Relevance of assessing quadriceps endurance in patients with COPD
Relevance of assessing quadriceps endurance in patients with COPD
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DOI：
10.1183/09031936.04.00079603
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发表时间：
2004-07-01
影响因子：
24.3
通讯作者：
Gea, J
中科院分区：
文献类型：
--
作者：
Coronell, C;Orozco-Levi, M;Gea, J
本研究的目的是调查肢体肌肉耐力损伤是否是慢性阻塞性肺疾病（COPD）患者的普遍发现，甚至影响那些患有轻中度疾病或相对正常体力活动的患者。此外，本研究旨在确定局部耐力测试中疲劳的生理病理，以及是否可以通过肌肉力量测量来预测股四头肌耐力的降低。根据肺功能测试，共有75名志愿者被分为两组：COPD患者或年龄匹配的健康对照组。功能评估包括股四头肌力量(最大自主收缩（Q(MVC)）和股四头肌耐力(在负荷下收缩相当于10% Q（MVC)，直到任务失败或最多30分钟的限制时间（qtrim））。与对照组相比，COPD患者的Q（MVC）下降了43%，Q（trim）下降了77%。任务失败仅发生在COPD患者中，并且是由于肌肉疲劳引起的，因为限制性症状与股四头肌肌电信号中位数频率的降低和QMVC的可逆降低有关。即使在轻度至中度气流阻塞患者和身体活动相对正常的个体中，骨骼肌耐力的损害也存在，并且与肺功能变量、人体测量数据或股四头肌力量无关。慢性阻塞性肺疾病患者外周肌肉耐力受损，即使是那些体力活动相对正常、轻度至中度气流阻塞的患者。这种损伤与肌肉疲劳的早期发作有关，不能从疾病的严重程度或股四头肌力量的减少来预测。
The aims of this study were to investigate whether the impairment in endurance of limb muscles is a general finding in chronic obstructive pulmonary disease (COPD) patients, affecting even those with mild-to-moderate disease or relatively normal physical activity. In addition, this study aimed to determine the physiopathology of exhaustion in local endurance tests and whether the reduction in quadriceps endurance can be predicted from muscle strength measurements.A total of 75 volunteers were assigned to one of two groups according to pulmonary function tests: COPD patients or healthy age-matched controls. Functional assessment included both quadriceps strength (maximum voluntary contraction (Q(MVC))), and quadriceps endurance (contractions against a load equivalent to 10% Q(MVC) until task failure or for up to a limiting time of 30 min (QTlim)).COPD patients showed a decrease of similar to43% in Q(MVC) and similar to77% in Q(Tlim) compared with controls. Task failure occurred only in COPD patients and was due to muscle fatigue, since limiting symptoms were associated with a decrease in the median frequency of quadriceps electromyographical signal and a reversible decrease in QMVC. The impairment in skeletal muscle endurance was present even in patients with mild-to-moderate airflow obstruction and individuals with relatively normal physical activity, and was irrespective of lung function variables, anthropometrical data or quadriceps strength.Peripheral muscle endurance was impaired in chronic obstructive pulmonary disease patients, even in those with relatively normal physical activity and mild-to-moderate airflow obstruction. This impairment associated with an early onset of muscle fatigue and could not be predicted from the severity of the disease or the reduction in quadriceps strength.