Diaz Posada Nestor A, Cano Rosales Diana J, Amaya Muñoz Maria C, Buitrago Gomez Mario A, Villabona Silvia J, Camacho López Paul Anthony
Internal Medicine, Fundación Oftalmológica de Santander, Bucaramanga, COL.
Pulmonology, Instituto Neumologico del Oriente, Bucaramanga, COL.
Cureus. 2024 Sep 14;16(9):e69404. doi: 10.7759/cureus.69404. eCollection 2024 Sep.
Introduction Chronic Obstructive Pulmonary Disease (COPD) is a systemic disease characterized by skeletal muscle dysfunction, leading to increased morbidity and mortality and deteriorating quality of life. Pulmonary rehabilitation therapy improves symptoms and long-term adherence. This study aimed to evaluate how COPD patients respond to pulmonary rehabilitation therapy and its correlation with handgrip strength measurements. Materials and methods A prospective cohort study was conducted in patients over 45 years old with a spirometric diagnosis of COPD from a specialized reference center in Bucaramanga. Handgrip strength was measured before and after completing the pulmonary rehabilitation program. Patients with neurological or cognitive impairments, decompensated cardiovascular disease, nutritional diseases, or those in a telerehabilitation program were excluded. Results Seventy-one patients were included in the study, with 66.2% completing follow-up after the program. The average age was 73.38 years (SD ±7.77), 53.52% were women, and 60.56% had a history of smoking. After the follow-up, the average handgrip strength delta was 1.64 kg (SD ±3.48) p<0.001, 74.47% of them representing a positive result after pulmonary rehabilitation program. A higher Charlson index correlated with a positive delta, while a negative delta correlated with a lower Charlson index (p=0.01). A positive handgrip strength delta was associated with higher baseline quality of life scores. Conclusions Periodic handgrip strength measurements predict frailty and muscle dysfunction in COPD patients. Pulmonary rehabilitation therapy is a simple and cost-effective intervention that correlates with the improvement of indirect prognosis and survival indicators.
引言 慢性阻塞性肺疾病（COPD）是一种以骨骼肌功能障碍为特征的全身性疾病，会导致发病率和死亡率增加以及生活质量下降。肺康复治疗可改善症状并提高长期依从性。本研究旨在评估COPD患者对肺康复治疗的反应及其与握力测量值的相关性。
材料与方法 对来自布卡拉曼加一家专业参考中心的45岁以上经肺活量测定诊断为COPD的患者进行了一项前瞻性队列研究。在完成肺康复计划前后测量握力。排除患有神经或认知障碍、失代偿性心血管疾病、营养疾病的患者或参加远程康复计划的患者。
结果 71名患者纳入研究，66.2%的患者在计划完成后完成了随访。平均年龄为73.38岁（标准差±7.77），53.52%为女性，60.56%有吸烟史。随访后，平均握力增量为1.64千克（标准差±3.48），p<0.001，其中74.47%在肺康复计划后显示为阳性结果。较高的查尔森指数与正增量相关，而负增量与较低的查尔森指数相关（p=0.01）。握力正增量与较高的基线生活质量评分相关。
结论 定期测量握力可预测COPD患者的虚弱和肌肉功能障碍。肺康复治疗是一种简单且具有成本效益的干预措施，与间接预后和生存指标的改善相关。
