Acute effect of oral steroids on muscle function in chronic obstructive pulmonary disease

Hopkinson, Nicholas S; Man, William D.-C.; Dayer, Mark; Ross, Ewen; Nickol, Annabel H.; Hart, Nicholas; Moxham, John; Polkey, Michael I.

doi:10.1183/09031936.04.00139003

Cited by 61 publications

(47 citation statements)

References 38 publications

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“…This may occur in patients frequently exposed to systemic corticosteroids (138,251). This finding may only apply to chronically treated patients, as no further decrease in quadriceps strength was reported in short-term corticosteroid-treated patients with COPD compared with untreated patients (252).…”

Section: Limb Muscle Function In Copdmentioning

confidence: 87%

An Official American Thoracic Society/European Respiratory Society Statement: Update on Limb Muscle Dysfunction in Chronic Obstructive Pulmonary Disease

Maltais¹,

Decramer²,

Casaburi³

et al. 2014

Am J Respir Crit Care Med

871

1,033

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Section: Limb Muscle Function In Copdmentioning

confidence: 87%

An Official American Thoracic Society/European Respiratory Society Statement: Update on Limb Muscle Dysfunction in Chronic Obstructive Pulmonary Disease

Maltais¹,

Decramer²,

Casaburi³

et al. 2014

Am J Respir Crit Care Med

871

1,033

View full text Add to dashboard Cite

“…The improvement in Pdi,tw could be explained by reduction in lung volume, suggesting that clinical doses of b 2 -agonists do not improve diaphragm contractility per se. Similarly, a 2-week course of oral corticosteroids does not have any detrimental effect on diaphragm strength [107]. One of the proposed benefits of lung volume reduction surgery is the reduction of hyperinflation and subsequent improvement in the forcelength relationship of the diaphragm.…”

Section: Chronic Obstructive Pulmonary Diseasementioning

confidence: 99%

Magnetic stimulation for the measurement of respiratory and skeletal muscle function

Man¹

2004

European Respiratory Journal

Self Cite

117

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Respiratory and skeletal muscle function is of interest in many areas of pulmonary and critical care medicine. The capacity of the respiratory muscle pump to respond to the load imposed by disease is the basis of an understanding of ventilatory failure. Over the last four decades, considerable progress has been made in quantifying the capacity of the respiratory muscles, in terms of strength, endurance and fatigue. With the development of magnetic stimulation, it has recently become possible to nonvolitionally assess the respiratory muscles in a clinically acceptable way. This is of particular interest in the investigation of patients receiving critical care, those with neuromuscular disease, and in children where volitional efforts are either not possible or likely to be sub-maximal. Furthermore, the adaptation of these techniques to quantify the strength of peripheral muscles, such as the quadriceps, has allowed the effects of muscle training or rehabilitation, uninfluenced by learning effect, to be assessed. This article focuses on the physiological basis of magnetic nerve stimulation, and reviews how the technique has been applied to measure muscle strength and fatigue, with particular emphasis upon the diaphragm. The translation of magnetic stimulation into a clinical tool is described, and how it may be of diagnostic, prognostic and therapeutic value in several areas of pulmonary medicine. In particular, the use of magnetic stimulation in neuromuscular disease, the intensive care setting, chronic obstructive pulmonary disease and paediatrics will be discussed. The nonvolitional assessment of skeletal musclesFor routine muscle strength measurements, the force generated from a maximum voluntary contraction (MVC) is often used. However volitional, effort-dependent manoeuvres for measuring strength are not always suitable for patients as the ability to perform a true MVC relies upon subject motivation and cooperation. This is particularly so in patients on intensive care units (ICU), children, patients with cognitive difficulties, and those patients prevented from performing a true MVC by pain (for example, following surgery). However, even in well-motivated subjects, sub-maximal muscle activation is common in routine clinical practice [1]. As volitional manoeuvres are influenced by a learning effect, the value of MVC is also limited in studies of training or rehabilitation. Consequently, there has been a need for nonvolitional methods to assess muscle strength. Skeletal muscle physiologySkeletal muscle is controlled by electrical impulses conducted by motor neurones that lead to the release of acetylcholine from the motor end plate, thus depolarising the muscle cell membrane. The force generated by muscle contraction is dependent upon a number of factors, including the number of muscle fibres stimulated, muscle length at the time of stimulation and the frequency of stimulation. The force-frequency curve of a muscle is of particular relevance in the understanding of nonvolitional techniques to asse...

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“…Data obtained from some of the healthy elderly controls contributed to the normal values of cough gastric pressure reported in a previous study, 18 and data obtained from some of the COPD patients contributed to baseline measurements reported in previous studies. 19 20 …”

mentioning

confidence: 99%

Abdominal muscle and quadriceps strength in chronic obstructive pulmonary disease

Man

Hopkinson²,

Harraf³

et al. 2005

Thorax

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Background: Quadriceps muscle weakness is common in chronic obstructive pulmonary disease (COPD) but is not observed in a small hand muscle (adductor pollicis). Although this could be explained by reduced activity in the quadriceps, the observation could also be explained by anatomical location of the muscle or fibre type composition. However, the abdominal muscles are of a similar anatomical and fibre type distribution to the quadriceps, although they remain active in COPD. Cough gastric pressure is a recently described technique that assesses abdominal muscle (and hence expiratory muscle) strength more accurately than traditional techniques. A study was undertaken to test the hypothesis that more severe weakness exists in the quadriceps than in the abdominal muscles of patients with COPD compared with healthy elderly controls. Methods: Maximum cough gastric pressure and quadriceps isometric strength were measured in 43 patients with stable COPD and 25 healthy elderly volunteers matched for anthropometric variables. Results: Despite a significant reduction in mean quadriceps strength (29.9 kg v 41.2 kg; 95% CI 217.9 to 24.6; p = 0.001), cough gastric pressure was preserved in patients with COPD (227.3 cm H 2 O v 204.8 cm H 2 O; 95% CI 25.4 to 50.6; p = 0.11). Conclusions: Abdominal muscle strength is preserved in stable COPD outpatients in the presence of quadriceps weakness. This suggests that anatomical location and fibre type cannot explain quadriceps weakness in COPD. By inference, we conclude that disuse and consequent deconditioning are important factors in the development of quadriceps muscle weakness in COPD patients, or that activity protects the abdominal muscles from possible systemic myopathic processes.

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Acute effect of oral steroids on muscle function in chronic obstructive pulmonary disease

Cited by 61 publications

References 38 publications

An Official American Thoracic Society/European Respiratory Society Statement: Update on Limb Muscle Dysfunction in Chronic Obstructive Pulmonary Disease

An Official American Thoracic Society/European Respiratory Society Statement: Update on Limb Muscle Dysfunction in Chronic Obstructive Pulmonary Disease

Magnetic stimulation for the measurement of respiratory and skeletal muscle function

Abdominal muscle and quadriceps strength in chronic obstructive pulmonary disease

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