Exercise-induced muscle oxygenation changes in fibrosing interstitial lung diseases: A near-infrared spectroscopy study

Esra  Pehlivan; Melih Zeren; Zeynep Betül Özcan; Fulya Senem Karaahmetoğlu; Barış Demirkol; Umut İlhan; Amine Ataç; Erdoğan Çetinkaya

doi:10.36141/svdld.v42i1.15942

Authors

Esra Pehlivan University of Health Sciences Turkey, Faculty of Hamidiye Health Sciences, Department of Physiotherapy and Rehabilitation, Istanbul, Turkey https://orcid.org/0000-0002-1791-5392
Melih Zeren Izmir Bakircay University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, İzmir, Turkey https://orcid.org/0000-0002-4397-9322
Zeynep Betül Özcan University of Health Sciences, Institute of Hamidiye Health Sciences, Department of Physiotherapy and Rehabilitation, Istanbul, Turkey https://orcid.org/0000-0003-1788-7755
Fulya Senem Karaahmetoğlu University of Health Sciences, Institute of Hamidiye Health Sciences, Department of Physiotherapy and Rehabilitation, Istanbul, Turkey https://orcid.org/0000-0002-4397-9322
Barış Demirkol University of Health Sciences Turkey, Department of Chest Diseases, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey https://orcid.org/0000-0001-5585-3842
Umut İlhan University of Health Sciences, Department of Chest Disease, Yedikule Chest Diseases and Chest Thoracic Surgery Training and Research Hospital https://orcid.org/0000-0001-9618-6417
Amine Ataç Istanbul Gedik University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Istanbul, Turkey. https://orcid.org/0000-0001-8211-9096
Erdoğan Çetinkaya University of Health Sciences, Department of Chest Disease, Yedikule Chest Diseases and Chest Thoracic Surgery Training and Research Hospital https://orcid.org/0000-0002-0891-0020

Keywords:

fibrotic hypersensitivity pneumonitis, idiopathic pulmonary fibrosis, near-infrared spectroscopy, nonspecific interstitial pneumonia, six minute walk test, exercise-induced oxygenation, interstitial lung disease exercise testing, fibrotic lung diseases

Abstract

Background: The impact of fibrosing interstitial lung disease (F-ILD) on the oxygenation of peripheral and respiratory muscles during exercise remains poorly understood. Specifically, it's unclear whether regional blood flow influences exercise capacity in these patients, and if so, to what degree.

Objectives: This study aimed to investigate changes in oxygenation and blood flow volume of the intercostal (IC) and quadriceps femoris (QF) muscles during exercise in patients with F-ILD.

Methods: Muscle oxygenation (SmO₂) and total haemoglobin (tHb) changes of IC and QF were measured in 36 F-ILD patients using near-infrared spectroscopy (NIRS) during six-minute walking test (6MWT). Resting, minute-by-minute change, and average data were analyzed.

Results: At rest, SmO₂ was significantly higher in IC compared to QF (p<0.001). When adjusted for SmO₂ at rest, SmO₂ at the different time points during 6MWT, average SmO₂ during 6MWT, and lowest SmO₂ during 6MWT did not differ between QF and IC muscles. Also, SmO₂ did not vary significantly during 6MWT in either QF (F=2.193) or IC muscle (F=1.262). THb increased more in QF than in IC. THb of IC inversely correlated to respiratory functions and 6MWT distance.

Conclusion: Peripheral and respiratory muscle oxygenation in F-ILD seems to be normal. However, blood flow volume in exercising muscle, not muscle oxygenation, may be a contributing factor to exercise intolerance. Patients with poorer respiratory function may require excessive blood flow in their respiratory muscles which in turn may limit the blood flow available for exercising peripheral muscles.

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