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Yogi S, Shirahata T, Sato H, Nishida Y, Inoue K, Niitsu M, Akagami T, Masaki K, Nagata M, Tanaka S, Katsukawa F, Nakamura H. Non-exercise Activity Thermogenesis Correlated With Clinical Parameters in Patients With or At-Risk for Chronic Obstructive Pulmonary Disease (COPD): A Pilot Study. Cureus 2024; 16:e53019. [PMID: 38410298 PMCID: PMC10895206 DOI: 10.7759/cureus.53019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2024] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND Attention to physical activity has grown in patients with chronic obstructive pulmonary disease (COPD), as it serves as a robust indicator for mortality associated with COPD. Non-exercise activity thermogenesis (NEAT) is the energy expenditure due to physical activities besides active sports-like exercises and resistance training in daily life, and decreased NEAT may be related to physical inactivity in patients with COPD. We examined whether NEAT assessed using a questionnaire reflects clinical parameters in patients with or at risk for COPD. METHODS The study participants consisted of 36 male patients (COPD=28; stage1=6, stage2=14, stage3/4=8, and at-risk for COPD=8) older than 50 years of age. The participants underwent anthropometric measurements, lung function testing, a six-minute walk test, muscle strength testing, and questionnaires, e.g., the COPD assessment test (CAT), modified Medical Research Council (mMRC) dyspnea scale, and Hospital Anxiety and Depression Scale. Image analysis with chest computed tomography (CT) included the number of trunk muscles, bronchial wall thickening, and emphysema (percentage of the lung field occupied by low attenuation area <-950 HU). We evaluated the relationship between these clinical parameters and NEAT questionnaire scores using Pearson correlation analysis and the Tukey-Kramer test. RESULTS The NEAT score was correlated with the severity of airflow limitation and airway wall thickness measured by chest CT, symptoms evaluated by the mMRC dyspnea scale and CAT, and inspiratory muscle strength and pectoralis muscle area assessed by CT. CONCLUSION Our study revealed the significance of NEAT as a valuable indicator in assessing the health status of patients with or at risk for COPD. The NEAT score was correlated with various clinical traits, suggesting that incorporating NEAT assessments using a questionnaire can contribute to a comprehensive understanding of the clinical condition in these patients. Further large-scale studies are warranted to validate and generalize these findings across diverse COPD populations.
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Affiliation(s)
- Sanehiro Yogi
- Respiratory Medicine, Saitama Medical University Hospital, Saitama, JPN
| | - Toru Shirahata
- Respiratory Medicine, Saitama Medical University Hospital, Saitama, JPN
| | - Hideaki Sato
- Respiratory Medicine, Saitama Medical University Hospital, Saitama, JPN
| | - Yuki Nishida
- Biostatistics, M&D Data Science Center, Tokyo Medical and Dental University, Tokyo, JPN
- Sports Medicine Research Center, Keio University, Yokohama, JPN
| | - Kaiji Inoue
- Radiology, Saitama Medical University Hospital, Saitama, JPN
| | - Mamoru Niitsu
- Radiology, Saitama Medical University Hospital, Saitama, JPN
| | - Tomoe Akagami
- Respiratory Medicine, Saitama Medical University Hospital, Saitama, JPN
| | - Kenji Masaki
- Respiratory Medicine, Saitama Medical University Hospital, Saitama, JPN
| | - Makoto Nagata
- Respiratory Medicine, Saitama Medical University Hospital, Saitama, JPN
| | - Shigeho Tanaka
- Faculty of Nutrition, Kagawa Nutrition University, Saitama, JPN
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Eyuboglu F, Inal-Ince D, Karamancioglu B, Vardar-Yagli N, Kaya-Utlu D, Dalkilic O, Somay G. Effect of tele-yoga on aerobic capacity, respiratory muscle strength, and cognitive performance in patients with obstructive sleep apnea syndrome. Heart Lung 2023; 62:157-167. [PMID: 37536116 DOI: 10.1016/j.hrtlng.2023.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 07/18/2023] [Accepted: 07/20/2023] [Indexed: 08/05/2023]
Abstract
BACKGROUND Obstructive sleep apnea syndrome (OSAS) causes a decrease in aerobic capacity, respiratory muscle strength, and cognitive function, negatively affecting health-related quality of life. OBJECTIVES This study aimed to compare aerobic capacity, respiratory muscle strength, cognitive performance, functional capacity, sleep quality and daytime sleepiness in OSAS patients practicing and not practicing tele-yoga (TY). METHODS 44 OSAS patients (40 M, 4F) were randomized into TY and control groups. TY group underwent live synchronous group-based TY sessions, 60 min/day, three days/week, for 12 weeks. Control group performed unsupervised thoracic expansion exercises at home 4 times daily for 12 weeks. The following were evaluated at baseline and at the end of the 6th and 12th weeks: inspiratory and expiratory respiratory muscle strength (MIP, MEP), cardiopulmonary exercise test, Corsi Block Tapping Test (CBTT) and Stroop TBAG test, six-minute walk test (6MWT), Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS). RESULTS TY significantly improved MIP, and exercise test parameters (VE, HRmax,%HR, heart rate recovery in the first minute and RQmax), CBTT (forward) and Stroop TBAG test scores (parts of 3,4,5) compared to the controls (p<0.05). There were no significant changes 6MWT in the TY group compared to the control group (p > 0.05). Sleep duration (min), sleep efficiency, sleep quality of PSQI and ESS score improved significantly in the TY group compared to the control group (p < 0.05). CONCLUSION We suggest including TY intervention as a method of exercise in addition to CPAP treatments since it improves the health-related parameters of OSAS patients.
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Affiliation(s)
- Filiz Eyuboglu
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Uskudar University, Istanbul, Turkey; Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey.
| | - Deniz Inal-Ince
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Berna Karamancioglu
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Uskudar University, Istanbul, Turkey
| | - Naciye Vardar-Yagli
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Defne Kaya-Utlu
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, University of Health Sciences, Istanbul, Turkey
| | - Orhan Dalkilic
- Department of Chest Diseases, Hisar Intercontinental Hospital, Istanbul, Turkey
| | - Goksel Somay
- Department of Neurogy, Intermed Ciftehavuzlar, Istanbul, Turkey
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Park TS, Tak YJ, Ra Y, Kim J, Han SH, Kim SH, Shin Y, Shin MJ, Kang JH. Reference Respiratory Muscle Strength Values and a Prediction Equation Using Physical Functions for Pulmonary Rehabilitation in Korea. J Korean Med Sci 2023; 38:e325. [PMID: 37846788 PMCID: PMC10578989 DOI: 10.3346/jkms.2023.38.e325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 06/13/2023] [Indexed: 10/18/2023] Open
Abstract
BACKGROUND In Korea, tests for evaluating respiratory muscle strength are based on other countries' clinical experience or standards, which can lead to subjective evaluations. When evaluating respiratory function based on the standards of other countries, several variables, such as the race and cultures of different countries, make it difficult to apply these standards. The purpose of this study was to propose objective respiratory muscle strength standards and predicted values for healthy Korean adults based on age, height, weight, and muscle strength, by measuring maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), and peak cough flow (PCF). METHODS This cross-sectional study analyzed MIP, MEP, and PCF in 360 people, each group comprising 30 adult men and women aged 20-70, diagnosed as healthy after undergoing medical check-ups at a general hospital. Hand grip strength (HGS) and the five times sit-to-stand test (FTSST) results were also recorded. Correlations among respiratory muscle strength, participant demographics, and overall muscle strength were evaluated using Pearson's correlation analysis. The predicted values of respiratory muscle strength were calculated using multiple regression analysis. RESULTS Respiratory muscle strength differed from the values reported in studies from other countries. In the entire samples, both MIP and MEP had the highest correlations with peak HGS (r = 0.643, r = 0.693; P < 0.05), while PCF had the highest correlation with forced expiratory volume in 1 s (r = 0.753; P < 0.05). Age, body mass index, peak HGS, and FTSST results were independent variables affecting respiratory muscle strength. A predictive equation for respiratory muscle strength was developed using the multiple regression equation developed in this study. CONCLUSION Respiratory muscle strength index may differ by country. For more accurate diagnoses, standard values for each country are required. This study presents reference values for Korea, and a formula for estimation is proposed when no respiratory muscle strength measurement equipment is available. TRIAL REGISTRATION Clinical Research Information Service Identifier: KCT0006778.
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Affiliation(s)
- Tae Sung Park
- Department of Convergence Medical Institute of Technology, Pusan National University Hospital, Busan, Korea
- Department of Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
- Department of Physical Therapy, College of Health Sciences, Catholic University of Pusan, Busan, Korea
| | - Young Jin Tak
- Department of Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
- Department of Family Medicine, Pusan National University Hospital, Busan, Korea
- Department of Family Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Youngjin Ra
- Department of Family Medicine, Pusan National University Hospital, Busan, Korea
| | - Jinmi Kim
- Department of Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
- Department of Biostatistics, Clinical Trial Center, Pusan National University Hospital, Busan, Korea
| | - Sang Hun Han
- Department of Rehabilitation Medicine, Pusan National University Hospital, Busan, Korea
| | - Sang Hun Kim
- Department of Rehabilitation Medicine, Pusan National University Hospital, Busan, Korea
| | - YongBeom Shin
- Department of Rehabilitation Medicine, Pusan National University Hospital, Busan, Korea
- Department of Rehabilitation Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Myung-Jun Shin
- Department of Convergence Medical Institute of Technology, Pusan National University Hospital, Busan, Korea
- Department of Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
- Department of Rehabilitation Medicine, Pusan National University Hospital, Busan, Korea
- Department of Rehabilitation Medicine, Pusan National University School of Medicine, Busan, Korea.
| | - Jong Ho Kang
- Department of Physical Therapy, College of Health Sciences, Catholic University of Pusan, Busan, Korea.
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4
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Haynes JM, Kaminsky DA, Ruppel GL. The Role of Pulmonary Function Testing in the Diagnosis and Management of COPD. Respir Care 2023; 68:889-913. [PMID: 37353330 PMCID: PMC10289615 DOI: 10.4187/respcare.10757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/25/2023]
Abstract
Pulmonary function testing (PFT) has a long and rich history in the definition, diagnosis, and management of COPD. For decades, spirometry has been regarded as the standard for diagnosing COPD; however, numerous studies have shown that COPD symptoms, pathology, and associated poor outcomes can occur, despite normal spirometry. Diffusing capacity and imaging studies have called into question the need for spirometry to put the "O" (obstruction) in COPD. The role of exercise testing and the ability of PFTs to phenotype COPD are reviewed. Although PFTs play an important role in diagnosis, treatment decisions are primarily determined by symptom intensity and exacerbation history. Although a seminal study positioned FEV1 as the primary predictor of survival, numerous studies have shown that tests other than spirometry are superior predictors of mortality. In years past, using spirometry to screen for COPD was promulgated; however, this only seems appropriate for individuals who are symptomatic and at risk for developing COPD.
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Affiliation(s)
- Jeffrey M Haynes
- Pulmonary Function Laboratory, Elliot Health System, Manchester, New Hampshire.
| | - David A Kaminsky
- Division of Pulmonary and Critical Care Medicine, University of Vermont College of Medicine, Burlington, Vermont
| | - Gregg L Ruppel
- Division of Pulmonary, Critical Care and Sleep Medicine, St. Louis University, St. Louis, Missouri
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Choi HE, Min EH, Kim HK, Kim HJ, Jang HJ. Peak oxygen uptake and respiratory muscle performance in patients with chronic obstructive pulmonary disease: Clinical findings and implications. Medicine (Baltimore) 2022; 101:e31244. [PMID: 36281098 PMCID: PMC9592275 DOI: 10.1097/md.0000000000031244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The maximal oxygen uptake (VO2max) is the gold standard measure of aerobic exercise capacity and is an important outcome measure in patients with chronic obstructive pulmonary disease (COPD). And respiratory muscle performance is also an important functional parameter for COPD patients. In addition to the traditional respiratory muscle strength test, the Test of Incremental Respiratory Endurance has recently been introduced and validated in patients with COPD. However, the relationship between VO2 and respiratory muscle performance in COPD is not well understood. Therefore, this study investigated the correlations among VO2 and respiratory muscle performance and other functional markers in COPD. A total of 32 patients with COPD were enrolled. All study participants underwent the following assessments: cardiopulmonary exercise test, pulmonary function test, respiratory muscle strength test, peripheral muscle strength test, and bioelectrical impedance analysis. When comparing VO2peak and respiratory muscle parameters, the sustained maximal inspiratory pressure (SMIP) was the only factor with a significant relationship with VO2peak. Among other functional parameters, the forced expiratory volume in one second (FEV1) showed the strongest correlation with VO2peak. It was followed by phase angle values of lower limbs, leg extension peak torque, age, and total skeletal muscle mass. When comparing respiratory muscle performance with other functional parameters, the SMIP showed the strongest correlation with hand grip strength, followed by peak cough flow, forced vital capacity, maximal inspiratory pressure, and FEV1. The results showed that the SMIP was more significantly correlated with VO2peak than the static measurement of respiratory muscle strength. This suggests that TIRE may be a useful assessment tool for patients with COPD. Additionally, FEV1 and other functional markers were significantly correlated with VO2peak, suggesting that various parameters may be used to evaluate aerobic power indirectly.
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Affiliation(s)
- Hee-Eun Choi
- Department of Physical Medicine and Rehabilitation, Inje University Haeundae Paik Hospital, Busan, Korea
| | - Eun-Ho Min
- Department of Physical Medicine and Rehabilitation, Inje University Haeundae Paik Hospital, Busan, Korea
- *Correspondence: Eun-Ho Min, Department of Physical Medicine and Rehabilitation, Inje University Haeundae Paik Hospital, 875, Haeun-daero, Haeundae-gu, Busan, Korea (e-mail: )
| | - Hyun-Kuk Kim
- Department of Internal Medicine, Inje University Haeundae Paik Hospital, Busan, Korea
| | - Hyo-Jung Kim
- Department of Internal Medicine, Inje University Haeundae Paik Hospital, Busan, Korea
| | - Hang-Jea Jang
- Department of Internal Medicine, Inje University Haeundae Paik Hospital, Busan, Korea
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6
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Erram J, Bari M, Domingo A, Cannon DT. Pulmonary function with expiratory resistive loading in healthy volunteers. PLoS One 2021; 16:e0252916. [PMID: 34115812 PMCID: PMC8195373 DOI: 10.1371/journal.pone.0252916] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 05/25/2021] [Indexed: 11/19/2022] Open
Abstract
Expiratory flow limitation is a key characteristic in obstructive pulmonary diseases. To study abnormal lung mechanics isolated from heterogeneities of obstructive disease, we measured pulmonary function in healthy adults with expiratory loading. Thirty-seven volunteers (25±5 yr) completed spirometry and body plethysmography under control and threshold expiratory loading of 7, 11 cmH2O, and a subset at 20 cmH2O (n = 11). We analyzed the shape of the flow-volume relationship with rectangular area ratio (RAR; Ma et al., Respir Med 2010). Airway resistance was increased (p<0.0001) with 7 and 11 cmH2O loading vs control (9.20±1.02 and 11.76±1.68 vs. 2.53± 0.80 cmH2O/L/s). RAR was reduced (p = 0.0319) in loading vs control (0.45±0.07 and 0.47±0.09L vs. 0.48±0.08). FEV1 was reduced (p<0.0001) in loading vs control (3.24±0.81 and 3.23±0.80 vs. 4.04±1.05 L). FVC was reduced (p<0.0001) in loading vs control (4.11±1.01 and 4.14±1.03 vs. 5.03±1.34 L). Peak expiratory flow (PEF) was reduced (p<0.0001) in loading vs control (6.03±1.67 and 6.02±1.84 vs. 8.50±2.81 L/s). FEV1/FVC (p<0.0068) was not clinically significant and FRC (p = 0.4) was not different in loading vs control. Supra-physiologic loading at 20 cmH2O did not result in further limitation. Expiratory loading reduced FEV1, FVC, PEF, but there were no clinically meaningful differences in FEV1/FVC, FRC, or RAR. Imposed expiratory loading likely leads to high airway pressures that resist dynamic airway compression. Thus, a concave expiratory flow-volume relationship was consistently absent-a key limitation for model comparison with pulmonary function in COPD. Threshold loading may be a useful strategy to increase work of breathing or induce dynamic hyperinflation.
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Affiliation(s)
- Jyotika Erram
- School of Exercise & Nutritional Sciences, San Diego State University, San Diego, California, United States of America
| | - Monica Bari
- School of Exercise & Nutritional Sciences, San Diego State University, San Diego, California, United States of America
| | - Antoinette Domingo
- School of Exercise & Nutritional Sciences, San Diego State University, San Diego, California, United States of America
| | - Daniel T. Cannon
- School of Exercise & Nutritional Sciences, San Diego State University, San Diego, California, United States of America
- * E-mail:
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Washino S, Mankyu H, Kanehisa H, Mayfield DL, Cresswell AG, Yoshitake Y. Effects of inspiratory muscle strength and inspiratory resistance on neck inspiratory muscle activation during controlled inspirations. Exp Physiol 2019; 104:556-567. [PMID: 30714220 DOI: 10.1113/ep087247] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 02/01/2019] [Indexed: 11/08/2022]
Abstract
NEW FINDINGS What is the central question of this study? What factors influence the onset and magnitude of activation of the neck inspiratory muscles during inspiration? What is the main finding and its importance? Recruitment of the sternocleidomastoid and scalene muscles during inspiration, measured by means of surface EMG, was strongly correlated with maximal inspiratory pressure. This result indicates that muscle recruitment depends on the capacity of an individual to generate inspiratory pressure. Surface measurements of neck inspiratory muscle EMG activity might complement tests currently used for the screening of respiratory-related disease. ABSTRACT The aims of the present study were as follows: (i) to examine the relationship between the onset of recruitment of the neck inspiratory muscles and inspiratory muscle strength; and (ii) to clarify the effect of inspiratory resistance on neck inspiratory muscle activation during inspiration at specific flow rates and to specific lung volumes. Inspiratory muscle strength, as indicated by maximal inspiratory pressure (MIP), and peak inspiratory flow rate (PFR) were measured in healthy participants. Subsequently, participants inspired at target inspiratory flow rates between 20 and 100% of PFR as closely as possible, with and without artificial inspiratory resistance. Electromyographic activity (EMGRMS ) of the sternocleidomastoid and scalene muscles was measured from surface electrodes at each target flow rate for each 10% increment of forced vital capacity (FVC) between 20 and 50% of FVC. Recruitment onset for each muscle was determined from %PFR-EMGRMS curves at each lung volume (%FVC). Finally, linear regression analyses were performed for MIP and recruitment onset for each muscle at each %FVC. Recruitment onset during inspiration without inspiratory resistance was strongly correlated with MIP (r > 0.60, P < 0.040). Specifically, a lower MIP was associated with earlier muscle recruitment (i.e. recruitment at a lower flow rate), especially for the sternocleidomastoid muscle (r > 0.75, P < 0.005). Recruitment of both neck inspiratory muscles at a given flow rate was also earlier when inspiratory resistance was added (P = 0.002). These results indicate that the recruitment and activation of the neck inspiratory muscles depends on both inspiratory muscle strength and inspiratory resistance.
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Affiliation(s)
- Sohei Washino
- Graduate School of Physical Education, National Institute of Fitness and Sports in Kanoya, Kanoya, Kagoshima, Japan
| | - Hirotoshi Mankyu
- Department of Coaching of Sports and Budo, National Institute of Fitness and Sports in Kanoya, Kanoya, Kagoshima, Japan
| | - Hiroaki Kanehisa
- Department of Sports and Life Sciences, National Institute of Fitness and Sports in Kanoya, Kanoya, Kagoshima, Japan
| | - Dean L Mayfield
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Andrew G Cresswell
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Yasuhide Yoshitake
- Department of Sports and Life Sciences, National Institute of Fitness and Sports in Kanoya, Kanoya, Kagoshima, Japan.,School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia.,Graduate School of Science and Technology, Shinshu University, Ueda, Nagano, Japan
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8
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Formiga MF, Vital I, Urdaneta G, Campos MA, Cahalin LP. Beyond inspiratory muscle strength: Clinical utility of single-breath work capacity assessment in veterans with COPD. Respir Med 2019; 147:13-18. [PMID: 30704693 DOI: 10.1016/j.rmed.2018.12.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 12/29/2018] [Accepted: 12/31/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND Inspiratory muscle function in COPD has been traditionally described in terms of maximal inspiratory pressure (MIP). Arguably, however, is the day-to-day relevance of MIP, given that individuals rarely need maximal inspiratory forces to perform general tasks, but rather repeated breathing muscle contractions which demand endurance. The sustained maximal inspiratory pressure (SMIP) reflects the ability of the respiratory muscles to maintain force over time (i.e. single-breath work capacity). We investigated the relationships between SMIP and COPD-related clinical outcomes, hypothesizing that SMIP would have superior correlational and discriminatory value when compared to MIP. METHODS 61 males with mild-to-very severe airflow obstruction underwent measures of spirometry, whole-body plethysmography, symptomatology, comorbidity, quality of life, exacerbations and mental health. MIP and SMIP were obtained via the Test of Incremental Respiratory Endurance. RESULTS The mean ± SD MIP and SMIP were 77.2 ± 22.9 cmH2O and 407.9 ± 122.8 PTU. Both MIP and SMIP positively correlated with pulmonary function, with SMIP displaying the highest correlations. We found significant differences in spirometry, hyperinflation, symptomatology, exacerbation frequency, comorbidity, quality of life and anxiety in subjects grouped as having reduced or normal single-breath work capacity. Finally, significantly lower SMIP values were found in individuals with an IC/TLC ratio ≤25%. CONCLUSIONS The assessment of SMIP appears to have superior clinical value than MIP in COPD. Our analyses revealed that subjects whose SMIP was reduced experienced more severe airflow obstruction, greater hyperinflation, as well as worse health and mental status with increased symptomatology and impaired quality of life.
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Affiliation(s)
- Magno F Formiga
- Department of Physical Therapy, University of Miami Miller School of Medicine, Coral Gables, FL, United States; CAPES Foundation, Ministry of Education of Brazil, Brasilia, DF, Brazil.
| | - Isabel Vital
- Pulmonary Section, Miami Veterans Administration Medical Center, Miami, FL, United States
| | - Gisel Urdaneta
- Pulmonary Section, Miami Veterans Administration Medical Center, Miami, FL, United States
| | - Michael A Campos
- Pulmonary Section, Miami Veterans Administration Medical Center, Miami, FL, United States; Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Lawrence P Cahalin
- Department of Physical Therapy, University of Miami Miller School of Medicine, Coral Gables, FL, United States.
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9
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Formiga MF, Roach KE, Vital I, Urdaneta G, Balestrini K, Calderon-Candelario RA, Campos MA, Cahalin LP. Reliability and validity of the test of incremental respiratory endurance measures of inspiratory muscle performance in COPD. Int J Chron Obstruct Pulmon Dis 2018; 13:1569-1576. [PMID: 29805255 PMCID: PMC5960252 DOI: 10.2147/copd.s160512] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Purpose The Test of Incremental Respiratory Endurance (TIRE) provides a comprehensive assessment of inspiratory muscle performance by measuring maximal inspiratory pressure (MIP) over time. The integration of MIP over inspiratory duration (ID) provides the sustained maximal inspiratory pressure (SMIP). Evidence on the reliability and validity of these measurements in COPD is not currently available. Therefore, we assessed the reliability, responsiveness and construct validity of the TIRE measures of inspiratory muscle performance in subjects with COPD. Patients and methods Test-retest reliability, known-groups and convergent validity assessments were implemented simultaneously in 81 male subjects with mild to very severe COPD. TIRE measures were obtained using the portable PrO2 device, following standard guidelines. Results All TIRE measures were found to be highly reliable, with SMIP demonstrating the strongest test-retest reliability with a nearly perfect intraclass correlation coefficient (ICC) of 0.99, while MIP and ID clustered closely together behind SMIP with ICC values of about 0.97. Our findings also demonstrated known-groups validity of all TIRE measures, with SMIP and ID yielding larger effect sizes when compared to MIP in distinguishing between subjects of different COPD status. Finally, our analyses confirmed convergent validity for both SMIP and ID, but not MIP. Conclusion The TIRE measures of MIP, SMIP and ID have excellent test-retest reliability and demonstrated known-groups validity in subjects with COPD. SMIP and ID also demonstrated evidence of moderate convergent validity and appear to be more stable measures in this patient population than the traditional MIP.
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Affiliation(s)
- Magno F Formiga
- Department of Physical Therapy, University of Miami Miller School of Medicine, Coral Gables, FL, USA.,CAPES Foundation, Ministry of Education of Brazil, Brasilia, Brazil
| | - Kathryn E Roach
- Department of Physical Therapy, University of Miami Miller School of Medicine, Coral Gables, FL, USA
| | - Isabel Vital
- Pulmonary Section, Miami Veterans Administration Medical Center, Miami, FL, USA
| | - Gisel Urdaneta
- Pulmonary Section, Miami Veterans Administration Medical Center, Miami, FL, USA
| | - Kira Balestrini
- Pulmonary Section, Miami Veterans Administration Medical Center, Miami, FL, USA
| | - Rafael A Calderon-Candelario
- Pulmonary Section, Miami Veterans Administration Medical Center, Miami, FL, USA.,Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Michael A Campos
- Pulmonary Section, Miami Veterans Administration Medical Center, Miami, FL, USA.,Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Lawrence P Cahalin
- Department of Physical Therapy, University of Miami Miller School of Medicine, Coral Gables, FL, USA
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10
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Van Eetvelde BLM, Cambier D, Vanden Wyngaert K, Celie B, Calders P. The Influence of Clinically Diagnosed Neuropathy on Respiratory Muscle Strength in Type 2 Diabetes Mellitus. J Diabetes Res 2018; 2018:8065938. [PMID: 30622971 PMCID: PMC6304822 DOI: 10.1155/2018/8065938] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 10/11/2018] [Accepted: 10/29/2018] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVES This cross-sectional study investigated the influence of clinically diagnosed neuropathy (cdNP) on respiratory muscle strength in patients with type 2 diabetes mellitus (T2DM). METHODS 110 T2DM patients and 35 nondiabetic healthy controls (≥60 years) were allocated to one of three groups depending on the presence of cdNP: T2DM without cdNP (D-; n = 28), T2DM with cdNP (D+; n = 82), and controls without cdNP (C; n = 35). Clinical neurological diagnostic examination consisted of Vibration Perception Threshold and Diabetic Neuropathy Symptom score. Respiratory muscle strength was registered by maximal Inspiratory and Expiratory Pressures (PImax and PEmax), and respiratory function by Peak Expiratory Flow (PEF). Isometric Handgrip Strength and Short Physical Performance Battery were used to evaluate peripheral skeletal muscle strength and physical performance. Univariate analysis of covariance was used with age, level of physical activity, and body mass index as covariates. RESULTS PImax, PEmax, and PEF were higher in C compared to D- and D+. Exploring more in detail, PImax, PEmax, and PEF were significantly lower in D+ compared to C. PEmax and PEF were also significantly lower in D- versus C. Measures of peripheral muscle strength and physical performance showed less associations with cdNP and T2DM. CONCLUSIONS The presence of cdNP affects respiratory muscle strength in T2DM patients compared to healthy controls. Both cdNP and diabetes in themselves showed a distinctive impact on respiratory muscle strength and function; however, an accumulating effect could not be ascertained in this study. As commonly used measures of peripheral muscle strength and physical performance seemed to be less affected at the given time, the integration of PImax, PEmax, and PEF measurements in the assessment of respiratory muscle weakness could be of added value in the (early) screening for neuropathy in patients with T2DM.
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Affiliation(s)
| | - Dirk Cambier
- Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, Belgium
| | | | - Bert Celie
- Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, Belgium
| | - Patrick Calders
- Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, Belgium
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Kim NS, Seo JH, Ko MH, Park SH, Kang SW, Won YH. Respiratory Muscle Strength in Patients With Chronic Obstructive Pulmonary Disease. Ann Rehabil Med 2017; 41:659-666. [PMID: 28971051 PMCID: PMC5608674 DOI: 10.5535/arm.2017.41.4.659] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Accepted: 12/05/2016] [Indexed: 11/05/2022] Open
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.
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Affiliation(s)
- Nam-Sik Kim
- Department of Physical Medicine and Rehabilitation, Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea
| | - Jeong-Hwan Seo
- Department of Physical Medicine and Rehabilitation, Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea
| | - Myoung-Hwan Ko
- Department of Physical Medicine and Rehabilitation, Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea
| | - Sung-Hee Park
- Department of Physical Medicine and Rehabilitation, Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea
| | - Seong-Woong Kang
- Department of Rehabilitation Medicine and Rehabilitation Institute of Neuromuscular Disease, Yonsei University College of Medicine, Seoul, Korea.,Pulmonary Rehabilitation Center, Gangnam Severance Hospital, Seoul, Korea
| | - Yu Hui Won
- Department of Physical Medicine and Rehabilitation, Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea
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López-de-Uralde-Villanueva I, Sollano-Vallez E, Del Corral T. Reduction of cervical and respiratory muscle strength in patients with chronic nonspecific neck pain and having moderate to severe disability. Disabil Rehabil 2017; 40:2495-2504. [DOI: 10.1080/09638288.2017.1337239] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Ibai López-de-Uralde-Villanueva
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Auto´noma de Madrid, Madrid, Spain
- Motion in Brains Research Group, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
- Instituto de investigación para la salud (IdiPAZ), Hospital La Paz, Madrid, Spain
| | - Ernesto Sollano-Vallez
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Auto´noma de Madrid, Madrid, Spain
| | - Tamara Del Corral
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Auto´noma de Madrid, Madrid, Spain
- Motion in Brains Research Group, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
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Grams ST, Kimoto KYM, Azevedo EMDO, Lança M, de Albuquerque ALP, de Brito CMM, Yamaguti WP. Unidirectional Expiratory Valve Method to Assess Maximal Inspiratory Pressure in Individuals without Artificial Airway. PLoS One 2015; 10:e0137825. [PMID: 26360255 PMCID: PMC4567335 DOI: 10.1371/journal.pone.0137825] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2014] [Accepted: 08/21/2015] [Indexed: 11/21/2022] Open
Abstract
Introduction Maximal Inspiratory Pressure (MIP) is considered an effective method to estimate strength of inspiratory muscles, but still leads to false positive diagnosis. Although MIP assessment with unidirectional expiratory valve method has been used in patients undergoing mechanical ventilation, no previous studies investigated the application of this method in subjects without artificial airway. Objectives This study aimed to compare the MIP values assessed by standard method (MIPsta) and by unidirectional expiratory valve method (MIPuni) in subjects with spontaneous breathing without artificial airway. MIPuni reproducibility was also evaluated. Methods This was a crossover design study, and 31 subjects performed MIPsta and MIPuni in a random order. MIPsta measured MIP maintaining negative pressure for at least one second after forceful expiration. MIPuni evaluated MIP using a unidirectional expiratory valve attached to a face mask and was conducted by two evaluators (A and B) at two moments (Tests 1 and 2) to determine interobserver and intraobserver reproducibility of MIP values. Intraclass correlation coefficient (ICC[2,1]) was used to determine intraobserver and interobserver reproducibility. Results The mean values for MIPuni were 14.3% higher (-117.3 ± 24.8 cmH2O) than the mean values for MIPsta (-102.5 ± 23.9 cmH2O) (p<0.001). Interobserver reproducibility assessment showed very high correlation for Test 1 (ICC[2,1] = 0.91), and high correlation for Test 2 (ICC[2,1] = 0.88). The assessment of the intraobserver reproducibility showed high correlation for evaluator A (ICC[2,1] = 0.86) and evaluator B (ICC[2,1] = 0.77). Conclusions MIPuni presented higher values when compared with MIPsta and proved to be reproducible in subjects with spontaneous breathing without artificial airway.
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Affiliation(s)
- Samantha Torres Grams
- Department of Rehabilitation, Hospital Sírio-Libanês (HSL), São Paulo, São Paulo, Brazil
| | - Karen Yumi Mota Kimoto
- Department of Rehabilitation, Hospital Sírio-Libanês (HSL), São Paulo, São Paulo, Brazil
| | | | - Marina Lança
- Department of Rehabilitation, Hospital Sírio-Libanês (HSL), São Paulo, São Paulo, Brazil
| | - André Luis Pereira de Albuquerque
- Department of Rehabilitation, Hospital Sírio-Libanês (HSL), São Paulo, São Paulo, Brazil
- Department of Pulmonary Function–Núcleo Avançado de Tórax (NAT), Hospital Sírio-Libanês (HSL), São Paulo, São Paulo, Brazil
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Bernardi E, Pomidori L, Bassal F, Contoli M, Cogo A. Respiratory muscle training with normocapnic hyperpnea improves ventilatory pattern and thoracoabdominal coordination, and reduces oxygen desaturation during endurance exercise testing in COPD patients. Int J Chron Obstruct Pulmon Dis 2015; 10:1899-906. [PMID: 26392764 PMCID: PMC4573075 DOI: 10.2147/copd.s88609] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background Few data are available about the effects of respiratory muscle training with normocapnic hyperpnea (NH) in COPD. The aim is to evaluate the effects of 4 weeks of NH (Spirotiger®) on ventilatory pattern, exercise capacity, and quality of life (QoL) in COPD patients. Methods Twenty-six COPD patients (three females), ages 49–82 years, were included in this study. Spirometry and maximal inspiratory pressure, St George Respiratory Questionnaire, 6-minute walk test, and symptom-limited endurance exercise test (endurance test to the limit of tolerance [tLim]) at 75%–80% of peak work rate up to a Borg Score of 8–9/10 were performed before and after NH. Patients were equipped with ambulatory inductive plethysmography (LifeShirt®) to evaluate ventilatory pattern and thoracoabdominal coordination (phase angle [PhA]) during tLim. After four supervised sessions, subjects trained at home for 4 weeks – 10 minutes twice a day at 50% of maximal voluntary ventilation. The workload was adjusted during the training period to maintain a Borg Score of 5–6/10. Results Twenty subjects completed the study. After NH, maximal inspiratory pressure significantly increased (81.5±31.6 vs 91.8±30.6 cmH2O, P<0.01); exercise endurance time (+150 seconds, P=0.04), 6-minute walk test (+30 meters, P=0.03), and QoL (−8, P<0.01) all increased. During tLim, the ventilatory pattern changed significantly (lower ventilation, lower respiratory rate, higher tidal volume); oxygen desaturation, PhA, and dyspnea Borg Score were lower for the same work intensity (P<0.01, P=0.02, and P<0.01, respectively; one-way ANOVA). The improvement in tidal volume and oxygen saturation after NH were significantly related (R2=0.65, P<0.01). Conclusion As expected, NH improves inspiratory muscle performance, exercise capacity, and QoL. New results are significant change in ventilatory pattern, which improves oxygen saturation, and an improvement in thoracoabdominal coordination (lower PhA). These two facts could explain the reduced dyspnea during the endurance test. All these results together may play a role in improving exercise capacity after NH training.
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Affiliation(s)
- Eva Bernardi
- Biomedical Sport Studies Center, University of Ferrara, Ferrara, Cona (FE), Italy
| | - Luca Pomidori
- Biomedical Sport Studies Center, University of Ferrara, Ferrara, Cona (FE), Italy
| | - Faisy Bassal
- Biomedical Sport Studies Center, University of Ferrara, Ferrara, Cona (FE), Italy
| | - Marco Contoli
- Respiratory Section, Department of Medical Sciences, University of Ferrara, Cona (FE), Italy
| | - Annalisa Cogo
- Biomedical Sport Studies Center, University of Ferrara, Ferrara, Cona (FE), Italy
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Impact of high fat low carbohydrate enteral feeding on weaning from mechanical ventilation. EGYPTIAN JOURNAL OF CHEST DISEASES AND TUBERCULOSIS 2014. [DOI: 10.1016/j.ejcdt.2014.07.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Testa A, Galeri S, Villafañe JH, Corbellini C, Pillastrini P, Negrini S. Efficacy of short-term intrapulmonary percussive ventilation in patients with chronic obstructive pulmonary disease. Disabil Rehabil 2014; 37:899-903. [DOI: 10.3109/09638288.2014.948130] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Ozkaya S, Dirican A, Kaya SO, Karanfil RC, Bayrak MG, Bostancı O, Ece F. The relationship between early reversibility test and maximal inspiratory pressure in patients with airway obstruction. Int J Chron Obstruct Pulmon Dis 2014; 9:453-6. [PMID: 24833899 PMCID: PMC4015719 DOI: 10.2147/copd.s58584] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Maximal inspiratory pressure (MIP) is a marker for assessing the degree of respiratory muscle dysfunction. Muscle dysfunction represents a pathophysiological feature of chronic obstructive pulmonary disease. We aimed to determinate the MIP value in patients with airway obstruction, to evaluate the change in MIP with bronchodilator drug, and to show the relationship between the changes in MIP and disease characteristics. We evaluated 21 patients with airway obstruction at the Department of Pulmonary Medicine, Samsun Medicalpark Hospital, Samsun, Turkey. We performed pulmonary function tests, measurement of MIP values, and reversibility tests with salbutamol. The baseline spirometry results were: mean forced vital capacity (FVC), 3,017±1,020 mL and 75.8%±20.8%; mean forced expiratory volume in 1 second (FEV1), 1,892±701 mL and 59.2%±18.2%; FEV1/FVC, 62.9%±5.5%; peak expiratory flow, 53%±19%. The pre-bronchodilator MIP value was 62.1±36.9 cmH2O. The reversibility test was found to be positive in 61.9% of patients with salbutamol. The absolute change and percentage of change in FEV1 were 318±223 mL and 19.8%±16.7%, respectively. The MIP value was increased by 5.5 cmH2O (8.8%) and was 67.7±30.3 cmH2O after bronchodilation. There was no significant relationship between age, FEV1, reversibility, and change in MIP with bronchodilator. However, the increase in MIP with bronchodilator drug was higher in patients with low body mass index (<25 kg/m(2)). We noted a 13.1% increase in FVC, a 19.8% increase in FEV1, a 20.2% increase in peak expiratory flow, and an 8.8% increase in MIP with salbutamol. In conclusion; MIP increases with bronchodilator therapy, regardless of changes in lung function, in patients with airway obstruction. The reversibilty test can be used to evaluate change in MIP with salbutamol.
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Affiliation(s)
- Sevket Ozkaya
- Department of Pulmonary Medicine, Faculty of Medicine, Bahcesehir University, Istanbul, Turkey
| | - Adem Dirican
- Department of Pulmonary Medicine, Samsun Medicalpark Hospital, Samsun, Turkey
| | - Sule Ozbay Kaya
- Department of Physical Therapy and Rehabilitation Clinic, Samsun Medicalpark Hospital, Samsun, Turkey
| | - Rabia C Karanfil
- Department of Physical Therapy and Rehabilitation Clinic, Samsun Medicalpark Hospital, Samsun, Turkey
| | - Merve G Bayrak
- Department of Pulmonary Medicine, Samsun Chest Diseases and Thoracic Surgery Hospital, Samsun, Turkey
| | - Ozgür Bostancı
- Academy of Sports, Ondokuzmayis University, Samsun, Turkey
| | - Ferah Ece
- Department of Pulmonary Medicine, Faculty of Medicine, Bahcesehir University, Istanbul, Turkey
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Khalil M, Wagih K, Mahmoud O. Evaluation of maximum inspiratory and expiratory pressure in patients with chronic obstructive pulmonary disease. EGYPTIAN JOURNAL OF CHEST DISEASES AND TUBERCULOSIS 2014. [DOI: 10.1016/j.ejcdt.2014.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Effect of thyroid function on COPD exacerbation frequency: a preliminary study. Multidiscip Respir Med 2013; 8:64. [PMID: 24079533 PMCID: PMC3845712 DOI: 10.1186/2049-6958-8-64] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2013] [Accepted: 07/12/2013] [Indexed: 12/04/2022] Open
Abstract
Background Frequent exacerbations of chronic obstructive pulmonary disease (COPD) have negative effects on quality of life and survival. Thus, factors related to exacerbations should be determined. We aimed to evaluate the effects of thyroid function on quality of life and exacerbation frequency in COPD patients. Methods The study population (n = 128) was divided into 3 groups (Group 1: COPD patients with hypothyroidism (n = 44); Group 2: COPD patients with normal thyroid function tests (n = 44); Group 3: Healthy subjects (n = 40)). Pulmonary function tests, maximum inspiratory pressure (MIP) and maximum expiratory pressure (MEP) measurements were performed. Quality of life questionnaire (Short Form 36, SF-36) was carried out. Patients were followed up for one year and number of exacerbations was recorded. Results FVC, FEV1/FVC, and FEF 25–75% measurements were statistically different between group 1 and 2 (p = 0.041, p = 0.001, p = 0.009 respectively). Although MEP values were significantly different between group 1 and 2 (p = 0.006), there was no significant difference in MIP values between groups (p = 0.77). Quality of life scores in group 1 and 2 were significantly lower than control group. Exacerbation frequency was significantly higher in group 1 than in group 2 (p = 0.017). TSH values and exacerbation frequency had positive correlation (p < 0.0001; r = 0.82). Conclusions The results of the present study suggest that thyroid function has an effect in exacerbation frequency of COPD. Decrease in exacerbation numbers with early detection of impairment in thyroid function will have positive contribution on quality of life in COPD patients.
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Ong BA, Caboot J, Jawad A, McDonough J, Jackson T, Arens R, Marcus CL, Smith-Whitley K, Mason TBA, Ohene-Frempong K, Allen JL. Respiratory muscle force and lung volume changes in a population of children with sickle cell disease. Br J Haematol 2013; 163:112-7. [PMID: 23869561 PMCID: PMC3776481 DOI: 10.1111/bjh.12481] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2013] [Accepted: 06/19/2013] [Indexed: 11/29/2022]
Abstract
Sickle cell disease (SCD) is a disorder known to impact the respiratory system. We sought to identify respiratory muscle force and lung volume relationships in a paediatric SCD population. Thirty-four SCD-SS subjects underwent pulmonary function testing. Height, weight, age, and gender-adjusted percent predicted maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) values were compared to spirometry and lung volumes. Statistical analyses were performed using Pearson's correlation coefficient and paired two-tailed t-test. The mean ± standard deviation (SD) MIP and MEP was 69·6 ± 31·6 cm H2 O and 66·9 ± 22·9 cm H2 O, respectively, and mean ± SD percent predicted MIP (101·3 ± 45·9) exceeded MEP (72·1 ± 26·0) (P = 0·002). MIP correlated with forced vital capacity (FVC; r = 0·51, P = 0·001) and TLC (r = 0·54, P < 0·0001). MEP also correlated with FVC (r = 0·43, P = 0·011) and total lung capacity (TLC; r = 0·42, P = 0·013). Pearson's correlation coefficient testing yielded relationships between MIP and MEP (r = 0·64, P < 0·0001). SCD-SS patients showed correlations between respiratory muscle force and lung volume, and reduced percent predicted expiratory muscle force compared to inspiratory muscle force. Respiratory muscle strength may affect lung volumes in these patients, and expiratory muscles may be more susceptible than the diaphragm to SCD-induced vaso-occlusive damage.
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Affiliation(s)
- Bruce A Ong
- Division of Pediatric Pulmonology, Tripler Army Medical Center, Honolulu, HI, USA
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Jácome C, Marques A, Gabriel R, Figueiredo D. Chronic obstructive pulmonary disease and functioning: implications for rehabilitation based on the ICF framework. Disabil Rehabil 2013; 35:1534-45. [DOI: 10.3109/09638288.2012.745625] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Lan CC, Su CP, Chou LL, Yang MC, Lim CS, Wu YK. Association of body mass index with exercise cardiopulmonary responses in lung function-matched patients with chronic obstructive pulmonary disease. Heart Lung 2012; 41:374-81. [DOI: 10.1016/j.hrtlng.2012.02.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2011] [Revised: 02/10/2012] [Accepted: 02/11/2012] [Indexed: 10/28/2022]
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Rodriguez Gonzalez-Moro JM, de Lucas Ramos P, Izquierdo Alonso JL, López-Muñiz Ballesteros B, Antón Díaz E, Ribera X, Martín A. Impact of COPD severity on physical disability and daily living activities: EDIP-EPOC I and EDIP-EPOC II studies. Int J Clin Pract 2009; 63:742-50. [PMID: 19392924 DOI: 10.1111/j.1742-1241.2009.02040.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
AIMS The severity of chronic obstructive pulmonary disease (COPD) is associated to patients' health-related quality of life (HRQL). Physical impairment increasingly affects daily activities creating economic, social and personal burden for patients and their families. This burden should be considered in the management of COPD patients; therefore, we intended to assess the impact of the disease severity on physical disability and daily activities. METHODS Two epidemiological observational cross-sectional descriptive studies were carried out in 1596 patients with moderate COPD and 2012 patients with severe or very severe COPD in the routine clinical practice. Demographic and basic clinical-epidemiological data were collected and patients completed questionnaires to assess their physical disability because of COPD [Medical Research Council (MRC)], COPD repercussion on daily activities [London Chest Activity of Daily Living (LCADL)], job, economy and family habits and their health status [EQ-5D visual analogue scale (VAS)]. RESULTS In all, 37% of severe/very severe COPD patients and 10% of moderate (p < 0.0001) had MRC grades 4 and 5. Mean global LCADL was significantly higher in severe/very severe than in moderate patients [29.6 (CI 95%: 28.91-30.25) vs. 21.4 (CI 95%: 20.8-21.9); p < 0.0001]. COPD job impact and economic and family habits repercussions were significantly higher and health status significantly worse in severe/very severe cases than in patients with moderate COPD. CONCLUSIONS COPD severity is highly associated with physical disability by MRC grading, with functionality on daily activities and with impairment of other social and clinical activities. Moderate COPD patients show already a significant degree of impairment in all these parameters.
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