Clinical Assessment of Peripheral Muscle Function in Patients with Chronic Obstructive Pulmonary Disease

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Abstract

Objective:

Correlation of muscle function, muscle mass and endurance, and exercise tolerance in chronic obstructive pulmonary disease (COPD).

Design:

Sixteen COPD patients (forced expiratory volume during the first second 38 ± 15% predicted) and 6 controls underwent magnetic resonance imaging of the thigh, muscle strength and endurance, and exercise tolerance assessments.

Results:

Thigh mass distribution was bimodal (cutoff 19.0 kg m−2). Six COPD patients (16 ± 2.5 kg m−2) (P < 0.05) presented reduced thigh mass (COPDLQ), whereas 10 patients with normal quadriceps mass (COPDNQ) and all controls had identical mass distribution (22 ± 2.4 kg m−2). COPDLQ patients had lower muscle function and lower exercise tolerance than both COPDNQ and controls (P < 0.05 each), but muscle strength corrected by mass was similar between COPD patients (COPDLQ 0.59 ± 0.12 and COPDNQ 0.55 ± 0.10 Nm kg−1 m−2) and controls (0.62 ± 0.04 Nm Kg−1 m−2). In contrast, endurance to muscle mass ratio was lower in COPD (COPDLQ and COPDNQ 0.91 ± 0.15 and 0.89 ± 0.15 J kg−1 m−2) than in controls (1.07 ± 0.11 J kg−1 m−2) (P < 0.05). Half-time phosphocreatine recovery (COPDLQ 66 ± 14 and COPDNQ 55 ± 9 secs, not significant) was also slower than in controls (43 ± 10 secs) (P < 0.01).

Conclusions:

Impaired muscle strength was explained by reduced muscle mass, but it did not account for abnormal muscle endurance. The latter seems associated to impaired O2 transport/O2 utilization, resulting in altered muscle bioenergetics.

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