Marino Diego Marmorato, Marrara Kamilla Tays, Ike Daniela, De Oliveira Antônio Delfino, Jamami Maurício, Di Lorenzo Valéria Amorim Pires
Physical Therapy Department, Federal University of São Carlos-UFSCar., Estância Suiça, São Carlos, São Paulo, Brazil.
Physiother Res Int. 2010 Sep;15(3):135-43. doi: 10.1002/pri.454.
Individuals with chronic obstructive pulmonary disease (COPD) present reduced peripheral muscle strength, which leads to impaired mobility and increased mortality risk. However, it is not clear whether there is any relationship between muscle strength, muscle mass and the body mass index, airflow obstruction, dyspnea, exercise performance (BODE) index scale, which is considered to be the best predictor of survival for individuals with COPD. The BODE Index is a multidimensional system that measures body composition (B), airway obstruction (O), dyspnea perception (D) and the ability to exercise (E), and rates the severity of the major changes found in individuals with COPD. The objective of this study was to verify any relationship between the BODE Index, muscle mass and maximum muscle strengths of the upper limb (UL) and lower limb (LL) in subjects with moderate to very severe COPD.
Twenty-six individuals with moderate to very severe COPD were evaluated by body composition (body mass index and muscle mass), BODE Index, handgrip strength (HS) and one repetition maximum (1RM) test of the UL and LL.
There was a positive correlation (Pearson, p < 0.05) of peripheral muscle strength, evaluated by HS and 1RM (pectoral and triceps, round muscles and dorsal section, quadriceps), to muscle mass (0.74, 0.57, 0.74 and 0.62, respectively) and the distance walked in the six-minute walking test (0.52, 0.50, 0.46 and 0.58, respectively), but no correlation of muscle strength was found to forced expiratory volume in one second to dyspnea or the BODE Index.
In accordance with the results of this study, peripheral muscle strength as measured by HS and 1RM is not related to the severity indexes for COPD, unlike UL and LL muscle strength. Therefore, UL and LL measurements now have an additional importance in COPD evaluation.
慢性阻塞性肺疾病(COPD)患者存在外周肌肉力量下降的情况,这会导致活动能力受损以及死亡风险增加。然而,肌肉力量、肌肉质量与体重指数、气流阻塞、呼吸困难、运动表现(BODE)指数量表之间是否存在关联尚不清楚,BODE指数量表被认为是COPD患者生存的最佳预测指标。BODE指数是一个多维系统,用于测量身体成分(B)、气道阻塞(O)、呼吸困难感知(D)和运动能力(E),并对COPD患者中发现的主要变化的严重程度进行评分。本研究的目的是验证中度至重度COPD患者的BODE指数、肌肉质量与上肢(UL)和下肢(LL)的最大肌肉力量之间的任何关系。
对26名中度至重度COPD患者进行了身体成分(体重指数和肌肉质量)、BODE指数、握力(HS)以及上肢和下肢的一次重复最大值(1RM)测试评估。
通过HS和1RM评估的外周肌肉力量(胸肌、三头肌、圆肌和背阔肌、股四头肌)与肌肉质量(分别为0.74、0.57、0.74和0.62)以及六分钟步行试验中的步行距离(分别为0.52、0.50、0.46和0.58)呈正相关(Pearson检验,p<0.05),但未发现肌肉力量与一秒用力呼气量、呼吸困难或BODE指数之间存在相关性。
根据本研究结果,与上肢和下肢肌肉力量不同,通过HS和1RM测量的外周肌肉力量与COPD的严重程度指标无关。因此,上肢和下肢测量在COPD评估中现在具有额外的重要性。