Distal Leg Muscle Function in Patients with COPD

Gagnon, Philippe; Maltais, François; Bouyer, Laurent J.; Ribeiro, Fernanda; Coats, Valérie; Brouillard, Cynthia; Noël, Martin; Rousseau-Gagnon, Mathieu; Saey, Didier

doi:10.3109/15412555.2012.719047

Cited by 37 publications

(42 citation statements)

References 26 publications

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“…Mechanical unloading due to physical inactivity contributes to peripheral muscle abnormalities and dysfunction. Muscle weakness in COPD has been reported primarily in thigh musculature (quadriceps, in both men and women [41]), and more recently documented in the ankle dorsiflexors and plantarflexors [42,43]. Taken together, these abnormalities indicate an overall decline in both the contractile and oxidative capacity of lower limbs muscles in patients with COPD [11].…”

Section: Source Of Gait Abnormalities In Copdmentioning

confidence: 82%

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

et al. 2018

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Background: Gait instability is a major fall-risk factor in patients with chronic obstructive pulmonary disease (COPD). Clinical gait analysis is a reliable tool to predict fall onsets. However, controversy still exists on gait impairments associated with COPD. Research question: Thus, the aims of this review were to evaluate the current understanding of spatiotemporal, kinematic and kinetic gait features in patients with COPD. Methods: In line with PRISMA guidelines, a systematic literature search was performed throughout Web of Science, PubMed Medline, Scopus, PEDro and Scielo databases. We considered observational cross-sectional studies evaluating gait features in patients with COPD as their primary outcome. Risk of bias and applicability of these papers were assessed according to the QUADAS-2 tool. Results: Seven articles, cross-sectional studies published from 2011 to 2017, met the inclusion criteria. Sample size of patients with COPD ranged 14-196 (mean age range: 64-75 years). The main reported gait abnormalities were reduced step length and cadence, and altered variability of spatiotemporal parameters. Only subtle biomechanical changes were reported at the ankle level. Significance: A convincing mechanistic link between such gait impairments and falls in patients with COPD is still lacking. The paucity of studies, small sample sizes, gender and disease status pooling were the main risk of biases affecting the results uncertainty. Two research directions emerged: stricter cohorts characterization in terms of COPD phenotype and longitudinal studies. Quantitative assessment of gait would identify abnormalities and sensorimotor postural deficiencies that in turn may lead to better falling prevention strategies in COPD.

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Section: Source Of Gait Abnormalities In Copdmentioning

confidence: 82%

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

et al. 2018

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“…Fatigue measured during the 6MWT using the Borg scale is associated with lower 6MWT, slower gait speed, more severe airflow obstruction, more dyspnoea on exertion and lower HRQoL [1]. Notably, low-frequency muscle fatigue in the quadriceps is seldom found with the 6MWT, although low-frequency fatigue in distal leg muscles has been reported to be greater in COPD patients compared with controls [62].…”

Section: Subjective Fatiguementioning

confidence: 97%

An official European Respiratory Society/American Thoracic Society technical standard: field walking tests in chronic respiratory disease

Holland¹,

Spruit²,

Troosters³

et al. 2014

Eur Respir J

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1,835

1,555

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Field walking tests are commonly employed to evaluate exercise capacity, assess prognosis and evaluate treatment response in chronic respiratory diseases. In recent years, there has been a wealth of new literature pertinent to the conduct of the 6-min walk test (6MWT), and a growing evidence base describing the incremental and endurance shuttle walk tests (ISWT and ESWT, respectively). The aim of this document is to describe the standard operating procedures for the 6MWT, ISWT and ESWT, which can be consistently employed by clinicians and researchers.The Technical Standard was developed by a multidisciplinary and international group of clinicians and researchers with expertise in the application of field walking tests. The procedures are underpinned by a concurrent systematic review of literature relevant to measurement properties and test conduct in adults with chronic respiratory disease.Current data confirm that the 6MWT, ISWT and ESWT are valid, reliable and responsive to change with some interventions. However, results are sensitive to small changes in methodology. It is important that two tests are conducted for the 6MWT and ISWT.This Technical Standard for field walking tests reflects current evidence regarding procedures that should be used to achieve robust results. OverviewThe aim of this Technical Standard is to document the standard operating procedures for the 6-min walk test (6MWT), incremental shuttle walk test (ISWT) and endurance shuttle walk test (ESWT) in adults with chronic respiratory disease. The testing procedures were developed by a multinational and multidisciplinary group of experts in field exercise testing, informed by a systematic review of the measurement properties and interpretation of the 6MWT, ISWT and ESWT in adults with chronic respiratory disease [1].The key findings of the Technical Standard are as follows.1) The 6-min walking distance (6MWD), ISWT and ESWT demonstrate good construct validity. Strong relationships with measures of exercise performance and physical activity support their conceptualisation as tests of functional exercise performance.2) A lower 6MWD is strongly associated with increased risk of hospitalisation and mortality in people with chronic respiratory disease, with a small number of studies suggesting a similar relationship for the ISWT.3) The 6MWD, ISWT and ESWT exhibit good test-retest reliability; however, there is strong evidence of a learning effect for the 6MWT and ISWT. Two tests should be performed when the 6MWT or ISWT are used to measure change over time.4) The 6MWD, ISWT and ESWT are responsive to treatment effects in people with chronic respiratory disease; however, most studies have evaluated responsiveness to rehabilitation and fewer data are available to confirm responsiveness to other interventions.5) The 6MWD and ISWT elicit a peak oxygen uptake (V9O 2 peak) that is similar to that during a cardiopulmonary exercise test (CPET). As a result, the contraindications and precautions for field testing should be consistent with those ...

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“…Interestingly, quadriceps fatigue is infrequent after exhaustive walking in patients with COPD, suggesting that the mechanisms of limitation in COPD are exercise specific (250,270). Nevertheless, the gastrocnemius and the tibialis anterior may also be susceptible to fatigue during walking (271,272).…”

Section: Limb Muscle Function In Copdmentioning

confidence: 99%

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

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Distal Leg Muscle Function in Patients with COPD

Cited by 37 publications

References 26 publications

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

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

An official European Respiratory Society/American Thoracic Society technical standard: field walking tests in chronic respiratory disease

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

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