Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada.
Adult Cystic Fibrosis Centre, St Michael's Hospital, Toronto, Ontario, Canada.
Respir Care. 2019 Jan;64(1):40-47. doi: 10.4187/respcare.06224. Epub 2018 Sep 25.
Muscle weakness is an important systemic consequence in adults with cystic fibrosis, but it can be challenging to evaluate clinically. This study examined the validity of lower-extremity functional tests to assess quadriceps muscle strength and muscle power.
The subjects underwent 4 functional tests: 30-s sit-to-stand test, stair-climb power test, vertical jump height, and triple hop distance. Quadriceps muscle strength and power were tested by using a dynamometer (the accepted standard). Quadriceps strength was measured from 5 maximum voluntary isometric contractions to obtain peak torque. Quadriceps power was evaluated from the peak power and peak velocity attained during isotonic contractions of the quadriceps at a preset load of 20% of the peak torque. Pearson correlations were used to determine associations between functional tests and accepted measures of quadriceps strength and power.
Fifteen adults with cystic fibrosis (9 males; mean ± SD age, 32 ± 13 y; mean ± SD FEV% predicted, 73 ± 19) completed the study. The stair-climb power test had the strongest correlations with peak torque (r = 0.84, < .001) and power (r = 0.65, = .009). Vertical jump height was moderately correlated with quadriceps strength (r = 0.62, = .014) and quadriceps peak power (r = 0.51, = .048). Similarly, triple hop distance had moderate correlations with quadriceps strength (r = 0.78, = .001) and peak power (r = 0.57, = .026). The sit-to-stand test was only associated with quadriceps strength (r = 0.55, = .034).
Functional tests can be applied clinically to measure leg muscle strength and power, with the stair-climb power test having the strongest associations with the standard measures. The utility of using functional tests to evaluate longitudinal changes in muscle function and its association with clinical outcomes should be examined in cystic fibrosis.
肌肉无力是囊性纤维化成人的重要全身后果,但临床评估具有挑战性。本研究旨在检验下肢功能测试评估股四头肌力量和肌肉功率的有效性。
研究对象接受了 4 项功能测试:30 秒坐站测试、爬楼梯力量测试、垂直跳跃高度和三级跳距离。使用测力计(公认的标准)测试股四头肌力量和功率。通过 5 次最大自主等长收缩获得峰值扭矩来测量股四头肌力量。通过在预设的 20%峰值扭矩的情况下对股四头肌进行等速收缩,评估股四头肌的峰值功率和峰值速度来评估股四头肌功率。采用 Pearson 相关分析确定功能测试与股四头肌力量和功率的公认测量值之间的相关性。
15 名囊性纤维化成人(9 名男性;平均年龄 ± 标准差,32 ± 13 岁;平均 ± 标准差 FEV%预计值,73 ± 19)完成了研究。爬楼梯力量测试与峰值扭矩(r = 0.84,<.001)和功率(r = 0.65,=.009)相关性最强。垂直跳跃高度与股四头肌力量中度相关(r = 0.62,=.014)和股四头肌峰值功率中度相关(r = 0.51,=.048)。同样,三级跳距离与股四头肌力量(r = 0.78,=.001)和峰值功率(r = 0.57,=.026)中度相关。坐站测试仅与股四头肌力量相关(r = 0.55,=.034)。
功能测试可用于临床测量腿部肌肉力量和功率,其中爬楼梯力量测试与标准测量值的相关性最强。应该在囊性纤维化中检查使用功能测试评估肌肉功能的纵向变化及其与临床结果的关联。