Janaudis-Ferreira Tania, Wadell Karin, Sundelin Gunnevi, Lindström Britta
Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden.
Respir Med. 2006 Aug;100(8):1451-7. doi: 10.1016/j.rmed.2005.11.001. Epub 2005 Dec 5.
The aim of this study was to evaluate thigh muscle strength and endurance in patients with COPD compared with healthy controls. Forty-two patients (26 women; 16 men) with moderate to severe COPD and 53 (29 women; 24 men) age-matched healthy controls participated in the study. The subjects were tested for maximum voluntary contractions (MVC), endurance and fatigue of the thigh muscles on an isokinetic dynamometer (KinCom). Endurance was expressed as the number of attained repetitions of knee extension and muscle fatigue as a fatigue index (FI). MVC in knee extension was 17% lower in female patients (P=0.017) but no difference was found in male patients (P=0.56) compared to controls. MVC in knee flexion was lower both in female (51%) (P<0.001) and male patients (40%) (P<0.001) compared to controls. Both female and male patients had significantly lower muscle endurance compared to controls. Female patients had a higher FI (22.5%) than female controls (10%) (P=0.001) while no difference was found regarding FI between male patients (15%) and male controls (10%) (P=0.103). The level of self-reported everyday physical activity did not differ between groups. The results showed impaired skeletal muscle function in COPD, except for MVC in knee extension in male patients. Female patients seemed to be more prone to decrease in thigh muscle function. More focus on improving muscle strength and muscle endurance should be considered when designing pulmonary rehabilitation programs. Patients with preserved level of physical activity can be included in exercise programs and gender-related differences should be taken into account.
本研究的目的是评估慢性阻塞性肺疾病（COPD）患者与健康对照者相比的大腿肌肉力量和耐力。42例中重度COPD患者（26名女性；16名男性）和53名年龄匹配的健康对照者（29名女性；24名男性）参与了该研究。受试者在等速测力计（KinCom）上接受大腿肌肉最大自主收缩（MVC）、耐力和疲劳测试。耐力以膝关节伸展达到的重复次数表示，肌肉疲劳以疲劳指数（FI）表示。与对照组相比，女性患者膝关节伸展的MVC降低了17%（P=0.017），但男性患者未发现差异（P=0.56）。与对照组相比，女性（51%）（P<0.001）和男性患者（40%）（P<0.001）膝关节屈曲的MVC均较低。与对照组相比，男性和女性患者的肌肉耐力均显著降低。女性患者的FI（22.5%）高于女性对照组（10%）（P=0.001），而男性患者（15%）和男性对照组（10%）之间的FI未发现差异（P=0.103）。各组之间自我报告的日常身体活动水平没有差异。结果显示，除男性患者膝关节伸展的MVC外，COPD患者的骨骼肌功能受损。女性患者似乎更容易出现大腿肌肉功能下降。在设计肺康复计划时，应更多地考虑改善肌肉力量和肌肉耐力。身体活动水平保持良好的患者可以纳入运动计划，并且应考虑性别相关差异。
