Highlights
- •Recovery of exercise capacity is variable after COPD exacerbation.
- •Quadriceps weakness at hospitalization predicts a poor recovery after 30 days.
- •No influence of respiratory and handgrip strength was observed.
- •Early rehabilitation should improve leg strength to accelerate functional recovery.
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 quadriceps strength and accelerate functional recovery after
AECOPD.
Keywords
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Article info
Publication history
Published online: November 23, 2022
Accepted:
November 18,
2022
Received in revised form:
November 6,
2022
Received:
October 11,
2022
Identification
Copyright
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