Relationship Between Respiratory Muscle Strength and Physical Performance in Elderly Hospitalized Patients
Relationship Between Respiratory Muscle Strength and Physical Performance in Elderly Hospitalized Patients
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DOI：
10.1089/rej.2014.1549
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发表时间：
2014-08-01
影响因子：
2.6
通讯作者：
Incalzi, Raffaele Antonelli
中科院分区：
文献类型：
--
作者：
Giua, Renato;Pedone, Claudio;Incalzi, Raffaele Antonelli
背景：与年龄相关的肺功能改变增加了呼吸肌的作功。面对这种增加的需求，肌肉质量差，经常与年龄和多种疾病相关，可能会降低呼吸肌的耐力和力量。此外，肌肉质量差本身可能会导致运动不耐受和体能下降。该研究的目的是评估呼吸肌力是否对老年人群的体能有显著影响。方法：68名年龄在65岁以上(平均79岁，标准差[SD]6)的老年患者在出院时处于稳定状态。通过测量最大吸气和呼气压力(MIP、MEP)和6分钟步行试验(6MWT)评估呼吸肌功能。结果：样本平均年龄78.2岁(SD 6.1)。MIP和MEP与6MWT距离的相关性有统计学意义(MIP，r=0.43，p&t；0.001；MEP，r=0.41，p=0.001)。在调整了1秒用力呼气量(FEV1)、用力肺活量(FVC)、年龄、性别、脱脂质量指数(FFMI)和腿部力量后，呼吸压力与6MWT之间的相关性保持不变。多元回归模型显示，在校正了性别、年龄、FEV1和FVC后，6分钟步行试验距离(6MWD)与MIP和MEP显著相关。此外，在多元Logistic回归模型中，MEP可以显著预测6MWD时的运动能力下降。结论：老年患者呼吸肌力下降与运动能力下降独立相关。
Background: Age-related changes in pulmonary function increase respiratory muscle work. In the face of this increased demand, poor muscle mass, frequently associated with age and multi-morbidity, can reduce endurance and strength of respiratory muscles. Furthermore, poor muscle mass may per se contribute to exercise intolerance and lower physical performance. The aim of the study was to evaluate if respiratory muscle strength has a significant impact on physical performance in an elderly population.Methods: We included 68 patients (28 men and 40 women) aged over 65 years (mean 79 years, standard deviation [ SD] 6) in stable condition at discharge from our acute care geriatric ward. We assessed the function of respiratory muscle by measuring maximal inspiratory and expiratory pressures (MIP, MEP) and physical function using the 6-Minute Walk Test (6MWT).Results: The mean age of our sample was 78.2 years (SD 6.1). There was a statistically significant correlation between MIP or MEP and 6MWT distance (MIP, r = 0.43, p < 0.001; MEP, r = 0.41, p = 0.001). The association between respiratory pressures and 6MWT was maintained after adjustment for forced expiratory volume in 1 sec (FEV1), forced vital capacity (FVC), age, sex, fat-free mass index (FFMI), and leg strength. The multiple regression model showed a significant relation between 6-Minute Walk Test distance (6MWD) and both MIP and MEP after correction for sex, age, FEV1, and FVC. Furthermore, MEP can significant predict poorer performance at 6MWD in a multiple logistic regression model.Conclusion: Reduced respiratory muscle strength is independently associated with worse physical performance in elderly patients.