The relationship between cough-specific quality of life and abdominal muscle endurance, fatigue, and depression in patients with COPD

Abstract

BackgroundCough is a prevalent symptom that impacts quality of life in COPD. The aim of this study was to assess the relationship between cough-specific quality of life, abdominal muscle endurance, fatigue, and depression in stable patients with COPD.MethodsTwenty-eight patients with COPD (mean age 60.6±8.7 years) referred for pulmonary rehabilitation participated in this cross-sectional study. Sit-ups test was used for assessing abdominal muscle endurance. Leicester Cough Questionnare (LCQ) was used to evaluate symptom-specific quality of life. Fatigue perception was evaluated with Fatigue Impact Scale (FIS). Beck Depression Inventory (BDI) was used for assessing depression level.ResultsThe LCQ total score was significantly associated with number of sit-ups; BDI score; FIS total; physical, cognitive, and psychosocial scores (P<0.05). Scores of the LCQ physical, social, and psychological domains were also significantly related with number of sit-ups, FIS total score, and BDI score (P<0.05). FIS total score and number of sit-ups explained 58% of the variance in LCQ total score (r=0.76, r2=0.577, F(2–20)=12.296, P<0.001).ConclusionChronic cough may adversely affect performance in daily life due to its negative effect on fatigue and decrease abdominal muscle endurance in patients with COPD. Decreased cough-related quality of life is related with increased level of depression in COPD patients. Effects of increased abdominal muscle endurance and decreased fatigue in COPD patients with chronic cough need further investigation.

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“… 26 Long-lasting cough may adversely affect performance in daily life due to its negative effect on fatigue and decrease abdominal muscle endurance in patients with COPD. 27 The progressive course of COPD could be complicated by episodes of acute worsening called exacerbations, in 25%–40% of subjects. 1 , 28 Although most guidelines and clinical trials define COPD exacerbations similarly, there are differences in the exact definition used.…”

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“…It is known that these conditions impact on economic and social systems [3] but most importantly, cause enormous challenges for individuals and respective families. These patients experience disabling symptoms (including dyspnoea, fatigue, cough, sputum, anxiety and depression), limitation in their activities of daily life and social/family interactions, exercise intolerance, low physical activity levels and impairments in their quality of life [4–19]. Caregivers provide invaluable support to these patients, i.e., emotional/spiritual (e.g., someone to whom they can talk to), physical/practical (e.g., dressing, mobility assistance, medication check, overnight vigilance) and social and financial [20, 21].…”