Abstract
BACKGROUND: A more profound investigation of the respiratory muscle strength during Chronic Obstructive Pulmonary Disease (COPD) exacerbations needs to be done. We aimed to investigate the strength of the respiratory muscles and its related factors in patients with COPD during and after hospitalization for exacerbation.
METHODS: Nineteen patients (12 males, mean age 67 ± 11 years, median forced expiratory volume in the first second [FEV1] 26 [19-32]% predicted) had their lung function, respiratory and quadriceps muscle strength assessed at admission (day 1), discharge and one month after discharge (1mD) for a hospitalization due to disease exacerbation.
RESULTS: At admission, 68% of the patients presented inspiratory muscle dysfunction (IMD, Maximal Inspiratory Pressure [PImax]<70% predicted). The inspiratory muscle strength increased from day 1 to 1mD (56 [45564] vs 65 [51574] cmH2O, respectively; P<.05), as well as the expiratory muscle strength from day 1 to both discharge and 1mD (99 [655117] vs 109 [775136] and 114 [905139] cmH2O, respectively; P<.05). The inspiratory capacity (IC) increased from discharge to 1mD (1.59 ± 0.44 vs 1.99 ± 0.54 liters, respectively; P<.05). No significant change was observed in other lung function variables or in quadriceps strength (P>.05 for all). Moreover, at admission the IMD and the reduction in IC (<80% predicted) correlated linearly (rϕ=0.62, P=.03), while the expiratory muscle strength correlated inversely to the FEV1 (Spearman's rho=50.61, P=.005) and the IC (Spearman's rho=50.54, P=.02).
CONCLUSIONS: There was a high prevalence of inspiratory muscle dysfunction during hospitalization due to COPD exacerbation. Inspiratory and expiratory muscle strength, however, increased markedly during and after hospitalization. The degree of airflow obstruction and hyperinflation were related to both these variables.
- Chronic Obstructive Pulmonary Disease
- Exacerbation
- Hospitalization
- Respiratory Muscles
- Respiratory Muscle Strength
- Observational Study
Footnotes
- Correspondence: Fabio Pitta PhD, Departamento de Fisioterapia — CCS, Hospital Universitário de Londrina, Av. Robert Koch, 60 — Vila Operária, 860385350 — Londrina, Paraná, Brazil. Phone.: +55 43 3371 2288; Fax: +55 43 3371 2459. Email: fabiopitta{at}uol.com.br
Conflict-of-interest statement The authors report no conflicts of interest.
This study received financial support from Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) - Brazil, grant number 474513/200952. Mr Mesquita was supported by Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)/Programa de Suporte à Pós-Graduação de Instituições de Ensino Particulares (PROSUP) — Brazil, Dr Pitta was supported by CNPq, and Dr Probst was supported by Fundação Nacional de Desenvolvimento do Ensino Superior Particular (FUNADESP).
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