Respiratory and skeletal muscle strength in chronic obstructive pulmonary disease: impact on exercise capacity and lower extremity function.
Respiratory and skeletal muscle strength in chronic obstructive pulmonary disease: impact on exercise capacity and lower extremity function.
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DOI：
10.1097/hcr.0b013e3182033663
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发表时间：
2011-03
影响因子：
3.8
通讯作者：
Blanc PD
中科院分区：
文献类型：
--
作者：
Singer J;Yelin EH;Katz PP;Sanchez G;Iribarren C;Eisner MD;Blanc PD
我们试图量化呼吸肌和下肢力量对慢性阻塞性肺疾病（COPD）患者运动能力和下肢功能的影响。在 828 名慢性阻塞性肺病患者中，我们评估了呼吸减少（最大吸气压，MIP）和下肢肌肉力量（股四头肌，QS）对运动能力（6 分钟步行距离，6MWT）和下肢功能（LEF，短体力表现电池）的影响。多元回归分析考虑了关键协变量，包括肺功能和吸烟，测试了肌肉力量与运动和功能能力之间的关联。 QS 每减少 1/2 标准差 (0.5 SD)，男性在 6MWT 期间步行量就会减少 18.3 米（95% CI -24.1 至 -12.4）；女性低 25.1 米（95% CI -31.1 至 -12.4）。 MIP 每减少 0.5 SD，男性在 6MWT 期间步行量就会减少 9.4 米（95% CI – 15.2 至 −3.6）；女性低 8.7 米（95% CI -14.1 至 -3.4）。 QS 每下降 0.5 个 SD，男性 LEF 较差的几率就会增加 1.32（95% CI：1.11 至 1.15）；女性的几率高出 1.87（95% CI：1.54 至 2.27）。较低的 MIP（每 0.5 SD）与女性 LEF 不良的几率增加相关（OR 1.18，95% CI：1.00 至 1.39），但与男性无关（OR 1.10，95% CI：0.93 至 1.31）。在慢性阻塞性肺病中，呼吸和下肢肌肉力量的下降与运动和功能能力的下降有关。肌肉无力可能是 COPD 患者损伤和残疾的重要组成部分。
We sought to quantify the impact of respiratory muscle and lower extremity strength on exercise capacity and lower extremity function in patients with chronic obstructive pulmonary disease (COPD). In 828 persons with COPD, we assessed the impact of reduced respiratory (maximum inspiratory pressure, MIP) and lower extremity muscle strength (quadriceps, QS) on exercise capacity (6 Minute Walk Distance, 6MWT) and lower extremity function (LEF, Short Physical Performance Battery). Multiple regression analyses taking into account key covariates, including lung function and smoking, tested the associations between muscle strength and exercise and functional capacity. For each ½ standard deviation (0.5 SD) decrement in QS, men walked 18.3 meters less during 6MWT (95% CI −24.1 to −12.4); women 25.1 meters less (95% CI −31.1 to −12.4). For each 0.5 SD decrement in MIP, men walked 9.4 meters less during 6MWT (95% CI – 15.2 to −3.6); women 8.7 meters less (95% CI −14.1 to −3.4). For each 0.5 SD decrease in QS, men had a 1.32 higher odds (95% CI: 1.11 to 1.15) of poor LEF; women, 1.87 higher odds (95% CI: 1.54 to 2.27). Lower MIP (per 0.5 SD) was associated with increased odds of poor LEF in women (OR 1.18, 95% CI: 1.00 to 1.39), but not in men (OR 1.10, 95% CI: 0.93 to 1.31). In COPD, reduced respiratory and lower extremity muscle strength are associated with decreased exercise and functional capacity. Muscle weakness is likely an important component of impairment and disability in patients with COPD.