Disfunción muscular esquelética en la EPOC

[The continuum of COPD and cardiovascular risk: A global scenario of disease]

Chronic obstructive pulmonary disease (COPD) is a serious public health problem in our country. COPD is a treatable and preventable disease which is underdiagnosed. The EPISCAN study revealed a prevalence of 10.2% in Spain between individuals of 40-80 years, with 73% underdiagnosis. In Primary Care occupies 8.5% of all queries with a high economic impact. These patients exhibit some degree of systemic inflammation characterized by increased plasma levels of some inflammatory mediators such as IL-1, IL-6, IL-8, CRP and TNF, which are also related to endothelial disorders and arteriosclerosis. In the continuum of COPD, comorbidities most frequently appear are: ischemic heart disease, heart failure, stroke, hypertension, type 2 diabetes mellitus, renal failure, osteoporosis, myopathy, anxiety, depression, cognitive impairment, malnutrition, anemia and lung cancer.

Effects of whole body vibration training in patients with severe chronic obstructive pulmonary disease

BACKGROUND AND OBJECTIVE

To determine if whole body vibration training (WBVT) improves muscular force and modifies functional capacity parameters in patients with severe chronic obstructive pulmonary disease (COPD).

METHODS

We performed a randomized controlled trial in the outpatient Physical Medicine and Rehabilitation Department of a general hospital. Sixty stable male patients with COPD and mean forced expiratory volume in 1 s (FEV1) 34.3% (predicted) were enrolled with 51 patients completing the study. Participants were randomized into two groups: Whole Body Vibration Training Group (WBVTG), (n = 26) undergoing three sessions per week for a total of 6 weeks and a Control Group (CG) (n = 25) without intervention. The main outcome measures were isokinetic knee flexor and extensor testing in a concentric-concentric regime and exercise capacity measured by the 6-min walking test (6MWT). Secondary outcomes were pulmonary muscular assessment with maximum inspiratory pressure (MIP) and maximum expiratory pressure (MEP).

RESULTS

No significant differences were observed between groups in maximum moment of isokinetic knee flexor/extensor testing force in a concentric-concentric regime. In contrast, WBVTG patients showed a significant increase in the 6MWT (81.2 ± 9.2) meters; mean ± SD; P < 0.001). There was also a significant decrease in maximum oxygen desaturation in the 6MWT after 6 weeks of training (3.1 ± 1.1; P = 0.01). There were significant differences between groups in MIP and MEP at the end of the study in favour of the WBVTG.

CONCLUSIONS

WBVT provided significant improvements in functional capacity in severe COPD patients without changes in muscular force.