in patients with COPD. A total of 217 studies were identified and after applying the inclusion criteria, 12 were selected. The data were systematically searched by two independent reviewers. Of the included articles, five evaluated the maximal voluntary contraction of the quadriceps muscle and the Transverse Section Area (TSA) measured by US, of these, 4 found a remarkably reduced strength in COPD and in one article, it was described that this reduction occurs in all grades of the disease. Moreover, the greater the thickness of the quadriceps, the greater the maximum voluntary contraction of this musculature, however, the TSA is reduced in these patients when compared to healthy individuals. Thus, it is suggested that the AST, evaluated by US, can be used to assess the presence and/or severity of musculoskeletal dysfunction in these patients. The sonographic evaluation of the quadriceps in patients with COPD may provide a safe, effective, low-cost, reliable and reproducible evaluation, allowing the identification and monitoring of peripheral muscle dysfunction in this population, even when compared with other strategies.

scholarly journals Physical activity and exercise capacity in patients with moderate COPD exacerbations

2016 ◽  
Vol 48 (2) ◽  
pp. 340-349 ◽  
Author(s):  
Ayedh D. Alahmari ◽  
Beverly S. Kowlessar ◽  
Anant R.C. Patel ◽  
Alex J. Mackay ◽  
James P. Allinson ◽  
...  
Keyword(s):  
Physical Activity ◽  
Exercise Capacity ◽  
Maximum Voluntary Contraction ◽  
Normal Activity ◽  
Voluntary Contraction ◽  
Walking Distance ◽  
Chronic Obstructive ◽  
Similar Time ◽  
Obstructive Pulmonary Disease ◽  
Copd Exacerbations

Little is known about changes in physical activity during moderate (out-patient managed) exacerbations.6-min walking distance (6MWD) was measured during 50 exacerbations when the patients were stable, and at 3 and 7 days post-exacerbation presentation. At similar time points, quadriceps maximum voluntary contraction (QMVC) was measured during 47 different exacerbations. Physical activity (SenseWear; Bodymedia Inc., Pittsburgh, PA, USA) was recorded over 2 consecutive-week periods post-presentation.6MWD fell from a median 422 m when stable to 373 m on day 3 (p=0.001). Similarly, QMVC fell from 32.6 versus 29.7 kg (p=0.026). Falls in 6MWD were associated with a rise in C-reactive protein (r= −0.364; p=0.041) and increased Functional Assessment of Chronic Illness Therapy–Fatigue (FACIT-F) (r= −0.44; p=0.013). Light physical activity was 2.18 h·day−1 during the first week post-exacerbation and was less over week 2 (1.98 h·day−1; p=0.009). Patients who had attended pulmonary rehabilitation had smaller changes in 6MWD than those who had not attended (−35.0 versus −114.9 m; p=0.013). Falls in physical activity were correlated with higher depression scores (rho= −0.51; p=0.006).These findings indicate that exercise capacity and muscle strength fall at exacerbation in chronic obstructive pulmonary disease patients who are treated at home and are free to maintain normal activity.

scholarly journals Oral prednisolone for 4 days does not increase exercise tolerance in men with COPD

2017 ◽  
Vol 15 (2) ◽  
pp. 220-222
Author(s):  
SL Karlsson ◽  
V Backer ◽  
Nina Skavlan Godtfredsen
Keyword(s):  
Lung Function ◽  
Controlled Trial ◽  
Maximum Voluntary Contraction ◽  
Oral Prednisolone ◽  
Voluntary Contraction ◽  
Annual Number ◽  
Chronic Obstructive ◽  
Time To Exhaustion ◽  
Obstructive Pulmonary Disease ◽  
Muscle Groups

One of the primary objectives in management of chronic obstructive pulmonary disease (COPD) is preventing decrease in lung function and reducing the annual number of acute exacerbations of COPD (AECOPD). An oral course of systemic corticosteroids is a commonly used treatment in AECOPD. We hypothesize that this treatment also increases exercise performance and decreases muscle fatigue. In a randomized double-blinded, parallel, placebo-controlled trial, we investigated 14 men (8 on prednisolone 37.5 mg vs. 6 on placebo) with severe and very severe COPD. For 5 consecutive days, the patients performed a submaximal endurance test measuring time to exhaustion (TTE, primary endpoint), spirometry, maximal inspiratory and expiratory pressure and maximal isometric contraction of the quadriceps femoris muscle (maximum voluntary contraction (MVC)). At visits 2, 3 and 4, a fatigue protocol was carried out after 40 minutes of cycling at 40% of maximal effort. No differences between groups were found for TTE, lung function or maximal inspiratory or expiratory pressure, however, patients on prednisolone showed significant increased MVC: median 5.15 [3.35; 9.15] against placebo: −2 [−5.57; 3.95] ( p = 0.03). This finding indicates an impact of corticosteroids on muscle groups being exposed to submaximal endurance.

scholarly journals Fatigue and multidimensional disease severity in chronic obstructive pulmonary disease

2010 ◽  
Vol 5 ◽  
Author(s):  
Deniz Inal-Ince ◽  
Sema Savci ◽  
Melda Saglam ◽  
Ebru Calik ◽  
Hulya Arikan ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Disease Severity ◽  
Airflow Obstruction ◽  
Muscle Endurance ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Bode Index ◽  
Peripheral Muscle ◽  
St George's Respiratory Questionnaire

Background and aims: Fatigue is associated with longitudinal ratings of health in patients with chronic obstructive pulmonary disease (COPD). Although the degree of airflow obstruction is often used to grade disease severity in patients with COPD, multidimensional grading systems have recently been developed. The aim of this study was to investigate the relationship between perceived and actual fatigue level and multidimensional disease severity in patients with COPD. Materials and methods: Twenty-two patients with COPD (aged 52-74 years) took part in the study. Multidimensional disease severity was measured using the SAFE and BODE indices. Perceived fatigue was assessed using the Fatigue Severity Scale (FSS) and the Fatigue Impact Scale (FIS). Peripheral muscle endurance was evaluated using the number of sit-ups, squats, and modified push-ups that each patient could do. Results: Thirteen patients (59%) had severe fatigue, and their St George’s Respiratory Questionnaire scores were significantly higher (p < 0.05). The SAFE index score was significantly correlated with the number of sit-ups, number of squats, FSS score and FIS score (p < 0.05). The BODE index was signif- icantly associated with the numbers of sit-ups, squats and modified push-ups, and with the FSS and FIS scores (p < 0.05). Conclusions: Peripheral muscle endurance and fatigue perception in patients with COPD was related to multidimensional disease severity measured with both the SAFE and BODE indices. Improvements in perceived and actual fatigue levels may positively affect multidimensional disease severity and health status in COPD patients. Further research is needed to investigate the effects of fatigue perception and exercise training on patients with different stages of multidimensional COPD severity.

Effect of adding neuromuscular electrical stimulation training to pulmonary rehabilitation in patients with chronic obstructive pulmonary disease: randomized clinical trial

2018 ◽  
Vol 33 (2) ◽  
pp. 195-206 ◽  
Author(s):  
Marwa Mekki ◽  
Thierry Paillard ◽  
Sonia Sahli ◽  
Zouhair Tabka ◽  
Yassine Trabelsi
Keyword(s):  
Electrical Stimulation ◽  
Pulmonary Rehabilitation ◽  
Center Of Pressure ◽  
Intervention Group ◽  
Neuromuscular Electrical Stimulation ◽  
Berg Balance Scale ◽  
Voluntary Contraction ◽  
Control Group ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease

Objective: To investigate the effectiveness of neuromuscular electrical stimulation added to pulmonary rehabilitation on walking tolerance and balance in patients with chronic obstructive pulmonary disease (COPD). Design: Randomized clinical trial. Setting: Outpatient, Faculty of Medicine of Sousse, Tunisia. Subjects: A total of 45 patients with COPD were assigned to an intervention group ( n = 25) or a control group ( n = 20). Interventions: The intervention group underwent a neuromuscular electrical stimulation added to pulmonary rehabilitation, and the control group underwent only a pulmonary rehabilitation, three times per week during six months. Main Measures: Measures were taken at baseline and after six months of training. A stabilometric platform, time up and go, Berg balance scale tests, 6 minute walking test, and the maximal voluntary contraction were measured. Results: In the intervention group, an increase in an exercise tolerance manifested by a longer distance walked in 6 minute walking test 619.5 (39.6) m was observed in comparison to the control group 576.3 (31.5) m. The values of the time up and go, Berg balance scale, and maximal voluntary contraction in the intervention group at follow-up were significantly higher than those in the control group ( P  = 0.02, P  = 0.01, P  = 0.0002, respectively). The center of pressure in the mediolateral and in the anteroposterior directions, as well as the center of pressure area was significantly more improved in open eyes and closed eyes in the intervention group compared to the control group ( P < 0.001). Conclusion: The neuromuscular electrical stimulation added to pulmonary rehabilitation group benefited from better walking tolerance and greater balance improvement than the only pulmonary rehabilitation.

scholarly journals Inspiratroy Capacity and Exercise Tolerance in Chronic Obstructive Pulmonary Disease

2000 ◽  
Vol 7 (3) ◽  
pp. 282-285 ◽  
Author(s):  
Joseph Milic-Emili
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Lung Function ◽  
Airway Obstruction ◽  
Pulmonary Disease ◽  
Exercise Tolerance ◽  
Forced Expiratory Volume ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Peripheral Muscle ◽  
Past Half Century

During the past half-century, many studies have investigated the correlation of exercise tolerance to routine lung function in patients with obstructive pulmonary disease. In virtually all of these studies, the degree of airway obstruction was assessed in terms of forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC). Because in most studies only a weak correlation was found between exercise tolerance and degree of airway obstruction, it has been concluded that factors other than lung function impairment (eg, deconditioning and peripheral muscle dysfunction) play a predominant role in limiting exercise capacity in patients with chronic airway obstruction. Recent work, however, suggests that in patients with chronic obstructive pulmonary disease, the inspiratory capacity is a more powerful predictor of exercise tolerance than FEV1 and FVC.

scholarly journals Fiber atrophy, oxidative stress, and oxidative fiber reduction are the attributes of different phenotypes in chronic obstructive pulmonary disease patients

2013 ◽  
Vol 115 (12) ◽  
pp. 1796-1805 ◽  
Author(s):  
Fares Gouzi ◽  
Aldjia Abdellaoui ◽  
Nicolas Molinari ◽  
Edith Pinot ◽  
Bronia Ayoub ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Muscle Protein ◽  
Statistical Significance ◽  
Chronic Obstructive ◽  
Type I ◽  
Obstructive Pulmonary Disease ◽  
Peripheral Muscle ◽  
Copd Patients

Peripheral muscle dysfunction, associated with reductions in fiber cross-sectional area (CSA) and in type I fibers, is a key outcome in chronic obstructive pulmonary disease (COPD). However, COPD peripheral muscle function and structure show great heterogeneity, overlapping those in sedentary healthy subjects (SHS). While discrepancies in the link between muscle structure and phenotype remain unexplained, we tested whether the fiber CSA and the type I fiber reductions were the attributes of different phenotypes of the disease, using unsupervised clustering method and post hoc validation. Principal component analysis performed on functional and histomorphological parameters in 64 COPD patients {forced expiratory volume in 1 s (FEV1) = 42.0 [30.0–58.5]% predicted} and 27 SHS (FEV1 = 105.0 [95.0–114.0]% predicted) revealed two COPD clusters with distinct peripheral muscle dysfunctions. These two clusters had different type I fiber proportion (26.0 ± 14.0% vs. 39.8 ± 12.6%; P < 0.05), and fiber CSA (3,731 ± 1,233 vs. 5,657 ± 1,098 μm2; P < 0.05). The “atrophic” cluster showed an increase in muscle protein carbonylation (131.5 [83.6–200.3] vs. 83.0 [68.3–105.1]; P < 0.05). Then, COPD patients underwent pulmonary rehabilitation. If the higher risk of exacerbations in the “atrophic” cluster did not reach statistical significance after adjustment for FEV1 (hazard ratio: 2.43; P = 0.11, n = 54), the improvement of VO2sl after training was greater than in the nonatrophic cluster (+24 ± 16% vs. +6 ± 13%; P < 0.01). Last, their age was similar (60.4 ± 8.8 vs. 60.8 ± 9.0 yr; P = 0.87), suggesting a different time course of the disease. We identified and validated two phenotypes of COPD patients showing different muscle histomorphology and level of oxidative stress. Thus our study demonstrates that the muscle heterogeneity is the translation of different phenotypes of the disease.

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