Physical performance, sarcopenia and respiratory function in older patients with chronic obstructive pulmonary disease

Cesari, Matteo; Pedone, Claudio; Chiurco, Domenica; Cortese, Livio; Conte, Maria Elisabetta; Scarlata, Simone; Incalzi, Raffaele Antonelli

doi:10.1093/ageing/afr167

Cited by 30 publications

(20 citation statements)

References 23 publications

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“…Studies on body composition in COPD individuals have shown fat‐free mass percentage, fat mass percentage, and fat‐free mass index alterations as evidence, even when BMI is within normal limits (Cesari et al, ; Eagan et al, ; Gologanu et al, ). Our results show that body composition changes related to fat‐free mass percentage decrease in subjects with inspiratory muscle weakness and BMI within normal limits.…”

Section: Discussionmentioning

confidence: 99%

Inspiratory muscle strength, diaphragmatic mobility, and body composition in chronic obstructive pulmonary disease

Souza

Cardim

Maia

et al. 2019

Physiotherapy Res Intl

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Background and purpose Chronic obstructive pulmonary disease (COPD) is a systemic inflammatory disease that can cause repercussions on respiratory muscles and body composition. The aim of the current study was to evaluate inspiratory muscle strength, diaphragmatic mobility, and body composition in COPD subjects and to correlate these variables. Methods This was a cross‐sectional study performed with 21 COPD patients. Inspiratory muscle strength (manovacuometry), pulmonary function test (forced vital capacity [FVC], forced expiratory volume in 1 s [FEV1], and FEV1/FVC ratio), diaphragmatic mobility (ultrasonography), and body composition (bioelectrical impedance analysis) were examined. Results COPD individuals in Stages II (28.9%), III (52%), and IV (19%) according to Global Initiative for Chronic Obstructive Disease were recruited, 61.9% of which were men. Inspiratory muscle weakness was found in 47.6% of subjects, who presented a lower fat‐free mass percentage (p = 0.017) and smaller fat‐free mass index (p = 0.001) and greater fat mass percentage (p = 0.029) and less diaphragmatic mobility (p = 0.007) compared with the nonrespiratory weakness group. Maximal inspiratory pressure exhibited a moderately positive relationship to the fat‐free mass index (r = 0.767, p < 0.001) and a weak positive relationship to diaphragmatic mobility (r = 0.496, p = 0.022). Conclusion Our study showed a high prevalence of inspiratory muscle weakness based on the severity of airway obstruction and on the presence of muscular depletion. The evaluation of body composition detected important changes. It also demonstrated that not only muscular weakness was present in these patients but also this had repercussions on the mobility of the diaphragm muscle.

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Section: Discussionmentioning

confidence: 99%

Inspiratory muscle strength, diaphragmatic mobility, and body composition in chronic obstructive pulmonary disease

Souza

Cardim

Maia

et al. 2019

Physiotherapy Res Intl

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“…One study aimed to verify the association between ASMI and physical functioning in older COPD outpatients [24]. However, they only assessed 6MWD as a measure for physical functioning and concluded that FEV1 was a stronger predictor of physical functioning in COPD patients than body composition.…”

Section: Discussionmentioning

confidence: 99%

“…Another study demonstrated that skeletal muscle weakness in COPD patients was due to loss of ASM, but was not related to airflow obstruction [25]. We explored the relation between low ASMI and a comprehensive set of functional outcome measures in the current population of COPD patients, as the relative influence of muscle mass versus impaired lung function on performance might differ between tests [24,26,27]. Indeed, we showed that sarcopenia (in general and expressed per kilogram ASM) is not only accompanied by impaired muscle strength, but also with impaired exercise performance, which was more pronounced for peak workload than for 6MWD.…”

Section: Discussionmentioning

confidence: 99%

Antagonistic implications of sarcopenia and abdominal obesity on physical performance in COPD

et al. 2015

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Decreased physical performance due to loss of muscle mass (i.e. sarcopenia) is prevalent in ageing and appears more pronounced in chronic disease. A comprehensive profile of the sarcopenic phenotype in chronic obstructive pulmonary disease (COPD) is not yet available. The aim of the present study was to characterise prevalence, functional implications and predictive value of sarcopenia with or without abdominal obesity in Dutch COPD patients eligible for pulmonary rehabilitation.505 COPD patients (aged 37-87 years; 57% male) underwent assessment of lung function, body composition and physical functioning, before entering pulmonary rehabilitation. Sarcopenia was assessed by appendicular skeletal muscle index (ASMI) and abdominal obesity by android/gynoid percentage fat mass (A/G%FM) using dual energy X-ray absorptiometry.86.5% of patients were sarcopenic and showed lower physical functioning, while coexistent abdominal obesity (78.0%) resulted in higher physical functioning. Implications on endurance were less pronounced in women. The predictive value for physical functioning was higher for the "three-compartment" model (ASMI, bone mineral content and A/G%FM) than the "two-compartment" model (fat-free mass index and fat mass index) or "one-compartment" model (body mass index).In patients eligible for pulmonary rehabilitation, sarcopenia is highly prevalent in all body mass index categories and associated with impaired strength, and in men also with decreased endurance. Abdominal obesity seems to have protective effects on physical functioning. ASMI is a better predictor for physical functioning than fat-free mass index. @ERSpublications Highly prevalent sarcopenia and abdominal obesity in COPD patients exert antagonistic effects on physical functioning http://ow.ly/L5b9r

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“…Physical function, such as cardiovascular fitness, is known to be closely related to respiratory function19, 20 ) . In children, active physical activity accompanied by normal motor development is essential for growth of organs related to respiration in terms of respiratory muscles, lung parenchymal and airway structures.…”

Section: Discussionmentioning

confidence: 99%

Differences of Respiratory Function According to Level of the Gross Motor Function Classification System in Children with Cerebral Palsy

Kwon¹,

Lee

2014

J Phys Ther Sci

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[Purpose] The current study was designed to investigate the difference in lung capacity and muscle strengthening related to respiration depending on the level of the Gross Motor Function Classification System (GMFCS) in children with cerebral palsy (CP) through tests of respiratory function and respiratory pressure. [Subjects and Methods] A total of 49 children with CP who were classified as below level III of the GMFCS were recruited for this study. They were divided into three groups (i.e., GMFCS level I, GMFCS level II, and GMFCS level III). All children took the pulmonary function test (PFT) and underwent respiratory pressure testing for assessment of respiratory function in terms of lung capacity and respiratory muscle strength. [Results] The GMFCS level III group showed significantly lower scores for all tests of the PFT (i.e., forced vital capacity (FVC), forced expiratory volume at one second (FEV1), and slow vital capacity (SVC)) and testing for respiratory pressures (maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP)) compared with the other two groups. The results of post hoc analysis indicated that the GMFCS level III group differed significantly from the other two groups in terms of FVC, FEV1, MIP, and MEP. In addition, a significant difference in SVC was observed between GMFCS level II and III. [Conclusion] Children with CP who had relatively low motor function showed poor pulmonary capacity and respiratory muscle weakness. Therefore, clinical manifestations regarding lung capacity and respiratory muscle will be required in children with CP who demonstrate poor physical activity.

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Physical performance, sarcopenia and respiratory function in older patients with chronic obstructive pulmonary disease

Cited by 30 publications

References 23 publications

Inspiratory muscle strength, diaphragmatic mobility, and body composition in chronic obstructive pulmonary disease

Inspiratory muscle strength, diaphragmatic mobility, and body composition in chronic obstructive pulmonary disease

Antagonistic implications of sarcopenia and abdominal obesity on physical performance in COPD

Differences of Respiratory Function According to Level of the Gross Motor Function Classification System in Children with Cerebral Palsy

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