Kaymaz Dicle, Candemir İpek Çaylı, Ergün Pınar, Demir Neşe, Taşdemir Filiz, Demir Pervin
Department of Pulmonary Rehabilitation and Home Care Center, Atatürk Chest Diseases and Chest Surgery Training and Research Hospital, Ankara, Turkey.
Department of Biostatistics, Yıldırım Beyazıt University School of Medicine, Ankara, Turkey.
Clin Respir J. 2018 Mar;12(3):1257-1263. doi: 10.1111/crj.12659. Epub 2017 Jun 22.
In chronic obstructive pulmonary disease (COPD), skeletal muscle weakness is characterized by reduced muscle strength, reduced muscle endurance and the presence of muscle fatigue especially in lower limbs. There has been little research into the upper limb skeletal muscles.
In this study, we aimed to investigate the relation of upper limb muscle strength with pulmonary function, exercise capacity, quality of life (QoL) and dyspnea sensation.
Eigthy-eight patients (89.8% male; age: 64.2 ± 8.7 years) with COPD (FEV1 = 34.2% ± 15.2%) were evaluated. Tests included hand grip strength and actual 1-repetition maximum (1RM) test for upper limb strength. Dyspnea sensation was assessed with medical research council (MRC) scale. St. George Respiratory Questionary (SGRQ) was used to evaluate patients health related QoL. Exercise capacity was evaluated with incremental shuttle walk test and endurance shuttle walk test.
Upper limb muscle strength correlated with exercise capacity but no correlations were found with pulmonary functions.There were negative correlations with all the domains of SGRQ both actual 1RM and handgrip strength. MRC scores revealed a negative correlation with upper limb muscle strength.
In our study, we showed that upper limb muscle strength correlated with exercise capacity, QoL, dyspnea sensation. Identifying patients who have greater reductions in strength will allow early interventions with a multidisciplinary manner.
在慢性阻塞性肺疾病（COPD）中，骨骼肌无力的特征是肌肉力量下降、肌肉耐力降低以及存在肌肉疲劳，尤其是在下肢。对上肢骨骼肌的研究很少。
在本研究中，我们旨在探讨上肢肌肉力量与肺功能、运动能力、生活质量（QoL）和呼吸困难感觉之间的关系。
对88例COPD患者（男性占89.8%；年龄：64.2±8.7岁，FEV1=34.2%±15.2%）进行评估。测试包括握力和上肢力量的实际1次重复最大量（1RM）测试。用医学研究委员会（MRC）量表评估呼吸困难感觉。使用圣乔治呼吸问卷（SGRQ）评估患者与健康相关的生活质量。通过递增往返步行试验和耐力往返步行试验评估运动能力。
上肢肌肉力量与运动能力相关，但与肺功能无关。实际1RM和握力与SGRQ的所有领域均呈负相关。MRC评分与上肢肌肉力量呈负相关。
在我们的研究中，我们表明上肢肌肉力量与运动能力、生活质量、呼吸困难感觉相关。识别出力量下降幅度更大的患者将有助于以多学科方式进行早期干预。
