Peripheral muscle weakness contributes to exercise limitation in COPD

Peripheral muscle weakness contributes to exercise limitation in COPD

R Gosselink, T Troosters and M Decramer
Respiratory Division, University Hospitals, Katholieke Universiteit Leuven, Belgium.

Recently, it was suggested that fatigue of peripheral muscles could contribute to exercise limitation in patients with chronic obstructive pulmonary disease (COPD). In order to quantify the role of peripheral muscle force, we restudied potential determinants of exercise capacity (6-min walking distance [6 MWD] and maximal oxygen consumption [V02max]) in 41 consecutive COPD patients (FEV1, 43 +/- 19% of predicted, TLCO, 56 +/- 25% of predicted) admitted to our pulmonary rehabilitation program. VO2max (incremental cycle ergometer test), 6 MWD (best of three), lung function (FEV1, FVC, TLC, FRC), diffusing capacity (TLCO), isometric quadriceps force (QF), hand grip force (HF), and maximal inspiratory (PImax) and expiratory (PEmax) pressures were measured. Patients had a poor 6 MWD (372 +/- 136 m) and VO2max (1.35 +/- 0.60 L, 71%), reduced respiratory (PImax 65 +/- 27%) and peripheral muscle force (QF 74 +/- 27%, HF 82 +/- 23%). In single regression analysis, significant correlations (r) were found for VO2max and TLCO (0.68), FEV1 (0.64), QF (0.55), HF (0.53), and body weight (0.49). Walking distance was significantly correlated with QF (0.63), HF (0.61), PImax (0.49), and TLCO (0.38). In stepwise multiple regression analysis, the variables significantly contributing to 6 MWD were QF and Plmax. For VO2max, variables significantly contributing were TLCO, QF, and FEV1. We conclude that lung function and peripheral muscle force are important determinants of exercise capacity in COPD.

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L. J. DOWSON, C. NEWALL, P. J. GUEST, S. L. HILL, and R. A. STOCKLEY
Exercise Capacity Predicts Health Status in {alpha}1-Antitrypsin Deficiency
Am. J. Respir. Crit. Care Med., March 15, 2001; 163(4): 936 - 941.
[Abstract] [Full Text]

A.M.W.J. Schols, G. Wesseling, A.D.M. Kester, G. de Vries, R. Mostert, J. Slangen, and E.F.M. Wouters
Dose dependent increased mortality risk in COPD patients treated with oral glucocorticoids
Eur. Respir. J., March 1, 2001; 17(3): 337 - 342.
[Abstract] [Full Text] [PDF]

M. Yoshikawa, T. Yoneda, H. Takenaka, A. Fukuoka, Y. Okamoto, N. Narita, and K. Nezu
Distribution of Muscle Mass and Maximal Exercise Performance in Patients With COPD
Chest, January 1, 2001; 119(1): 93 - 98.
[Abstract] [Full Text] [PDF]

M C Steiner and M D L Morgan
Enhancing physical performance in chronic obstructive pulmonary disease
Thorax, January 1, 2001; 56(1): 73 - 77.
[Full Text]

D. Murciano, A. Ferretti, J. Boczkowski, C. Sleiman, M. Fournier, and J. Milic-Emili
Flow Limitation and Dynamic Hyperinflation During Exercise in COPD Patients After Single Lung Transplantation
Chest, November 1, 2000; 118(5): 1248 - 1254.
[Abstract] [Full Text] [PDF]

V. Noonan and E. Dean
Submaximal Exercise Testing: Clinical Application and Interpretation
Physical Therapy, August 1, 2000; 80(8): 782 - 807.
[Abstract] [Full Text] [PDF]

L. M A Heunks and P N R. Dekhuijzen
Respiratory muscle function and free radicals: from cell to COPD
Thorax, August 1, 2000; 55(8): 704 - 716.
[Full Text]

M. T. E. Hernandez, T. M. Rubio, F. O. Ruiz, H. S. Riera, R. S. Gil, and J. C. Gomez
Results of a Home-Based Training Program for Patients With COPD
Chest, July 1, 2000; 118(1): 106 - 114.
[Abstract] [Full Text] [PDF]

L. M. A. Heunks, A. Bast, C. L. A. van Herwaarden, G. R. M. M. Haenen, and P. N. R. Dekhuijzen
Effects of emphysema and training on glutathione oxidation in the hamster diaphragm
J Appl Physiol, June 1, 2000; 88(6): 2054 - 2061.
[Abstract] [Full Text] [PDF]

H. R Gosker, E. F. Wouters, G. J van der Vusse, and A. M. Schols
Skeletal muscle dysfunction in chronic obstructive pulmonary disease and chronic heart failure: underlying mechanisms and therapy perspectives
Am. J. Clinical Nutrition, May 1, 2000; 71(5): 1033 - 1047.
[Abstract] [Full Text] [PDF]

R. Casaburi
Skeletal Muscle Function in COPD
Chest, May 1, 2000; 117 (2009): 267S - 271S.
[Abstract] [Full Text] [PDF]

M. P. Engelen, A. M. Schols, J. D Does, and E. F. Wouters
Skeletal muscle weakness is associated with wasting of extremity fat-free mass but not with airflow obstruction in patients with chronic obstructive pulmonary disease
Am. J. Clinical Nutrition, March 1, 2000; 71(3): 733 - 738.
[Abstract] [Full Text] [PDF]