Souza Rosália M P, Cardim Adriane B, Maia Tuíra O, Rocha Lívia G, Bezerra Shirley D, Marinho Patrícia Érika M
Cardiopulmonary Physical Therapy Laboratory, Department of Physical Therapy, Universidade Federal de Pernambuco, Recife, Brazil.
Physiother Res Int. 2019 Apr;24(2):e1766. doi: 10.1002/pri.1766. Epub 2019 Jan 9.
Chronic obstructive pulmonary disease (COPD) is a systemic inflammatory disease that can cause repercussions on respiratory muscles and body composition. The aim of the current study was to evaluate inspiratory muscle strength, diaphragmatic mobility, and body composition in COPD subjects and to correlate these variables.
This was a cross-sectional study performed with 21 COPD patients. Inspiratory muscle strength (manovacuometry), pulmonary function test (forced vital capacity [FVC], forced expiratory volume in 1 s [FEV ], and FEV /FVC ratio), diaphragmatic mobility (ultrasonography), and body composition (bioelectrical impedance analysis) were examined.
COPD individuals in Stages II (28.9%), III (52%), and IV (19%) according to Global Initiative for Chronic Obstructive Disease were recruited, 61.9% of which were men. Inspiratory muscle weakness was found in 47.6% of subjects, who presented a lower fat-free mass percentage (p = 0.017) and smaller fat-free mass index (p = 0.001) and greater fat mass percentage (p = 0.029) and less diaphragmatic mobility (p = 0.007) compared with the nonrespiratory weakness group. Maximal inspiratory pressure exhibited a moderately positive relationship to the fat-free mass index (r = 0.767, p < 0.001) and a weak positive relationship to diaphragmatic mobility (r = 0.496, p = 0.022).
Our study showed a high prevalence of inspiratory muscle weakness based on the severity of airway obstruction and on the presence of muscular depletion. The evaluation of body composition detected important changes. It also demonstrated that not only muscular weakness was present in these patients but also this had repercussions on the mobility of the diaphragm muscle.
慢性阻塞性肺疾病(COPD)是一种全身性炎症性疾病,可对呼吸肌和身体组成产生影响。本研究的目的是评估COPD患者的吸气肌力量、膈肌活动度和身体组成,并将这些变量进行关联分析。
这是一项对21例COPD患者进行的横断面研究。检测了吸气肌力量(压力计法)、肺功能测试(用力肺活量[FVC]、第1秒用力呼气容积[FEV₁]和FEV₁/FVC比值)、膈肌活动度(超声检查)和身体组成(生物电阻抗分析)。
根据慢性阻塞性肺疾病全球倡议,招募了处于II期(28.9%)、III期(52%)和IV期(19%)的COPD患者,其中61.9%为男性。47.6%的受试者存在吸气肌无力,与无呼吸肌无力组相比,这些受试者的去脂体重百分比更低(p = 0.017)、去脂体重指数更小(p = 0.001)、脂肪量百分比更高(p = 0.029)且膈肌活动度更小(p = 0.007)。最大吸气压力与去脂体重指数呈中度正相关(r = 0.767,p < 0.001),与膈肌活动度呈弱正相关(r = 0.496,p = 0.022)。
我们的研究表明,基于气道阻塞的严重程度和肌肉消耗情况,吸气肌无力的患病率较高。身体组成评估发现了重要变化。这也表明,这些患者不仅存在肌无力,而且对膈肌的活动度也有影响。