Ozalp Ozge, Inal-Ince Deniz, Calik Ebru, Vardar-Yagli Naciye, Saglam Melda, Savci Sema, Arikan Hulya, Bosnak-Guclu Meral, Coplu Lutfi
Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Hacettepe University, 06100, Samanpazari, Ankara, Turkey.
Multidiscip Respir Med. 2012 Jun 11;7(1):3. doi: 10.1186/2049-6958-7-3.
There are limited number of studies investigating extrapulmonary manifestations of bronchiectasis. The purpose of this study was to compare peripheral muscle function, exercise capacity, fatigue, and health status between patients with bronchiectasis and healthy subjects in order to provide documented differences in these characteristics for individuals with and without bronchiectasis.
Twenty patients with bronchiectasis (43.5 ± 14.1 years) and 20 healthy subjects (43.0 ± 10.9 years) participated in the study. Pulmonary function, respiratory muscle strength (maximal expiratory pressure - MIP - and maximal expiratory pressure - MEP), and dyspnea perception using the Modified Medical Research Council Dyspnea Scale (MMRC) were determined. A six-minute walk test (6MWT) was performed. Quadriceps muscle, shoulder abductor, and hand grip strength (QMS, SAS, and HGS, respectively) using a hand held dynamometer and peripheral muscle endurance by a squat test were measured. Fatigue perception and health status were determined using the Fatigue Severity Scale (FSS) and the Leicester Cough Questionnaire (LCQ), respectively.
Number of squats, 6MWT distance, and LCQ scores as well as lung function testing values and respiratory muscle strength were significantly lower and MMRC and FSS scores were significantly higher in patients with bronchiectasis than those of healthy subjects (p < 0.05). In bronchiectasis patients, QMS was significantly associated with HGS, MIP and MEP (p < 0.05). The 6MWT distance was significantly correlated to LCQ psychological score (p < 0.05). The FSS score was significantly associated with LCQ physical and total and MMRC scores (p < 0.05). The LCQ psychological score was significantly associated with MEP and 6MWT distance (p < 0.05).
Peripheral muscle endurance, exercise capacity, fatigue and health status were adversely affected by the presence of bronchiectasis. Fatigue was associated with dyspnea and health status. Respiratory muscle strength was related to peripheral muscle strength and health status, but not to fatigue, peripheral muscle endurance or exercise capacity. These findings may provide insight for outcome measures for pulmonary rehabilitation programs for patients with bronchiectasis.
研究支气管扩张症肺外表现的研究数量有限。本研究的目的是比较支气管扩张症患者与健康受试者的外周肌肉功能、运动能力、疲劳程度和健康状况，以便为患有和未患有支气管扩张症的个体提供这些特征方面的记录差异。
20例支气管扩张症患者（43.5±14.1岁）和20名健康受试者（43.0±10.9岁）参与了本研究。测定了肺功能、呼吸肌力量（最大吸气压力-MIP-和最大呼气压力-MEP）以及使用改良医学研究委员会呼吸困难量表（MMRC）评估的呼吸困难感知。进行了六分钟步行试验（6MWT）。使用手持测力计测量股四头肌、肩外展肌和握力（分别为QMS、SAS和HGS），并通过深蹲试验测量外周肌肉耐力。分别使用疲劳严重程度量表（FSS）和莱斯特咳嗽问卷（LCQ）确定疲劳感知和健康状况。
支气管扩张症患者的深蹲次数、6MWT距离和LCQ评分以及肺功能测试值和呼吸肌力量均显著低于健康受试者，而MMRC和FSS评分则显著高于健康受试者（p<0.05）。在支气管扩张症患者中，QMS与HGS、MIP和MEP显著相关（p<0.05）。6MWT距离与LCQ心理评分显著相关（p<0.05）。FSS评分与LCQ身体和总分以及MMRC评分显著相关（p<0.05）。LCQ心理评分与MEP和6MWT距离显著相关（p<0.05）。
支气管扩张症的存在对外周肌肉耐力、运动能力、疲劳程度和健康状况产生了不利影响。疲劳与呼吸困难和健康状况相关。呼吸肌力量与外周肌肉力量和健康状况有关，但与疲劳、外周肌肉耐力或运动能力无关。这些发现可能为支气管扩张症患者的肺康复计划的结局指标提供见解。
