Respiratory and peripheral muscle strength influence recovery of exercise capacity after severe exacerbation of COPD? An observational prospective cohort study

Author(s)

Heubel, Alessandro D. ; Kabbach, Erika Z. ; Leonardi, Naiara T. ; Schafauser, Nathany S. ; Kawakamia, Debora M. O. ; Sentanin, Anna Claudia ; Di Lorenzoa, Valeria A. Pires ; Silva, Audrey Borghi ; Hurst, John R. ; Mendes, Renata G.

• Document type: Journal article
• Source: HEART & LUNG; v. 58, p. 7-pg., 2023-03-01.

Abstract

Background: Patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) have decreased exercise tolerance, which may persist for months. In this context, little is known about the associations between muscle strength and recovery of exercise capacity. Objective: To assess whether respiratory and peripheral muscle strength influence recovery of exercise capacity in patients hospitalized due to AECOPD. Methods: Twenty-seven AECOPD patients (aged 69 +/- 7 years, 56% male) were included. The following assessments were performed within 24 to 72 h of hospital admission: (i) respiratory muscle strength, measured by maximal inspiratory and expiratory pressures (MIP and MEP); (ii) peripheral muscle strength, assessed by handgrip and quadriceps muscle strength; and (iii) exercise capacity, measured by 6-min walking distance (6MWD). The 6MWD was reassessed 30 days later to determine the recovery of exercise capacity. Results: After 30 days, while 63% of the patients showed clinically important improvement in the 6MWD (recovery >= 30 m), 37% showed no change (recovery < 30 m). During hospital stay, the non-recovered group had lower quadriceps muscle strength compared to the recovered group (15 +/- 5 vs. 22 +/- 6 kgf; P = 0.006), with no significant difference for MIP, MEP and handgrip strength. Only quadriceps muscle strength was associated with recovery of exercise capacity (r = 0.56; P = 0.003). Conclusion: AECOPD patients with quadriceps muscle weakness during hospitalization have poor recovery of exercise capacity after 30 days. This finding suggests the importance of early rehabilitation to improve quad-riceps strength and accelerate functional recovery after AECOPD. (c) 2022 Elsevier Inc. All rights reserved. (AU)

• FAPESP's process: 15/26501-1 - Study of limiting factors to physical exercise and adjunct effects to rehabilitation on cardiorespiratory disease: a multicentre approach
• Grantee: Audrey Borghi Silva
• Support Opportunities: Research Projects - Thematic Grants
• FAPESP's process: 15/12763-4 - Exacerbation of COPD and COPD overlap heart failure and noninvasive ventilatory support: impact on endothelial function and cardiac autonomic modulation and relationship among cardiovascular outcomes and clinical and functional aspects
• Grantee: Renata Gonçalves Mendes
• Support Opportunities: Regular Research Grants