Department of Clinical Mycobacteriology, Nagasaki University Graduate School of Biomedical Sciences.
Respiratory Care and Rehabilitation Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association.
Tohoku J Exp Med. 2020 Jan;250(1):43-48. doi: 10.1620/tjem.250.43.
The incidence of nontuberculous mycobacterial lung disease (NTMLD) is increasing worldwide, the number of lung surgeries is increasing accordingly. The disease is progressive and is characterized by exertional intolerance, respiratory dysfunctions, and impaired health-related quality of life (HRQOL). Treatment comprises multidrug antibiotic treatment combined with lung resection. The incremental shuttle walk distance (ISWD) is a standard tool for assessing the patients' tolerance to lung resection. The exertional tolerance, physical functions and HRQOL among pre-surgical patients with NTMLD are clinically important, but not fully studied yet from the viewpoint of physiotherapy. The purpose of this study was to explore the clinical significance of ISWD for assessing the exercise capacity of pre-surgical patients with NTMLD. For peripheral muscle evaluation, the strength of the quadriceps femoris muscle was measured. HRQOL was evaluated using scores of the St. George's Respiratory Questionnaire (SGRQ). Thirty-three patients (mean age 54.9 ± 13 years) were enrolled. The mean ISWD was 505 ± 134 m, shorter than the reference values (ISWD %predicted: 96 ± 27%). Regression analysis showed significant associations between ISWD and percent-predicted vital capacity (r = 0.38, p = 0.03) and percent quadriceps force/body weight (r = 0.54, p = 0.001). HRQOL assessed by SGRQ scores was correlated with ISWD (r < -0.4, p < 0.05). Multiple regression analysis showed that ISWD was significantly associated with leg muscle strength and with HRQOL. In conclusion, ISWD is useful to evaluate the exercise capacity among pre-surgical patients with NTMLD.
非结核分枝杆菌肺病（NTMLD）的发病率在全球范围内呈上升趋势，相应地，肺部手术的数量也在增加。该疾病呈进行性发展，其特征是运动不耐受、呼吸功能障碍和健康相关生活质量（HRQOL）受损。治疗包括多药抗生素治疗联合肺切除术。递增穿梭步行距离（ISWD）是评估患者对肺切除术耐受性的标准工具。NTMLD 术前患者的运动耐受力、身体功能和 HRQOL 具有重要的临床意义，但从物理治疗的角度来看，尚未得到充分研究。本研究旨在探讨 ISWD 评估 NTMLD 术前患者运动能力的临床意义。对于外周肌肉评估，测量股四头肌的力量。使用圣乔治呼吸问卷（SGRQ）评分评估 HRQOL。共纳入 33 名患者（平均年龄 54.9 ± 13 岁）。平均 ISWD 为 505 ± 134 m，短于参考值（ISWD%预测值：96 ± 27%）。回归分析显示 ISWD 与预计肺活量百分比（r = 0.38，p = 0.03）和股四头肌力量/体重百分比（r = 0.54，p = 0.001）显著相关。SGRQ 评分评估的 HRQOL 与 ISWD 相关（r < -0.4，p < 0.05）。多元回归分析显示，ISWD 与腿部肌肉力量和 HRQOL 显著相关。总之，ISWD 可用于评估 NTMLD 术前患者的运动能力。
