NURSING MODEL--RESPIRATORY MUSCLE STRENGTH IN COPD

慢性阻塞性肺疾病(COPD)患者展示 吸气肌的功能强度减弱 他们有患呼吸肌疲劳的危险， 并导致呼吸困难和呼吸困难的感觉 最终导致功能性能下降。这项研究将是 一项纵向研究，随访10年，但工作描述 这里涵盖了研究的前五年，并反映了前三年 多年的跟踪调查。本研究的具体目的是：(1)描述 吸气肌力在自然过程中的退化 对本病的研究，(2)考察病情恶化的关系 吸气肌力，胸部过度充气和丧失 肌肉质量，(3)描述吸气状态恶化的结果 肌肉力量与呼吸困难和功能表现的关系 (4)描述病情恶化的长期影响 吸气肌力、外周肌力和肌肉质量。 这项研究将包括100名中重度COPD患者和50名 健康的受试者。所有变量将在基线上测量四次 并在三年内每年一次。将测量变量的子集 在每次病情加重和/或呼吸道感染后康复 (RTI)。主要变量包括：(L)吸气肌力测量 作为最大吸气压力，(2)过度充气定义为 残气量与总肺活量的比率；(3)身体成分 用双能x射线吸收测量仪测量，皮褶厚度和 臂中肌区，(4)膝关节周围肌力 屈肌/伸肌和握手，(5)慢性呼吸困难 疾病问卷，(6)12分钟功能表现 长距离步行、功能表现量表与疾病的影响 侧写。前四个变量将在恢复后进行测量 每次加重/RTI。数据将使用描述性统计进行分析 重复测量方差分析。

Patients with chronic obstructive pulmonary disease (COPD) demonstrate a reduced functional strength of the inspiratory muscles which places them at risk for the development of respiratory muscle fatigue and ventilatory failure and contributes to sensations of dyspnea and ultimately to a decrease in functional performance. This study will be a longitudinal study with 10 years of follow-up, but the work described here covers the first five years of the study and reflects the first 3 years of follow-up. The specific aims of this study are: (1) to describe the deterioration in inspiratory muscle strength over the natural course of the disease, (2) to examine the relationship between deterioration inspiratory muscle strength, hyperinflation of the chest and loss of muscle mass, (3) to describe the outcomes of deterioration in inspiratory muscle strength with respect to dyspnea and functional performance and (4) to describe the long-term effects of exacerbations with respect to inspiratory muscle strength, peripheral muscle strength and muscle mass. This study will include 100 patients with moderate to severe COPD and 50 healthy subjects. All variables will be measured four times, at baseline and annually for three years. A subset of variables will be measured after recovery from each exacerbation and/or respiratory tract infection (RTI). Major variables include: (l) inspiratory muscle strength measured as the maximal inspiratory pressure, (2) hyperinflation defined as the ratio of the residual volume to total lung capacity, (3) body composition measured with dual energy x-ray absorptiometry, skinfold thicknesses and mid-arm muscle area, (4) peripheral muscle strength of the knee flexors/extensors and hand grip, (5) dyspnea with the Chronic Respiratory Disease Questionnaire, (6) functional performance with the 12 minute distance walk, Functional Performance Inventory and the Sickness Impact Profile. The first four variables will be measured after recovery from each exacerbation/RTI. Data will be analyzed with descriptive statistics and repeated measures ANOVA.