On the Functional Capacity and Quality of Life of Patients with Acromegaly: Are They Candidates for Rehabilitation Programs?

Abstract

[Purpose] This study compared patients having active acromegaly with those having controlled acromegaly in terms of peripheral muscle strength, body composition, and functional capacity. We also examined the associations between these measures. [Methods] A total of 14 patients with active acromegaly, 12 patients with controlled acromegaly, and 12 healthy controls were subjected to isometric dynamometry, surface electromyography, electrical bioimpedance, and a six-minute walk test. [Results] The active acromegaly group exhibited significantly more fat-free mass than the control group. With respect to the peripheral muscle performance, the controlled acromegaly group presented a significantly lower electromyographic median frequency than the control group. The quadriceps maximum strength was significantly lower in the controlled acromegaly group than in the control group. The fat-free mass was significantly correlated with the quadriceps maximum strength. The global scores of the Acromegaly Quality of Life Questionnaire were significantly correlated with the six-minute walk distance. [Conclusion] Patients with acromegaly have more fat-free mass, less peripheral muscle strength, and greater fatigability than healthy control subjects. These findings depend on the degree of hormonal control. In acromegalic patients, peripheral muscle strength is related to body composition, and functional capacity is correlated with quality of life.

Physical and cardiovascular performance in cases with acromegaly after regular short‐term exercise

“…Acromegaly is a chronic disorder which, in addition to metabolic and cardiovascular impairment, is well known for its detrimental effects on functional capacity, sense of well‐being and fatigue . Previously, we showed that exercise may lessen the negative self‐image people with acromegaly .…”

“…It has a wide range of systemic involvement, varying from soft tissue and skin to cardiovascular changes . Consequently, it has detrimental effects on both the functional performance and psychosocial status of the cases involved . Although acromegaly is amenable to treatment, not all complications are reversible and even after remission, quality of life may not be restored …”

What is the effect of peripheral muscle fatigue, pulmonary function, and body composition on functional exercise capacity in acromegalic patients?

“…In this study, exercise capacity was examined using the 6MWD and was lower than the predicted values. Several factors may be involved in the reduced exercise performance in patients with acromegaly, including cardiopulmonary dysfunction, musculoarticular involvement, and metabolic changes 6 , 8 ) . In addition, the systemic impairments caused by acromegaly can result in a more sedentary lifestyle, thereby resulting in an overall loss of muscle strength and a consequent reduction in functional capacity.…”

“…More recently, the six-minute walk test (6MWT) has been promoted as a method to analyze various multisystemic diseases, and because it is a submaximal test, it can assess the functional capacity of an individual when performing their normal daily living activities 7 ) . Nevertheless, there are still few studies that have used the 6MWT on acromegalic patients 8 ) .…”

“…Several studies have documented the muscle changes in acromegaly 9 , 10 , 11 , 12 ) , but a limited number of studies have been published regarding how the damage to peripheral muscles compromises functional exercise capacity 8 ) . GH induces important anabolic actions on skeletal muscle, including the induction of a positive nitrogen balance and the stimulation of protein synthesis 11 , 12 ) .…”