Department of Pulmonary Diseases, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Research and Development, Ciro, Horn, the Netherlands; Nutrim School of Nutrition and Translational Research in Metabolism, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands.
Department of Research and Development, Ciro, Horn, the Netherlands; Nutrim School of Nutrition and Translational Research in Metabolism, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands; Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), Maastricht, the Netherlands.
Braz J Phys Ther. 2022 Sep-Oct;26(5):100451. doi: 10.1016/j.bjpt.2022.100451. Epub 2022 Oct 17.
Isokinetic testing of peripheral muscle function is valid and reliable in patients with chronic obstructive pulmonary disease (COPD).
To evaluate whether and to what extent isokinetic testing of quadriceps function meets pre-defined test criteria in patients with COPD; to determine the response to pulmonary rehabilitation (PR), and to calculate minimal important differences (MIDs) of isokinetic quadriceps function.
Retrospective analysis of 2033 patients with COPD (age: 65±9 years, body mass index: 26±6 kg/m, FEV: 49±22% predicted) who followed a comprehensive PR program. Pre and post PR isokinetic quadriceps function was assessed with 30 maximal extension-flexion contractions at an angular speed of 90°/s on a computerized dynamometer. The chosen anchors were 6-min walk test and COPD assessment test.
Pre PR, 27% of the patients performed the isokinetic test incorrectly. In male and female patients with a correct pre and post PR isokinetic test, peak torque (Δ=10±13 Nm or 9% and Δ=7±9 Nm or 10%, respectively) and total work (Δ=263±270 J or 14% and Δ=198±190 J or 15%, respectively) improved significantly. There was no change in work fatigue index following PR. Using distribution-based calculations, MID estimates for peak torque and total work ranged between 6-7 Nm and 97-135 J in males and between 4-5 Nm and 62-99 J in females.
Based on the current test criteria, three in four patients with COPD performed the isokinetic quadriceps test correctly during baseline PR assessment. Furthermore, peak torque and total work, but not work fatigue index, were responsive to PR and sex-specific MIDs were established.
等速测试在外周肌肉功能在慢性阻塞性肺疾病（COPD）患者中是有效且可靠的。
评估 COPD 患者的股四头肌等速测试是否符合预定义的测试标准，以及在多大程度上符合；确定对肺康复（PR）的反应，并计算等速股四头肌功能的最小临床重要差异（MID）。
回顾性分析了 2033 名接受综合 PR 计划的 COPD 患者（年龄：65±9 岁，体重指数：26±6kg/m，FEV：49±22%预计值）的资料。使用计算机测力计在 90°/s 的角速度下进行 30 次最大伸展-屈曲收缩来评估 PR 前后的等速股四头肌功能。所选锚定为 6 分钟步行试验和 COPD 评估测试。
PR 前，27%的患者等速测试不正确。在男性和女性患者中，正确的 PR 前和 PR 后等速测试中，峰值扭矩（Δ=10±13 Nm 或 9%和Δ=7±9 Nm 或 10%）和总功（Δ=263±270 J 或 14%和Δ=198±190 J 或 15%）均显著提高。PR 后工作疲劳指数没有变化。使用基于分布的计算，男性的峰值扭矩和总功的 MID 估计值范围在 6-7 Nm 和 97-135 J 之间，女性的 MID 估计值范围在 4-5 Nm 和 62-99 J 之间。
根据目前的测试标准，在 PR 评估的基线时，四分之三的 COPD 患者等速股四头肌测试正确。此外，峰值扭矩和总功（而非工作疲劳指数）对 PR 有反应，并且建立了性别特异性的 MID。
