Clinical significance of pectoralis muscle strength in elderly patients with idiopathic pulmonary fibrosis Pectoralis muscle strength in IPF
Main Article Content
Keywords
Idiopathic pulmonary fibrosis, Pectoralis muscle strength, Pulmonary function test, Chest wall muscle
Abstract
Introduction: Investigations of muscle dysfunction in patients with idiopathic pulmonary fibrosis (IPF) are limited to peripheral muscles. However, decreased thoracic muscle mass is known and deterioration of chest wall muscle strength is not clear. Objective: The aims of the present study were to evaluate pectoralis muscle strength located on the chest wall and to investigate the relationship of spirometric measurements and respiratory muscle strength with pectoralis muscle strength. Methods: Elderly patient with IPF (mean disease duration 7.47±7.04 years) and the age-and sex-matched healthy volunteers were recruited in this cross-sectional study. The pulmonary function test was performed by a portable spirometer for spirometric variables and a gas analyzer for diffusing capacity for carbon monoxide (DLCO). Maximal inspiratory (MIP) and expiratory pressure (MEP) were measured with mouth pressure device. Modified Medical Research Council Dyspnea Scale (MMRC) was used to determined dyspnea severity. The pectoralis muscle strength was assessed isometrically during shoulder joint horizontal adduction movement with a handheld dynamometer. Results: A total of 17 patients with IPF (9 males, mean age 69.06±3.94years) and 19 healthy controls (10 males, mean age 70.95 ±4.99years) were included. Patients with IPF had lower pectoralis muscle strength than healthy controls (p<0.001). Significant relationships were found between pectoralis muscle strength and MIP (r=0.79, p<0.001), MEP (r=0.81, p<0.001), FEV1% (r=0.54, p=0.02), FVC% (r=0.68, p<0.003) and DLCO (r=0.61, p=0.009). With multiple linear regression analysis, pectoralis muscle strength was the only independent predictor of FVC% (adjusted R2=0.37, p<0.05). Conclusion: In patients with IPF, pectoralis muscle strength decreases and is associated with pulmonary function. In particular pectoralis muscle strength is likely to have an important impact on FVC%. Therefore, we consider that this test should be included routinely in chest diseases and rehabilitation clinics. The trial was registered U.S. National Library of Medicine clinical trial registry (https://clinicaltrials.gov, Trial ID: NCT04803617)
References
2. Jackson RM, Gomez-Marin OW, Ramos CF, et al. Exercise limitation in IPF patient. Lung. 2014 192(3):367–376.
3. Schertel A, Funke- Chambor M, Geiser T, Brill AB. Novel insights in cough and breathing patterns of patients with idiopathic pulmonary fibrosis performing repeated 24-hour-respiratory polygraphies. Respir Res. 2017;18(1):190.
4. Walterspacher S, Schlager D, Walker DJ, Muller-Quernheim J, Windisch W, Kabitz HJ. Respiratory muscle strength in interstitial lung disease. Eur Respir J. 2013; 42(1): 211–219.
5. Sieck GC, Ferreira LF, Reid MB, Mantilla CB. Mechanical properties of respiratory muscles. Compr Physiol. 2013; 3(4): 1553–1567.
6. Takashi N, Shirai Y, Suzuki M, Kuwana M. Chest wall muscle atrophy as a contributory factor for forced vital capacity decline in systemic sclerosis-associated interstitial lung disease. Rheumatology(Oxford) 2021;60(1):250-255.
7. Ortega F, Toral J, Cejudo P, et al. Comparison of effects of strength and endurance training in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2002;166(5): 669–674.
8. Hirano M, Katoh M, Kawaguchi S, Uemura T. Intrarater reliabilities of shoulder joint horizontal adductor muscle strength measurements using a handheld dynamometer for geriatric and stroke patients. J. Phys. Ther. Sci. 2016;28(1):51–55.
9. Moon SW, Choi JS, Lee SH, et al. Thoracic skeletal muscle quantification: low muscle mass is related with worse prognosis in idiopathic pulmonary fibrosis patients. Respir Res. 2019;20(1):35.
10. Bak SH, Kwon SO, Han SS, Kim WJ. Computed tomography-derived area and density of pectoralis muscle associated disease severity and longitudinal changes in chronic obstructive pulmonary disease: a case control study. Respir Res. 2019;20(1):226.
11. Jaitovich A, Barreiro E. Skeletal muscle dysfunction in chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2018;198(2):175-186.
12. Panagiotou M, Polychronopoulos V, Strange C. Respiratory and lower limb muscle function in interstitial lung disease. Chron Respir Dis. 2016;13(2):162–172.
13. Miller MR, Hankinson J, Brusasco V, et al. Standardisation of spirometry. Eur Respir J. 2005;26(2):319– 338.
14. American Thoracic Society. Single-breath carbon monoxide diffusing capacity (transfer factor). Recommendations for a standard technique- 1995 update. Am J Respir Crit Care Med. 1995 ;152(6):2185–98.
15. ATS/ERS. Statement on respiratory muscle testing. Am J Respir Crit Care Med. 2002;166(4):518-624.
16. Kabitz HJ, Windisch W. Respiratory muscle testing: state of the art. Pneumologie. 2007; 61: 582-587.
17. Papiris SA, Danill ZA Malagari K, et al. The Medical Research Council dyspnea scale in the estimation of disease severity in idiopathic pulmonary fibrosis. Respir Med. 2005;99(6):755-761.
18. Nishiyama O, Taniguchi H, Kondoh Y et al. Quadriceps weakness is related to exercise capacity in idiopathic pulmonary fibrosis. Chest. 2005;127(6):2028–33.
19. Mendoza L, Gogali A, Shrıkrishna D, et al. Quadriceps strength and endurance in fibrotic idiopathic interstitial pneumonia. Respirology. 2014;19(1):138–143.
20. Skeletal muscle dysfunction in chronic obstructive pulmonary disease. A statement of the American Thoracic Society and European Respiratory Society. Am J Respir Crit Care Med. 1999;159(4): S1–S40.
21. Mendes P, Wickerson L, Helm D, Janaudis-Ferreira BD, Singer LG, Mathur S. Skeletal muscle atrophy in advanced interstitial lung disease. Respirology. 2015;20(6): 953–959.
22. Dourado VZ, Antunes LCO, Tanni SE, Paiva SAR, Padovani CR, Godoy I. Relationship of upper-limb and thoracic muscle strength to 6-min walk distance in COPD patients. Chest.2006; 129(3):551–557.
23. Watanabe F, Taniguchi H, Sakamoto K, et al. Quadriceps weakness contributes to exercise capacity in nonspecific interstitial pneumonia. Respir Med. 2013;107(4): 622–628.
24. Olukogbon K. L., Thomas P., Colasanti R., Hope-Gill B, Williams EM. Breathing pattern and breathlessness in idiopathic pulmonary fibrosis: An observational study. Respirology.2016; 21: 344–349.
25. Kaymaz D, Candemir IC, Ergun P, Demir N, Tasdemir F, Demir P. Relation between upper-limb muscle strength with exercise capacity, quality of life dyspnea ın patients with severe chronic obstructive pulmonary disease. Clin Respir J. 2018;12(3):1257-1263.
26. Costa D, Cancelliero KM, IKE D, Larenjeria TL, Pantoni CBF, Borghi-Silva A. Strategy for respiratory exercise pattern associated with upper limb movements in COPD patients. Clinics.2011;66(2):299-305.
27. Mathur S, Rozenberg D, Verwell L, Orsso CE, Singer LG. Chest computed tomography is a valid measure of body composition in individuals with advanced lung disease. Clin Physiol Funct Imaging. 2020;40(5):360–368.
28. Ebihara K, Iwanami Y, Yamasaki K, et al. Appendicular skeletal muscle mass correlates with patient- reported outcomes and physical performance in patients with idiopathic pulmonary fibrosis. Tohoku J. Exp. Med.2021;253(1): 61-68.
29. Guler SA, Hur SA, Lear SA, Camp PG, Ryerson CJ. Body composition, muscle function, and physical performance in fibrotic interstitial lung disease: a prospective cohort study. Respiratory Research. 2019; 20:56.
30. Rozenberg D, Martelli V, Vieira L, et al. Utilization of non-invasive imaging tools for assessment of peripheral skeletal muscle size and composition in chronic lung disease: A systematic review. Respir Med.2017;131: 125-134.
31. Kono M, Nakamura Y, Enomoto N, et al. Prognostic impact of an early marginal decline in forced vital capacity in idiopathic pulmonary fibrosis patients treated with pirfenidone. Respir Investig. 2019;57(6):552-560.
32. Marklund S, Bui KL, Nyberg A. Measuring and monitoring skeletal muscle function in COPD: current perspectives. Int J Chron Obstruct Pulmon Dis. 2019;14:1825–1838.
33. Lassenius MI, Toppila I, Pöntynen N, et al. Forced Vital Capacity (FVC) decline, mortality and healthcare resource utilization in idiopathic pulmonary fibrosis. European Clinical Respiratory Journal 2019;7:1.
34. Hanada M, Sakamoto N, Ishimatsu Y, et al. Effect of long-term treatment with corticosteroids on skeletal muscle strength, functional exercise capacity and health status in patients with interstitial lung disease. Respirology. 2016;21(6):1088–1093.
Article Sidebar
Article Details
How to Cite
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Transfer of Copyright and Permission to Reproduce Parts of Published Papers.
Authors retain the copyright for their published work. No formal permission will be required to reproduce parts (tables or illustrations) of published papers, provided the source is quoted appropriately and reproduction has no commercial intent. Reproductions with commercial intent will require written permission and payment of royalties.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
