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Muscular Dysfunction in COPD: Systemic Effect or Deconditioning?

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Abstract

Background

Muscular dysfunction has been described as one of the systemic manifestations of chronic obstructive pulmonary disease (COPD).

Objective

The aim of this study was to evaluate muscular strength of the different anatomical compartments in patients with severe COPD compared with healthy controls.

Method

We performed a cross-sectional study in patients with severe COPD. We evaluated the muscular strength of the respiratory muscles, flexors and extensors of the cervical spine and knee, as well as handgrip force. The 6-min walking test (6MWT) and serum inflammatory markers were also analysed.

Results

Twenty-eight male patients with COPD (mean age 67.8 years, mean FEV1 (%) 39 %) and 24 male healthy controls (mean age 70.2 years) were studied. The strength of the flexors and extensors of the knee was significantly reduced in patients with COPD (p < 0.001 and p = 0.003). No differences were observed in the flexors and extensors of the cervical spine and handgrip force between groups. No correlation was observed between the muscular strength in the different anatomic compartments and the concentrations of blood inflammatory biomarkers or the metres walked in the 6MWT in COPD patients. However, a significant negative linear correlation was observed between the 6MWT and IL-6 and IL-8 levels (rho = −0.67, p = 0.001; rho = −0.57, p = 0.008). In addition, we found a negative correlation between the 6MWT and inspiratory capacity (rho = −0.755, p = 0.031).

Conclusions

Our results suggest that muscular dysfunction in patients with COPD differs in different muscular compartments. The main factor for a reduced exercise capacity was a reduction in inspiratory capacity.

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References

  1. Watz H, Waschki B, Boehme C et al (2007) Extrapulmonary effects of chronic obstructive pulmonary disease on physical activity. Am J Respir Crit Care Med 29:653–659

    Google Scholar 

  2. Gea J, Casadevall C, Pascual S et al (2012) Respiratory diseases and muscle dysfunction. Expert Rev Respir Med 6:75–90

    Article  CAS  PubMed  Google Scholar 

  3. Hopkinson NS, Tennant RC, Dayer MJ et al (2007) A prospective study of decline in fat free mass and skeletal muscle strength in chronic obstructive pulmonary disease. Respir Res 13:8–25

    Google Scholar 

  4. Gea J, Orozco-Levi M, Barreiro E, Ferrer A et al (2001) Structural and functional changes in the skeletal muscles of COPD patients: the “compartments” theory. Monaldi Arch Chest Dis 56:214–224

    CAS  PubMed  Google Scholar 

  5. Swallow EB, Reyes D, Hopkinson NS et al (2007) Quadriceps strength predicts mortality in patients with moderate to severe chronic obstructive pulmonary disease. Thorax 62:115–120

    Article  PubMed  PubMed Central  Google Scholar 

  6. Takeda K, Kawasaki Y, Yoshida K et al (2013) The 6-minute pegboard and ring test is correlated with upper extremity activity of daily living in chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis 8:347–351

    Article  PubMed  PubMed Central  Google Scholar 

  7. Seger JY, Westing SH, Hanson M et al (1988) A new dynamometer measuring concentric and eccentric muscle strength in accelerated, decelerated, or isokinetic movements. Validity and reproducibility. Eur J Appl Physiol Occup Physiol 57:526–533

    Article  CAS  PubMed  Google Scholar 

  8. Ritti-Dias RM, Basyches M, Câmara L et al (2010) Test-retest reliability of isokinetic strength and endurance tests in patients with intermittent claudication. Vasc Med 15:275–278

    Article  PubMed  Google Scholar 

  9. Pleguezuelos E, Pérez ME, Guirao L et al (2013) Effects of whole body vibration training in patients with severe chronic obstructive pulmonary disease. Respirology 18:1028–1034

    Article  PubMed  Google Scholar 

  10. Chiu TT, Lam TH, Hedley AJ (2002) Maximal isometric muscle strength of the cervical spine in healthy volunteers. Clin Rehabil 16:772–779

    Article  PubMed  Google Scholar 

  11. Peolsson A, Hedlund R, Oberg B (2001) Intra- and inter-tester reliability and reference values for hand strength. J Rehabil Med 33:36–41

    Article  CAS  PubMed  Google Scholar 

  12. American Thoracic Society ATS Statement (2002) Guidelines for the six-minute walk test. Am J Respir Crit Care Med 166:111–117

    Article  Google Scholar 

  13. Miravitlles M, Marin A, Monsó E et al (2010) Colour of sputum is a marker of bacterial colonization in COPD. Respir Res 11:58

    Article  PubMed  PubMed Central  Google Scholar 

  14. Agustí A, Edwards LD, Rennard SI et al (2012) Evaluation of COPD longitudinally to identify predictive surrogate endpoints (ECLIPSE) investigators persistent systemic inflammation is associated with poor clinical outcomes in COPD: a novel phenotype. PLoS One 7:e374–e383

    Article  Google Scholar 

  15. Evans RA, Kaplovitch E, Beauchamp MK et al (2015) Is quadriceps endurance reduced in COPD? A systematic review. Chest 147:673–684

    Article  PubMed  Google Scholar 

  16. Pitta F, Troosters T, Spruit MA et al (2005) Characteristics of physical activities in daily life in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 171:972–977

    Article  PubMed  Google Scholar 

  17. Hunt T, Madigan S, Williams MT et al (2014) Use of time in people with chronic obstructive pulmonary disease—a systematic review. Int J Chron Obstruct Pulmon Dis 12:1377–1388

    Article  Google Scholar 

  18. Spector SA, Simard CP, Fournier M et al (1982) Architectural alterations of rat hind-limb skeletal muscles immobilized at different lengths. Exp Neurol 76:94–110

    Article  CAS  PubMed  Google Scholar 

  19. Williams PE (1998) Effect of intermittent stretch on immobilised muscle. Ann Rheum Dis 47:1014–1016

    Article  Google Scholar 

  20. Coutinho EL, Gomes ARS, França CN et al (2004) Effect of passive stretching on the immobilized soleus muscle fibre morphology. Braz J Med Biol Res 37:1853–1861

    Article  CAS  PubMed  Google Scholar 

  21. Boyle R, Pompeiano O (1980) Responses of vestibulospinal neuronsto sinusoidal rotation of neck. J Neurophysiol 44:633–649

    CAS  PubMed  Google Scholar 

  22. Heijdra YF, Pinto-Plata V, Frants R et al (2003) Muscle strength and exercise kinetics in COPD patients with a normal fat-free mass index are comparable to control subjects. Chest 124:75–82

    Article  PubMed  Google Scholar 

  23. Gosselink R, Troosters T, Decramer M (1996) Peripheral muscle weakness contributes to exercise limitation in COPD. Am J Respir Crit Care Med 153:976–980

    Article  CAS  PubMed  Google Scholar 

  24. Shah S, Nahar P, Vaidya S et al (2013) Upper limb muscle strength and endurance in chronic obstructive pulmonary disease. Indian J Med Res 138:492–496

    PubMed  PubMed Central  Google Scholar 

  25. García-Río F, Miravitlles M, Soriano JB et al (2010) Systemic inflammation in chronic obstructive pulmonary disease: a population-based study. Respir Res 11:63

    Article  PubMed  PubMed Central  Google Scholar 

  26. Yende S, Waterer GW, Tolley EA et al (2006) Inflammatory markers are associated with ventilatory limitation and muscle dysfunction in obstructive lung disease in well-functioning elderly subjects. Thorax 61:10–16

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Gagnon P, Lemire BB, Dubé A et al (2014) Preserved function and reduced angiogenesis potential of the quadriceps in patients with mild COPD. Respir Res 15:4

    Article  PubMed  PubMed Central  Google Scholar 

  28. Barreiro E, Schols AM, Polkey MI et al (2008) ENIGMA in COPD project. Cytokine profile in quadriceps muscles of patients with severe COPD. Thorax 63:100–107

    Article  CAS  PubMed  Google Scholar 

  29. Gan WQ, Man SF, Senthilselvan A et al (2004) Association between chronic obstructive pulmonary disease and systemic inflammation: a systematic review and a meta-analysis. Thorax 59:574–580

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Stockley RA (2009) Progression of chronic obstructive pulmonary disease: impact of inflammation, comorbidities and therapeutic intervention. Curr Med Res Opin 25:1235–1245

    Article  PubMed  Google Scholar 

  31. Gatta D, Aliprandi G, Pini L et al (2011) Dynamic pulmonary hyperinflation and low grade systemic inflammation in stable COPD patients. Eur Rev Med Pharmacol Sci 15:1068–1073

    CAS  PubMed  Google Scholar 

  32. Garcia-Rio F, Lores V, Mediano O et al (2009) Daily physical activity in patients with chronic obstructive pulmonary disease is mainly associated with dynamic hyperinflation. Am J Respir Crit Care Med 180:506–512

    Article  PubMed  Google Scholar 

  33. Rossi A, Aisanov ZR, Avdeev S et al (2015) Mechanisms, assessment and therapeutic implications of lung hyperinflation in COPD. Respir Med 109:785–802

    Article  PubMed  Google Scholar 

  34. Miravitlles M, Soriano JB, García-Río F et al (2009) Prevalence of COPD in Spain: impact of undiagnosed COPD on quality of life and daily life activities. Thorax 64:863–868

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Physical Medicine and Rehabilitation Department, Hospital Mataró, C/Cirera s/n 08302, Mataró, Barcelona, Spain

    Eulogio Pleguezuelos & Lluis Guirao

  2. Department of Experimental Science and Healthcare, Faculty of Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain

    Eulogio Pleguezuelos & Alex Merí

  3. Faculty of Health Sciences Blanquerna, Universitat Ramón LLull, Barcelona, Spain

    Eulogio Pleguezuelos & Alex Merí

  4. Pneumology Department, Hospital Universitari Vall d’Hebron, Ciber de Enfermedades Respiratorias (CIBERES), Barcelona, Spain

    Cristina Esquinas & Marc Miravitlles

  5. Physical Medicine and Rehabilitation Department, Hospitalet General Hospital, L´Hospitalet de Llobregat, Barcelona, Spain

    Eva Moreno

  6. Biomechanics Laboratory, INVALCOR, Barcelona, Spain

    Javier Ortiz & Joan Garcia-Alsina

Authors
  1. Eulogio Pleguezuelos
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  2. Cristina Esquinas
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  3. Eva Moreno
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  4. Lluis Guirao
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  5. Javier Ortiz
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  6. Joan Garcia-Alsina
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  7. Alex Merí
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  8. Marc Miravitlles
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Corresponding author

Correspondence to Eulogio Pleguezuelos.

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The authors have no conflicts of interest in relation to this work.

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Pleguezuelos, E., Esquinas, C., Moreno, E. et al. Muscular Dysfunction in COPD: Systemic Effect or Deconditioning?. Lung 194, 249–257 (2016). https://doi.org/10.1007/s00408-015-9838-z

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  • DOI: https://doi.org/10.1007/s00408-015-9838-z

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