Chest
Clinical InvestigationsQuadriceps Weakness Is Related to Exercise Capacity in Idiopathic Pulmonary Fibrosis
Section snippets
Study Design
Forty-one consecutive patients with IPF were included. IPF was diagnosed by a physician using the diagnostic criteria in the ATS/ERS consensus statement.2 Surgical lung biopsies were performed in 21 patients, and pathologic diagnosis of IPF was also based on the consensus statement.2 Chest high-resolution CT showed typical manifestations of IPF13 in all patients. Patients were excluded if they had any of the following: obstructive lung disease such as COPD or asthma, active coronary artery
Patient Characteristics and Anthropometric and Pulmonary Function Data
As shown in Table 1, patients had mild decreases in VC and TLC, consistent with a mild restrictive defect. There was a moderate reduction in diffusing capacity consistent with a pulmonary vascular disorder.
Exercise Performance
Exercise performance of these patients are shown in Table 2. Mean o2max (893 ± 314 mL/min) shows poor exercise capacity in these patients; the reduction in exercise capacity is out of proportion to lung mechanical alterations. AT could be measured in 37 patients by V-slope method, and
Discussion
In the present study, we found that QF is reduced in patients with IPF, and this weakness correlates with exercise limitation as well as lung function impairment in those patients. Among these variables, VC and QF were particularly significant contributing factors according to the stepwise analysis. To our knowledge, this is the first report clarifying the relationship between peripheral muscle performance and exercise capacity in patients with IPF.
Some factors and mechanisms that determine
References (32)
- et al.
Pathophysiology of activity limitation in patients with interstitial lung disease
Chest
(1996) Exercise limitation and clinical exercise testing in chronic obstructive pulmonary disease
Clin Chest Med
(1994)- et al.
Abnormalities of skeletal muscle in patients with chronic heart failure
Int J Cardiol
(1988) Skeletal muscle function in COPD
Chest
(2000)- et al.
Corticosteroid-induced myopathy and the respiratory muscles. Report of two cases
Chest
(1989) - et al.
Idiopathic pulmonary fibrosis
N Engl J Med
(2001) American Thoracic Society. Idiopathic pulmonary fibrosis: diagnosis and treatment; international consensus statement
Am J Respir Crit Care Med
(2000)- et al.
Pattern of breathing during exercise in patients with interstitial lung disease
Thorax
(1983) American Thoracic Society. American Thoracic Society/European Respiratory Society international multidisciplinary consensus classification of the idiopathic interstitial pneumonias
Am J Respir Crit Care Med
(2002)American Thoracic Society/European Respiratory Society. Skeletal muscle dysfunction in chronic obstructive pulmonary disease
Am J Respir Crit Care Med
(1999)
Peripheral muscle weakness in patients with chronic obstructive pulmonary disease
Am J Respir Crit Care Med
Peripheral muscle weakness contributes to exercise limitation in COPD
Am J Respir Crit Care Med
Quadriceps fatigue after cycle exercise in patients with chronic obstructive pulmonary disease
Am J Respir Crit Care Med
Impaired skeletal muscle function in patients with congestive heart failure. Relationship to systemic exercise performance
J Clin Invest
Idiopathic interstitial pneumonias: diagnostic accuracy of thin-section CT in 129 patients
Radiology
Medical Section of the American Lung Association. Standardization of spirometry: 1994 update
Am J Respir Crit Care Med
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Pectoralis muscle area and its association with indices of disease severity in interstitial lung disease
2021, Respiratory MedicineFunctional performance tests in interstitial lung disease: Impairment and measurement properties
2021, Respiratory MedicineCitation Excerpt :Albeit functional tests are widely investigated in respiratory diseases [4,19,20], there are particularities of ILD that may result in different outcomes in functional tests. For instance, patients with idiopathic pulmonary fibrosis have a faster disease progression an present an uneven distribution of the loss of muscle function [3]. Additionally, patients with connective tissue disease-related ILD experience joint problems impairing activities of daily living [21].
The Physiology of Interstitial Lung Disease
2021, Encyclopedia of Respiratory Medicine, Second EditionCorticosteroids are associated with reduced skeletal muscle function in interstitial lung disease patients with mild dyspnea
2020, Respiratory MedicineCitation Excerpt :Exercise limitations are mainly caused by impaired pulmonary gas exchange and circulatory factors [4–6]; however, peripheral and respiratory muscle dysfunction may also contribute to impaired exercise tolerance in these patients [7]. Previous studies have reported that quadriceps muscle force (QF) is significantly reduced and directly linked to exercise intolerance in ILD patients [8–10]. Dyspnea is one of the most common symptoms experienced by ILD patients [11]; thus its evaluation is important for chronic ILD management.
The 1-minute sit-to-stand test to evaluate quadriceps muscle strength in patients with interstitial lung disease
2020, Respiratory Medicine and Research
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