MUSCLE STRENGTH, SYMPTOM INTENSITY, AND EXERCISE CAPACITY IN PATIENTS WITH CARDIORESPIRATORY DISORDERS
MUSCLE STRENGTH, SYMPTOM INTENSITY, AND EXERCISE CAPACITY IN PATIENTS WITH CARDIORESPIRATORY DISORDERS
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DOI：
10.1164/ajrccm.152.6.8520771
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发表时间：
1995-12-01
影响因子：
24.7
通讯作者：
JONES, NL
中科院分区：
文献类型：
--
作者：
HAMILTON, AL;KILLIAN, KJ;JONES, NL
在正常人和患有心肺疾病的患者中检查了肌肉力量对症状强度和工作能力的贡献。测量了 4,617 名接受临床运动测试的受试者的呼吸肌力量（最大吸气和呼气压力）和外周肌肉力量（腿部伸展、腿部弯曲、坐姿卧推和坐姿划船）。然后，受试者在自行车测力计上评估增量运动任务（每分钟 100 公里/分钟）期间的腿部用力强度、呼吸不适（呼吸困难）和胸痛（博格量表）。根据肺功能、心脏疾病的药物治疗以及运动时出现胸痛且心电图变化表明心肌缺血的情况将受试者分组。与正常人相比，心肺疾病患者的呼吸肌力和外周肌力（根据年龄、性别和身高差异标准化）显着降低。肌肉力量是健康和疾病症状强度和工作能力的重要因素；肌肉力量增加两倍，腿部用力和呼吸困难的强度减少 25% 至 30%，工作能力增加 1.4 至 1.6 倍。这些结果强调需要在运动不耐受的评估和治疗管理中采取综合方法，除了通气、气体交换和循环障碍的影响之外，还考虑肌肉无力对过度症状和工作能力降低的影响。
The contribution of muscle strength to symptom intensity and work capacity was examined in normal individuals and patients with cardiorespiratory disorders. Respiratory muscle strengths (maximal inspiratory and expiratory pressures) and peripheral muscle strengths (leg extension, leg flexion, seated bench press, and seated row) were measured in 4,617 subjects referred for clinical exercise testing. Subjects then rated the intensity of leg effort, discomfort with breathing (dyspnea), and chest pain (Borg scale) during an incremental exercise task (100 kpm/min each minute) to capacity on a cycle ergometer. Subjects were classified into groups on the basis of pulmonary function, drug therapy for cardiac disorders, and the presence of chest pain during exercise with electrocardiographic changes indicative of myocardial ischemia. Respiratory and peripheral muscle strengths, normalized for differences in age, sex, and height, were significantly reduced in patients with cardiorespiratory disorders compared with normal individuals. Muscle strength was a significant contributor to symptom intensity and work capacity in both health and disease; a two-fold increase in muscle strength was associated with a 25 to 30% decrease in the intensity of both leg effort and dyspnea and a 1.4- to 1.6-fold increase in work capacity. These results emphasize the need for an integrative approach in the assessment and therapeutic management of exercise intolerance, which considers the contribution of muscle weakness to excessive symptoms and reduced work capacity, in addition to the contribution of ventilatory, gas exchange, and circulatory impairments.