Deficits in Muscle Strength, Mass, Quality, and Mobility in People With Chronic Obstructive Pulmonary Disease

Abstract

Purpose-Mid-thigh intramuscular fat (IF), a feature of reduced muscle quality, is an important predictor of self-reported mobility loss in the elderly. This study compared measures of muscle strength, mass, IF, and mobility in people with COPD and healthy subjects. Associations between measures of muscle strength, mass, IF and mobility were explored.Methods-Knee extensors muscle strength was assessed with an isokinetic dynamometer. Crosssectional area (CSA) and IF of the thigh muscles were measured with computerized tomography. Mobility was assessed with the Repetitive Sit-To-Stand (RSTS), Self-Selected Gait Speed (SSGS) and Six-Minute Walk Distance (6MWT) tests.Results-Twenty-one people of mean ± SD age 71.3 ± 8.1 years with COPD and a percentage predicted force expiratory volume in one second (FEV 1 ) of 47.2 ± 12.9 and 21 healthy subjects matched for age (67.4 ± 8.6), gender and body mass participated in the study. People with COPD showed reduced average knee extensors strength (29%;p=0.016) CSA of the thigh muscles (17%;p=0.007) and mobility measures (~23%;p≤0.001). Knee extensors and flexors IF was twofold greater in people with COPD (p≤0.005). Measures of knee extensors muscle strength, mass and IF were not associated with mobility measures.Conclusions-Compared with healthy controls, people with moderate to severe COPD show marked deficits in muscle strength, mass, quality as well as mobility. More studies with larger sample size are required to elucidate whether any of these muscle deficits can explain mobility impairments in COPD.

Physical Activity as a Predictor of Absence of Frailty in Subjects With Stable COPD and COPD Exacerbation

“…This can be explained not only by physical deterioration; cognitive impairment 62 and depression 63 are more severe in COPD exacerbation. It has been previously reported that subjects with COPD experienced marked deficits in mobility, 56,59,60 gait speed, 60 and gait stability, 64 exhibiting balance unsteadiness and limited physical activity when compared with controls. 65,66 This contributes to the high prevalence of frailty in COPD as well as the reduction of physical activity.…”

“…As reported by the study of Park et al, 6 the high prevalence of frailty among the COPD population is not surprising, taking into account the clinical characteristics of these individuals. The increase of disease severity and the shortness of breath lead to inactivity, [53][54][55] which in turn leads to a deterioration of muscle strength, [56][57][58] independence, 59,60 and finally, frailty. People with COPD experience a loss of muscle strength, primarily in lower limb muscles, 57,61 which is greater when individuals with COPD suffer from an exacerbation.…”

Gait analysis in patients with chronic obstructive pulmonary disease: a systematic review

“…Patients with COPD present a deficit of proprioceptive control and a higher body oscillation frequency [7]. Impaired balance and slower reaction times in response to perturbations increase the risk for falls and important complications, such as fractures [8,24]. It was suggested that increased mediolateral body oscillations in patients with COPD may be due to thoracoabdominal asynchrony with inadequate contribution to the thorax compartment to tidal volume that eases postural sway [7].…”

“…In particular, as skeletal muscle weakness leads to limited mobility, motor incoordination and functional limitations, individuals with COPD present postural control impairment with respect to age-matched healthy controls [6][7][8][9]. As a consequence of such balance deficits, patients with COPD fall frequently [10][11][12][13].…”

Aplicación del test de caminata de 6 minutos en la valoración del sujeto con EPOC

“…Produce en los sujetos con enfermedad pulmonar avanzada alteraciones funcionales que se manifiestan con disnea e intolerancia a las actividades de la vida diaria y al ejercicio (3)(4)(5)(6)(7)(8)(9)(10).…”