Spruit Martijn A, Franssen Frits M E, Rutten Erica P A, Wagers Scott S, Wouters Emiel F M
Program Development, CIRO+ Rehabilitation Network, Hornerheide 1, Horn, the Netherlands.
Rev Bras Fisioter. 2012 Apr;16(2):148-56. doi: 10.1590/s1413-35552012005000011. Epub 2012 Mar 1.
Reductions in quadriceps strength and peak aerobic capacity (VO2) in patients with chronic obstructive pulmonary disease (COPD) have been studied in relatively small samples over a short period. Moreover, results were not corrected for confounding variables, such as lean muscle mass, gender, and gas transfer capacity of the lungs.
To compare quadriceps muscle strength and peak V.O2 in women and men while stratifying for age and gas transfer capacity. We then corrected for lower-limb lean muscle mass to see whether and to what extent the age-graded reduction remained evident.
Retrospectively, data of 374 women and 593 men with COPD were analyzed: lung function, current drug therapy, quadriceps strength, peak V.O2, lower-limb lean muscle mass, and gas transfer capacity.
Quadriceps strength and peak V.O2 were lower in older women and men with a gas transfer capacity of <50% predicted, also after adjustment for lower-limb lean muscle mass. Moreover, quadriceps strength and peak V.O2 were lower in older women and men with a gas transfer capacity of <50% predicted, also after adjustment for lower-limb lean muscle mass. Moreover, quadriceps strength and peak V.O2 were related to age in COPD, particularly in women and men with a gas transfer capacity of >50% predicted. Yet, counter to our hypothesis, lower-limb lean muscle mass did not show an age-graded reduction and, in turn, could not account for the relationship of age with quadriceps strength and peak V.O2.
It is apparent that there is an age-graded reduction in skeletal muscle function in patients with COPD. Therefore, prevention of an age-graded decline in quadriceps muscle strength and peak V.O2 may need to become an outcome of pulmonary rehabilitation of patients with COPD.
慢性阻塞性肺疾病（COPD）患者股四头肌力量和峰值有氧能力（VO₂）的降低在相对较小的样本中进行了短期研究。此外，结果未对混杂变量进行校正，如瘦肌肉量、性别和肺气体交换能力。
在按年龄和气体交换能力分层的情况下，比较男性和女性的股四头肌力量和峰值VO₂。然后对下肢瘦肌肉量进行校正，以观察年龄分级降低是否仍然明显以及在何种程度上仍然明显。
回顾性分析了374例女性和593例男性COPD患者的数据：肺功能、当前药物治疗、股四头肌力量、峰值VO₂、下肢瘦肌肉量和气体交换能力。
在气体交换能力<预测值50%的老年女性和男性中，股四头肌力量和峰值VO₂较低，在对下肢瘦肌肉量进行校正后也是如此。此外，在气体交换能力<预测值50%的老年女性和男性中，股四头肌力量和峰值VO₂较低，在对下肢瘦肌肉量进行校正后也是如此。此外，在COPD患者中，股四头肌力量和峰值VO₂与年龄相关，特别是在气体交换能力>预测值50%的女性和男性中。然而，与我们的假设相反，下肢瘦肌肉量并未显示出年龄分级降低，因此无法解释年龄与股四头肌力量和峰值VO₂之间的关系。
显然，COPD患者的骨骼肌功能存在年龄分级降低。因此，预防股四头肌力量和峰值VO₂的年龄分级下降可能需要成为COPD患者肺康复的一个结果。
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