NURSING MODEL--RESPIRATORY MUSCLE STRENGTH IN COPD

慢性阻塞性肺疾病（COPD）患者表现出 吸气肌的功能强度降低， 他们有发生呼吸肌疲劳的风险， 呼吸衰竭，并导致呼吸困难的感觉， 最终导致功能性能下降。本研究将 一项为期10年的纵向研究，但这项工作描述了 这里涵盖了研究的前五年，并反映了前三年 多年的后续。本研究的具体目的是：（1）描述 在自然过程中吸气肌肉力量的退化 （2）检查病情恶化与 吸气肌肉力量，胸部过度充气和 肌肉质量，（3）描述吸气功能恶化的结果 与呼吸困难和功能表现有关的肌肉力量， (4)描述急性加重对以下方面的长期影响 吸气肌力、外周肌力和肌肉质量。 本研究将纳入100例中度至重度COPD患者和50例 例正常人所有变量将在基线时测量4次 每年一次，持续三年。将测量变量的子集 每次急性加重和/或呼吸道感染恢复后 （RTI）。主要变量包括：（l）测量的吸气肌力 最大吸气压力，（2）过度充气，定义为 残气量与肺总容量的比值，（3）身体成分 用双能X线吸收法测量，皮褶厚度和 臂中肌面积;（4）膝关节周围肌力 屈肌/伸肌和握力，（5）慢性呼吸道疾病引起的呼吸困难 疾病问卷，（6）12分钟功能表现 远距离步行、功能性行为量表和疾病影响 Profile.前四个变量将在恢复后测量， 每次加重/RTI。将使用描述性统计分析数据 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.