Dusgun Elif Sena, Aslan Goksen Kuran, Abanoz Ebru Seker, Kiyan Esen
Fenerbahce University, Vocational School of Health Sciences, Department of Physiotherapy, Istanbul, Turkey.
Istanbul University-Cerrahpasa, Faculty of Health Sciences, Division of Physiotherapy and Rehabilitation, Istanbul, Turkey.
Respir Care. 2022 May;67(5):526-533. doi: 10.4187/respcare.09338. Epub 2022 Mar 22.
An increase in respiratory work load and resistance to respiration cause a decrease in respiratory muscle endurance (RME) in patients with obesity hypoventilation syndrome (OHS). We aimed to evaluate and compare RME in subjects with OHS and a control group using an incremental load test and compare the RME of subjects with OHS in whom noninvasive ventilation (NIV) was and was not used.
Forty subjects with OHS (divided according to body mass index [BMI] as group I: 30-40 kg/m; and group II: ≥ 40 kg/m) and 20 subjects with obesity (control group: 30-40 kg/m) were included in the study. RME was evaluated using the incremental load test, and respiratory muscle strength (RMS) was evaluated using mouth pressure measurements. The 6-min walk test, Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI), Fatigue Severity Scale (FSS), EQ-5D Health-Related Quality of Life Questionnaire (EQ-5D), and the Obesity and Weight-Loss Quality of Life Instrument (OWLQOL) were performed.
RME and RMS (%) in group I were lower than the control group ( = .001, = .005, and = .001, respectively). No significant difference was found between the 3 groups in terms of 6-min walk distance (6MWD) percentage predicted values ( = .98). RME in the NIV user group was higher than the non-user group ( = .006). ESS, total PSQI, and FSS scores in the control group were less than group I ( = .01, = .009, and = .005, respectively) and group II ( = .01, < .001, and < .001, respectively). The EQ-5D scores of the control group were higher than group II only ( = .005 and = .005, respectively). There were no differences in OWLQOL between the groups ( = .053).
RME was low in subjects with OHS but higher in those who used NIV. The incremental load test could be performed easily and safely in a clinic setting.
肥胖低通气综合征（OHS）患者的呼吸工作量增加和呼吸阻力增大导致呼吸肌耐力（RME）下降。我们旨在通过递增负荷试验评估和比较OHS患者与对照组的RME，并比较使用和未使用无创通气（NIV）的OHS患者的RME。
本研究纳入了40例OHS患者（根据体重指数[BMI]分为I组：30 - 40 kg/m²；II组：≥40 kg/m²）和20例肥胖患者（对照组：30 - 40 kg/m²）。使用递增负荷试验评估RME，通过口腔压力测量评估呼吸肌力量（RMS）。进行6分钟步行试验、爱泼华嗜睡量表（ESS）、匹兹堡睡眠质量指数（PSQI）、疲劳严重程度量表（FSS）、EQ - 5D健康相关生活质量问卷（EQ - 5D）以及肥胖与体重减轻生活质量量表（OWLQOL）。
I组的RME和RMS（%）低于对照组（分别为P = .001、P = .005和P = .001）。三组在6分钟步行距离（6MWD）预测值百分比方面无显著差异（P = .98）。NIV使用组的RME高于非使用组（P = .006）。对照组的ESS、PSQI总分和FSS评分低于I组（分别为P = .01、P = .009和P = .005）以及II组（分别为P = .01、P < .001和P < .001）。对照组的EQ - 5D评分仅高于II组（分别为P = .005和P = .005）。各组之间的OWLQOL无差异（P = .053）。
OHS患者的RME较低，但使用NIV的患者RME较高。递增负荷试验可在临床环境中轻松、安全地进行。
