Breukink S O, Strijbos J H, Koorn M, Koëter G H, Breslin E H, van der Schans C P
University of Groningen, The Netherlands.
Respir Med. 1998 Apr;92(4):676-82. doi: 10.1016/s0954-6111(98)90517-0.
Patients with chronic illnesses, such as chronic obstructive pulmonary disease (COPD), report an increase in the perception of fatigue in the clinical setting. Subjective fatigue associated with physiological factors has not been reported. The purpose of this study was to determine the relationship between subjective fatigue and pulmonary function, respiratory and peripheral muscle force and exercise capacity in patients with COPD. Nineteen patients with COPD participated in the study [mean (SD) FEV1 38% (17%) predicted]. Fatigue was measured with the Multidimensional Fatigue Inventory 20 (MFI-20) that includes the following subscale dimensions: general fatigue, physical fatigue, reduced activity, reduced motivation, and mental fatigue. The following physical variables were measured: forced expiratory volume in 1 s (FEV1), vital capacity (VC), maximal inspiratory peak pressure (PImax), symptom-limited bicycle exercise capacity (maximum workload) and maximal voluntary isometric muscle force of both left and right quadriceps (Qu), hamstrings (Ha), biceps (Bi) and triceps (Tr). The MFI-20 fatigue dimensions, reduced activity and reduced Motivation, are significantly correlated with FEV1 (% predicted) (r = -0.62, r = -0.55 respectively). No significant correlation was found between the dimensions of fatigue and maximum workload. In contrast the fatigue dimension, physical fatigue, shows significant correlations with seven of eight muscle forces measured (Qu left r = -0.49, right r = -0.54; Ha left r = -0.49, right r-0.38; Tr left r = -0.61, right r = -0.45; Bi left r = -0.46, right r = -0.48). Data from this study show that activity and physical dimensions of subjective fatigue are related to pulmonary function and skeletal muscle force in COPD patients. Interventions to improve skeletal muscle force might improve subjective fatigue in patients with COPD.
患有慢性疾病（如慢性阻塞性肺疾病，简称COPD）的患者在临床环境中报告称疲劳感有所增加。尚未有与生理因素相关的主观疲劳的报道。本研究的目的是确定COPD患者主观疲劳与肺功能、呼吸及外周肌肉力量和运动能力之间的关系。19名COPD患者参与了该研究[平均（标准差）第1秒用力呼气容积（FEV1）为预测值的38%（17%）]。使用多维疲劳量表20（MFI - 20）测量疲劳，该量表包括以下子量表维度：总体疲劳、身体疲劳、活动减少、动力下降和精神疲劳。测量了以下身体变量：第1秒用力呼气容积（FEV1）、肺活量（VC）、最大吸气峰压（PImax）、症状限制的自行车运动能力（最大工作量）以及左右股四头肌（Qu）、腘绳肌（Ha）、肱二头肌（Bi）和肱三头肌（Tr）的最大自主等长肌力。MFI - 20疲劳维度中的活动减少和动力下降与FEV1（预测值百分比）显著相关（分别为r = -0.62，r = -0.55）。在疲劳维度与最大工作量之间未发现显著相关性。相比之下，疲劳维度中的身体疲劳与所测量的八项肌肉力量中的七项显著相关（左股四头肌r = -0.49，右股四头肌r = -0.54；左腘绳肌r = -0.49，右腘绳肌r = -0.38；左肱三头肌r = -0.61，右肱三头肌r = -0.45；左肱二头肌r = -0.46，右肱二头肌r = -0.48）。本研究数据表明，COPD患者主观疲劳的活动和身体维度与肺功能及骨骼肌力量相关。改善骨骼肌力量的干预措施可能会改善COPD患者的主观疲劳。
