The influence of body composition on respiratory muscle, lung function and diaphragm thickness in adults with cystic fibrosis

Enright, Stephanie; Chatham, Ken; Ionescu, Alina; Unnithan, Viswanath B.; Shale, Dennis J.

doi:10.1016/j.jcf.2007.02.006

Cited by 69 publications

(64 citation statements)

References 47 publications

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“…This is the largest controlled study to investigate the prevalence of peripheral and respiratory muscle weakness in CF. Consistent with other studies, the present authors did not find respiratory muscle weakness in CF patients [28]. Quadriceps force was significantly reduced and was abnormal in ,60% of the study cohort.…”

Section: Discussionsupporting

confidence: 92%

Skeletal muscle weakness, exercise tolerance and physical activity in adults with cystic fibrosis

Troosters¹,

Langer²,

Vrijsen³

et al. 2009

European Respiratory Journal

208

273

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The aim of the present study was to investigate the prevalence of muscle weakness and the importance of physical inactivity in cystic fibrosis (CF), and its relationship to exercise tolerance and muscle strength.Exercise tolerance, skeletal and respiratory muscle strength were studied in a group of 64 adults with CF (age 26¡8 yrs, FEV1 % predicted 65¡19) and in 20 age-matched controls. Physical activity (PA) was assessed in 20 patients and all controls.Quadriceps muscle weakness was present in 56% of the patients. Peak oxygen uptake and 6-min walking distance were below normal in 89 and 75% of patients, respectively. Respiratory muscle strength was normal. The differences remained after correcting for PA. Quadriceps force was correlated to the 6-min walking distance but not to peak oxygen uptake. ''Mild'' PA (.3 metabolic equivalents (METS)) and the number of steps overlapped with controls, but CF patients had less moderate PA (.4.8 METS). Moderate PA was related to peak oxygen uptake and quadriceps force.Skeletal muscle weakness and exercise intolerance are prevalent in cystic fibrosis. Physical inactivity is a factor significantly contributing to exercise tolerance and skeletal muscle force in adults with cystic fibrosis, but these impairments are in excess to that expected from physical inactivity only.

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Section: Discussionsupporting

confidence: 92%

Skeletal muscle weakness, exercise tolerance and physical activity in adults with cystic fibrosis

Troosters¹,

Langer²,

Vrijsen³

et al. 2009

European Respiratory Journal

208

273

View full text Add to dashboard Cite

show abstract

“…Furthermore, the gender difference in body composition may also have an effect. For example, previous studies reported that the mass of the diaphragm was related to the lean body mass or the fat-free mass [17, 18]. There are gender differences in lean body mass and fat-free mass, and body composition has an effect on physical performance [19].…”

Section: Discussionmentioning

confidence: 99%

Sniff Nasal Inspiratory Pressure in Healthy Japanese Subjects: Mean Values and Lower Limits of Normal

Kamide

Ogino²,

Yamashina³

et al. 2008

Respiration

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Background: When assessing respiratory muscle strength using sniff nasal inspiratory pressure (SNIP), it is important to consider ethnic differences. Therefore, it is necessary to determine the mean values and lower limits of normal for SNIP in the Japanese population. Objective: To determine the mean values and lower limits of normal for SNIP, which is used as an assessment of inspiratory muscle strength, in healthy Japanese subjects. Methods: A total of 223 healthy Japanese volunteers (112 men, 111 women), aged 18–69 years, were studied; none had a history of pulmonary disease, heart disease, neuromuscular disease or sinusitis. To measure SNIP, a nasal plug was inserted into one nostril and the mouth was kept closed. Each subject was asked to take short, sharp sniffs with maximal effort from functional residual volume. Results: Based on the intraclass correlation coefficient, SNIP measurements showed good reproducibility in both men and women. The mean SNIP values were 76.8 ± 28.9 cm H₂O in men and 60.0 ± 20.0 cm H₂O in women; the values were significantly higher in men than in women (p < 0.01). On stepwise multiple linear regression analysis, the SNIP values were negatively related to age in men and positively related to body mass index (BMI) in women. The lower limits of normal for SNIP were 32.9 cm H₂O in men and 28.8 cm H₂O in women. Conclusions: In healthy Japanese subjects, the mean SNIP value was higher in men than in women. In Japanese subjects, SNIP values appear to be related to age in men and BMI in women.

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“…Recently, in patients with cystic fibrosis, TD has been found to be related to both lung volume and FFM [20]. …”

Section: Introductionmentioning

confidence: 99%

Ultrasonographic Assessment of the Diaphragm in Chronic Obstructive Pulmonary Disease Patients: Relationships with Pulmonary Function and the Influence of Body Composition - A Pilot Study

et al. 2014

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Background: Skeletal muscle weakness with loss of fat-free mass (FFM) is one of the main systemic effects of chronic obstructive pulmonary disease (COPD). The diaphragm is also involved, leading to disadvantageous conditions and poor contractile capacities. Objectives: We measured the thickness of the diaphragm (TD) by ultrasonography to evaluate the relationships between echographic measurements, parameters of respiratory function and body composition data. Methods: Thirty-two patients (23 males) underwent (1) pulmonary function tests, (2) echographic assessment of TD in the zone of apposition at various lung volumes, i.e. TD at residual volume (TDRV), TD at functional residual capacity (TDFRC) and TD at total lung capacity (TDTLC), and (3) bioelectrical body impedance analysis. The BMI and the BODE (BMI-Obstruction-Dyspnea-Exercise) index values were reported. Results: TDRV, TDFRC and TDTLC measured 3.3, 3.6 and 6 mm, respectively, with good intraobserver reproducibility (0.97, 0.97 and 0.96, respectively). All the TDs were found to be related to FFM, with the relationship being greater for TDFRC (r² = 0.39 and p = 0.0002). With regard to lung volumes, inspiratory capacity (IC) was found to be closely related to TDTLC (r² = 0.42 and p = 0.0001). The difference between TDTLC and TDRV, as a thickening value (TDTLCRV), was closely related to FVC (r² = 0.34 and p = 0.0004) and to air-trapping indices (RV/TLC, FRC/TLC and IC/TLC): the degree of lung hyperinflation was greater and the TDTLCRV was less. Finally, we found a progressive reduction of both thicknesses and thickenings as the severity of IC/TLC increased, with a significant p value for the trend in both analyses (p = 0.02). Conclusions: Ultrasonographic assessment of the diaphragm could be a useful tool for studying disease progression in COPD patients, in terms of lung hyperinflation and the loss of FFM.

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The influence of body composition on respiratory muscle, lung function and diaphragm thickness in adults with cystic fibrosis

Abstract: PImax is relatively well preserved in adults with CF although there is a relationship between the loss of inspiratory muscle work capacity, FFM, PAS and pulmonary function. Furthermore loss of FFM is associated with loss of diaphragm muscle mass.

Cited by 69 publications

References 47 publications

Skeletal muscle weakness, exercise tolerance and physical activity in adults with cystic fibrosis

Skeletal muscle weakness, exercise tolerance and physical activity in adults with cystic fibrosis

Sniff Nasal Inspiratory Pressure in Healthy Japanese Subjects: Mean Values and Lower Limits of Normal

Ultrasonographic Assessment of the Diaphragm in Chronic Obstructive Pulmonary Disease Patients: Relationships with Pulmonary Function and the Influence of Body Composition - A Pilot Study

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