Upper and Lower Limb Muscles in Patients With COPD: Similarities in Muscle Efficiency But Differences in Fatigue Resistance

Miranda, Eduardo Foschini; Malaguti, Carla; Marchetti, Paulo Henrique; Corso, Simone Dal

doi:10.4187/respcare.02439

Cited by 16 publications

(16 citation statements)

References 45 publications

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“…These ratings on dyspnea and muscle fatigue are comparable to the ratings of perceived exertion (arm 5 [SD 2.5], leg 4 [SD 3.1]) reported by Robles et al [8]. Furthermore, Miranda et al [31] investigated the fatigability of the quadriceps muscle during an isometric knee extension exercise performed at 60 knee flexion and the middle deltoid during an isometric shoulder abduction exercise performed with the shoulder placed at Is the hypothesis/aim/objective of the study clearly described? 90 abduction.…”

Section: Resistance Exercisessupporting

confidence: 82%

“…They found a greater decline in median frequency throughout an isometric local muscle endurance test at 60% of maximal voluntary contraction for the middle deltoid compared to the quadriceps femoris. When corrected for time of the endurance test, the dyspnea and fatigue scores were higher for the middle deltoid during the isometric shoulder abduction exercise than for the quadriceps femoris during the isometric knee extension exercise [31].…”

Section: Resistance Exercisesmentioning

confidence: 89%

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Physiological and Symptomatic Responses to Arm versus Leg Activities in People with Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis

Frykholm

Lima

Selander

et al. 2019

COPD: Journal of Chronic Obstructive Pulmonary Disease

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While the mechanisms underlying exercise limitations and symptoms during leg activities have been investigated in detail, knowledge of potential differences between leg and arm activities are not well understood and results from individual studies are contradictory. Thus, the aim of the present study was to synthesize physiological and symptomatic responses during activities involving the arms relative to activities involving the legs in people with Chronic Obstructive Pulmonary Disease (COPD). Any study with a cross-sectional comparison of acute physiological (cardiorespiratory, metabolic) and symptomatic responses to activities performed with the arms versus the legs were included. Studies were sub-grouped based on the type of activity performed (cycle ergometer, resistance exercises, or functional test/activities). Eighteen studies with 423 individuals with COPD were included. Leg cycle ergometer resulted in greater tidal volume (137 mL), minute ventilation (4.8 L/min), and oxygen consumption (164 mL/min) than arm cycle ergometer, while symptomatic responses were similar. Resistance exercises resulted in similar physiological and symptomatic responses irrespective of whether the legs or the arms were involved while studies on functional activities report different results depending on the type and intensity of the activity performed. With the exception of cycle ergometer activities, physiological and symptomatic responses do not seem to depend on whether the arms or the legs are used, but rather seem to be task and intensity dependent. These novel findings suggest, for example, that strategies used to increase exercise tolerance should not be dependent on whether the arms or the legs are used, but rather the intensity of specific activity performed.

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Section: Resistance Exercisessupporting

confidence: 82%

Section: Resistance Exercisesmentioning

confidence: 89%

Physiological and Symptomatic Responses to Arm versus Leg Activities in People with Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis

Frykholm

Lima

Selander

et al. 2019

COPD: Journal of Chronic Obstructive Pulmonary Disease

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“…9 In a recent study done by Eduardo FM et al in 2014 observed that mid-thigh muscle area {Mid-thigh muscle area = mid-thigh circumference in cm* (0.314 *anterior thigh skin-fold in cm) 2 /(4* 3.14)} was significantly low in COPD patients. 10 There was no statistically significant difference seen in serum protein level between COPD cases and control group (p = 0.308). There was no significant difference seen between severities of disease.…”

Section: Discussionmentioning

confidence: 79%

A study to assess nutritional profile in chronic obstructive pulmonary disease patients

et al. 2017

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Background: The potential ill effects of malnutrition are numerous, such as decreased maximal respiratory muscle force, decreased hypoxic Ventilatory response and decreased resistance to infection. The objective was to assess nutritional profile in chronic obstructive pulmonary disease (COPD) patient.Methods: The study was conducted at a tertiary care referral hospital. Period of study was one year. Present study was case control study. Institutional Ethics committee permission was taken. A total of 75 cases of chronic obstructive pulmonary disease and comparable controls were included in the study.Results: Present study shows that there was significant difference in mid arm circumference and mid-thigh circumference between COPD cases and control groups as well as between serum pre-albumin and serum transferrin level, serum uric acid (p=0.018) and serum calcium level (p=0.002). There was no statistically difference with respect to serum total protein (p=0.308), serum albumin (p=0.533) and serum phosphorus level (p=0.064) between COPD patient and control groups. There was statistically significant difference in total lymphocyte count between COPD cases and control groups as well as between serum LDL and serum HDL, serum LDL and serum HDL with COPD grading. As COPD grading increased there was significant decrease in serum LDL and serum HDL level. There was no significant difference with respect serum TG (p=0.738), VLDL and total cholesterol level (p=0.063) between COPD cases and control groups.Conclusions: Simple measurement of BMI, mid arm circumference and mid-thigh circumference can assess mal-nutrition in COPD patients and biochemical parameter like serum pre-albumin and serum transferrin may helpful in early detection of malnutrition.

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“…No supporting evidence could be found in the literature on the relationship between leg strength and arm exercise capacity; however, previous studies have compared upper body strength with lower body strength and upper body aerobic capacity with lower body aerobic capacity in CRD. Recently, Miranda et al 27 compared middle deltoid and quadriceps femoris strength and endurance of 21 CRD patients with a mean FEV 1 of 46.1 ± 10.3% predicted. The researchers found deltoid and quadriceps to be similar with regard to absolute strength (similar differences when compared to healthy controls), but quadriceps had higher fatigability, indicating better upper body muscle (deltoid) fatigue resistance.…”

Section: Discussionmentioning

confidence: 99%

Disease severity and muscular strength as predictors of arm and leg ergometry capacity in chronic respiratory disease

Chapman

Dreyer

2016

Cardiovascular and Thoracic Open

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Background: The aim was to examine the predictability of stage of disease (FEV 1 ) and measures of strength (arm and leg) to arm and leg ergometry capacity of patients with chronic respiratory diseases. Methods: A total of 44 chronic respiratory disease patients, 16 males and 28 females (mean age = 59.8 ± 11.9 years), with an FEV 1 of 22%-89% predicted (mean FEV 1 % predicted = 54.6 ± 18.3) participated. All participants completed spirometry, Medical Research Council grade, anthropometric assessment, submaximal arm and leg ergometry testing, grip strength, and isokinetic quadriceps and hamstrings strength and endurance testing. Results:To determine contributing and predictor variables of arm and leg ergometry capacity, multiple linear and binary regression analyses were performed. Multiple regression analysis demonstrated that quadriceps strength (N m), FEV 1 % and grip strength (kg) predicted 64% of peak wattage during submaximal leg ergometry testing (adjusted R 2 = 64%, F = 26.387 and p = 0.00). Quadriceps strength showed the highest predictability of peak leg ergometry wattage (p = 0.00, β = 0.844 and t = 6.238), followed by grip strength and FEV 1 % (p = 0.038, β = −0.270 and t = −2.143 and p = 0.028, β = −0.230 and t = 2.279, respectively). A second regression analysis determined that quadriceps strength (N m), FEV 1 % and grip strength (kg) predicted 53% of peak wattage during submaximal arm ergometry testing (adjusted R 2 = 0.53, F = 17.018 and p = 0.00). Quadriceps strength was the only independent variable that showed predictability of peak arm ergometry wattage (p = 0.00, β = 0.793 and t = 5.125). The odds ratio analysis indicated that chronic respiratory disease patients with high quadriceps strength have 13.76 times higher odds of having high peak arm ergometry wattage. This odds ratio equated to an 85% probability of having high arm ergometry peak wattage if quadriceps strength is high. Conclusions: In summary, the main factors predicting leg ergometry capacity were quadriceps strength, FEV 1 and grip strength. Quadriceps strength was the only statistically significant predictor of peak arm ergometry wattage, suggesting a relationship between arm and leg functionality in chronic obstructive pulmonary disease patients.

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Upper and Lower Limb Muscles in Patients With COPD: Similarities in Muscle Efficiency But Differences in Fatigue Resistance

Cited by 16 publications

References 45 publications

Physiological and Symptomatic Responses to Arm versus Leg Activities in People with Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis

Physiological and Symptomatic Responses to Arm versus Leg Activities in People with Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis

A study to assess nutritional profile in chronic obstructive pulmonary disease patients

Disease severity and muscular strength as predictors of arm and leg ergometry capacity in chronic respiratory disease

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