Patients hospitalized for community-acquired pneumonia present reduced functional performance

Abstract

| Background: Symptoms of fatigue and dyspnea, treatment with oral corticosteroids, high circulating levels of cytokines, and oxidant/antioxidant imbalance in patients hospitalized with community-acquired pneumonia (CAP) could affect the patients' exercise tolerance and peripheral muscle strength (PMS). Objective: To evaluate the functional capacity (FC) of patients hospitalized for CAP and to correlate the FC with length of hospital stay. Method: We prospectively evaluated 45 patients (49±16 years; CAP group) and 20 healthy subjects (53±17 years; control group). They were randomized to perform, on separate days, a 6-minute walk test (6MWT), a test of PMS, and the Glittre test (GT). Additionally, the SF-36 questionnaire and the MRC scale were completed and evaluated. Results: There were significant differences between the groups (CAP and controls) for the 6MWT (381.3±108 vs. 587.1±86.8 m) and GT (272.8±104.3 vs. 174±39 sec). The CAP group also presented worse health-related quality of life (HRQoL) scores, reduced strength (quadriceps and biceps), and higher scores of dyspnea. The time required to perform the GT correlated with the length of hospital stay (r=0.35, P=0.02) and dyspnea (r=0.36, P=0.02). Significant correlations were observed between GT and 6MWT (r=-0.66, P=0.0001) and between GT with the physical functioning domain of SF-36 (r=-0.51, P=0.0001). Conclusions:Patients hospitalized for CAP presented with reduced FC, PMS, and HRQoL during hospitalization. In addition, GT performance was related to the length of hospital stay.Keywords: pneumonia; physical therapy; exercise tolerance; quality of life; muscle strength. HOW TO CITE THIS ARTICLE

Reduced Step Count and Clinical Frailty in Hospitalized Adults With Community-Acquired Pneumonia

“…Community-acquired pneumonia (CAP) is defined as an acute infection of the lower respiratory tract occurring in a patient who has not resided in a hospital or health care facility in the previous 14 d. 1 Earlier work has shown that, following a hospitalization for CAP, adults report a decline in exercise capacity and difficulty undertaking activities of daily living. 2,3 The reasons for these impairments are likely to be multifactorial but include cardiovascular and skeletal muscle deconditioning that results from convalescence. [4][5][6] Given what is known in other hospitalized populations, 7,8 we would expect that adults hospitalized with CAP accumulate very little walking-based activity.…”

Ventilatory demand and dynamic hyperinflation induced during ADL-based tests in Chronic Obstructive Pulmonary Disease patients

“…The Glittre-ADL test is a multiple-task test that assesses functional status related to ADL in stable 8 - 11 and hospitalized 12 , 13 patients with respiratory disease. It includes activities that require rising from a seated position, activities with lower and upper extremities, as well as walking 8 .…”

Step Tests Are Safe for Assessing Functional Capacity in Patients Hospitalized With Acute Lung Diseases

“…In a previous study conducted by our research group, patients hospitalized for acute lung diseases exhibited a decrease in FC upon admission to hospital, as well as diminished peripheral muscle strength and quality of life. 21 In this study, the CST and the MIST were correlated with the 6MWT, and exercise-induced desaturation was equivalent among the tests. Thus, both step tests are viable field test options for evaluating FC in patients with acute lung diseases, especially when limited physical space is available for executing the 6MWT, such as in a hospital setting.…”