Expiratory muscle endurance in chronic obstructive pulmonary disease

Ramírez-Sarmiento, A.; Orozco-Levi, M.; Barreiro, E.; Méndez, R.; Ferrer, A.; Broquetas, J.; Geo, J.
February 2002
Thorax;Feb2002, Vol. 57 Issue 2, p132
Academic Journal
Background: A reduction in expiratory muscle (ExM) endurance in patients with chronic obstructive pulmonary disease (COPD) may have clinically relevant implications. This study was carried out to evaluate ExM endurance in patients with COPD. Methods: Twenty three patients with COPD (FEV1 35 (14)% predicted) and 14 matched controls were studied. ExM endurance was assessed using a method based on the use of an expiratory threshold valve which includes two steps. In step 1 the load is progressively increased (50 g every 2 minutes) until task failure is reached, and the pressure generated against the highest tolerated load is defined as the maximal expiratory sustainable pressure (Pthmax). In step 2 subjects breathe against a submaximal constant load (80% of Pthmax) and the time elapsed until task failure is termed the expiratory endurance time (Tth80). In addition, the strength of peripheral muscles (handgrip, HGS) and respiratory muscles (maximal inspiratory and expiratory pressures, Rmax and PEmax, respectively) was evaluated. Results: Patients with COPD had lower ExM strength and endurance than controls: PEmax 64 (19)% predicted v 84 (1 4)% predicted (mean difference 20%; 95% confidence intervals (Cl) 14 to 39); Pthmax 52 (27) v 151(46) cm H2O (mean difference 99, 95% Cl 74 to 123); and Tth80 9.4 (6.3) v 14.2 (7.4) mm (mean difference 4.8, 95% CI 1 .0 to 10.4; p<0.0l for all). Interestingly, ExM endurance directly correlated with both the severity of airways obstruction (Pthmax with FEV1, r=0.794, p<0.0l) and the reduction in strength observed in different muscle groups (Pthmax with HG, Pimax or PEmax, r=0.550, p<0.05; r=0.583, p<0.001; and r=0.584, p<0.001, respectively). Conclusions: ExM endurance is decreased in patients with COPD. This impairment is proportional to the severity of the disease and is associated with lower strength in different muscle groups. This suggests that systemic effects are implicated in the impairment observed in ExM function.


Related Articles

  • Variação diurna de parâmetros de função pulmonar e de força muscular respiratória em pacientes com DPOC. Fregonezi, Guilherme; Resqueti, Vanessa Regiane; Cury, Juliana Loprete; Paulin, Elaine; Brunetto, Antonio Fernando // Jornal Brasileiro de Pneumologia;mar2012, Vol. 38 Issue 2, p257 

    Objective: To evaluate the magnitude of diurnal changes in the parameters of pulmonary function and respiratory muscle strength/endurance in a sample of patients with COPD. Methods: A group of 7 patients underwent spirometry, together with determination of MIP and MEP, at two distinct times...

  • Impaired function of upper limb muscles in patients with chronic obstructive pulmonary disease. Rassler, Beate // Indian Journal of Medical Research;Oct2013, Vol. 138 Issue 4, p443 

    The author describes the importance of improving skeletal muscle function in the treatment of chronic obstructive pulmonary disease (COPD) patients. Skeletal muscle dysfunction is a secondary impairment of COPD which is typically characterized by reduced muscle strength and endurance. The author...

  • Particularidades fisiopatológicas de las alteraciones musculares en el paciente con EPOC. Gea, J.; Orozco-Levi, M.; Barreiro, E. // Nutricion Hospitalaria;2006 supplement, Vol. 21, p62 

    Patients with chronic obstructive pulmonary disease (COPD) frequently have skeletal muscle dysfunction, of either respiratory muscles or those located of the limbs. This dysfunction may appear even at relatively early stages and it conditions symptoms and patient's quality of life. In the case...

  • Does ICU-acquired paresis lengthen weaning from mechanical ventilation? De Jonghe, Bernard; Bastuji-Garin, Sylvie; Sharshar, Tarek; Outin, Hervé; Brochard, Laurent // Intensive Care Medicine;Jun2004, Vol. 30 Issue 6, p1117 

    Objective. To determine whether ICU-acquired paresis (ICUAP) is an independent risk factor of prolonged weaning. Design. Second study of a prospective cohort of 95 patients who were enrolled in an incidence and risk factor study of ICUAP. Setting. Three medical and two surgical ICUs in four...

  • Respiratory Muscle Dysfunction in COPD: From Muscle to Cell. Klimathianaki, M.; Vaporidi, K.; Georgopoulos, D. // Current Drug Targets;Apr2011, Vol. 12 Issue 4, p478 

    No abstract available.

  • Respiratory Muscle Training in Patients with COPD. CARTER, RICK; RODRIGUEZ, BRITTNEE; WILLIAMS, JIM; KOH, YUNSUK; CHILEK, DANIEL R. // RT: The Journal for Respiratory Care Practitioners;Jul2011, Vol. 24 Issue 7, p8 

    The article focuses on the respiratory muscle training (RMI) for patients with chronic obstructive pulmonary disease (COPD). It says that RMI focuses on the inspiratory muscle training (IMT) that establishes the muscle function, and the expiratory muscle training (EMT). Moreover, IMT devices can...

  • Resistance vs aerobic exercise and COPD.  // Neurology Alert;Feb2010 Primary Care, p4 

    The article discusses research conducted by S. O'Shea and colleagues on the benefits brought by resistance exercises in improving the muscle strength of patients with chronic obstructive pulmonary disease (COPD).

  • Targeted Inspiratory Muscle Training Improves Respiratory Muscle Function and Reduces Dyspnea in Patients with Chronic Obstructive Pulmonary Disease. Harver, Andrew; Mahler, Donald A.; Daubenspeck, J. Andrew // Annals of Internal Medicine;7/15/89, Vol. 111 Issue 2, p117 

    Examines the effects of targeted inspiratory muscle training on respiratory muscle function, clinical ratings of dyspnea and perception of resistive loads in symptomatic patients with chronic obstructive pulmonary disease. Increase in respiratory muscle function in symptomatic patients;...

  • Expiratory Muscle Endurance in Middle-Aged Healthy Subjects. Orozco-Levi, M.; Gea, J.; Ferrer, A.; Mendez, R.; Ramirez-Sarmiento, A.; Maldonado, D.; Broquetas, J. // Lung;2001, Vol. 179 Issue 2, p93 

    To evaluate expiratory muscle endurance in middle-aged healthy subjects using incremental as well as constant expiratory loads, 14 healthy volunteers (51 - 16 years) were submitted to a specific endurance test, which was performed breathing against a threshold valve, and was divided into two...


Read the Article


Sign out of this library

Other Topics