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Published in: Multidisciplinary Respiratory Medicine 1/2012

Open Access 01-12-2012 | Original research article

Extrapulmonary features of bronchiectasis: muscle function, exercise capacity, fatigue, and health status

Authors: Ozge Ozalp, Deniz Inal-Ince, Ebru Calik, Naciye Vardar-Yagli, Melda Saglam, Sema Savci, Hulya Arikan, Meral Bosnak-Guclu, Lutfi Coplu

Published in: Multidisciplinary Respiratory Medicine | Issue 1/2012

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Abstract

Background

There are limited number of studies investigating extrapulmonary manifestations of bronchiectasis. The purpose of this study was to compare peripheral muscle function, exercise capacity, fatigue, and health status between patients with bronchiectasis and healthy subjects in order to provide documented differences in these characteristics for individuals with and without bronchiectasis.

Methods

Twenty patients with bronchiectasis (43.5 ± 14.1 years) and 20 healthy subjects (43.0 ± 10.9 years) participated in the study. Pulmonary function, respiratory muscle strength (maximal expiratory pressure – MIP - and maximal expiratory pressure - MEP), and dyspnea perception using the Modified Medical Research Council Dyspnea Scale (MMRC) were determined. A six-minute walk test (6MWT) was performed. Quadriceps muscle, shoulder abductor, and hand grip strength (QMS, SAS, and HGS, respectively) using a hand held dynamometer and peripheral muscle endurance by a squat test were measured. Fatigue perception and health status were determined using the Fatigue Severity Scale (FSS) and the Leicester Cough Questionnaire (LCQ), respectively.

Results

Number of squats, 6MWT distance, and LCQ scores as well as lung function testing values and respiratory muscle strength were significantly lower and MMRC and FSS scores were significantly higher in patients with bronchiectasis than those of healthy subjects (p < 0.05). In bronchiectasis patients, QMS was significantly associated with HGS, MIP and MEP (p < 0.05). The 6MWT distance was significantly correlated to LCQ psychological score (p < 0.05). The FSS score was significantly associated with LCQ physical and total and MMRC scores (p < 0.05). The LCQ psychological score was significantly associated with MEP and 6MWT distance (p < 0.05).

Conclusions

Peripheral muscle endurance, exercise capacity, fatigue and health status were adversely affected by the presence of bronchiectasis. Fatigue was associated with dyspnea and health status. Respiratory muscle strength was related to peripheral muscle strength and health status, but not to fatigue, peripheral muscle endurance or exercise capacity. These findings may provide insight for outcome measures for pulmonary rehabilitation programs for patients with bronchiectasis.
Literature
1.
go back to reference Onen ZP, Gulbay BE, Sen E, Yildiz OA, Saryal S, Acican T, Karabiyikoglu G: Analysis of the factors related to mortality in patients with bronchiectasis. Respir Med. 2007, 101: 1390-1397. 10.1016/j.rmed.2007.02.002.CrossRefPubMed Onen ZP, Gulbay BE, Sen E, Yildiz OA, Saryal S, Acican T, Karabiyikoglu G: Analysis of the factors related to mortality in patients with bronchiectasis. Respir Med. 2007, 101: 1390-1397. 10.1016/j.rmed.2007.02.002.CrossRefPubMed
2.
go back to reference MacIntyre NR: Mechanisms of functional loss in patients with chronic lung disease. Respir Care. 2008, 53: 1177-1184.PubMed MacIntyre NR: Mechanisms of functional loss in patients with chronic lung disease. Respir Care. 2008, 53: 1177-1184.PubMed
3.
go back to reference Allaire J, Maltais F, Doyon JF, Noël M, LeBlanc P, Carrier G, Simard C, Jobin J: Peripheral muscle endurance and the oxidative profile of the quadriceps in patients with COPD. Thorax. 2004, 59: 673-678. 10.1136/thx.2003.020636.PubMedCentralCrossRefPubMed Allaire J, Maltais F, Doyon JF, Noël M, LeBlanc P, Carrier G, Simard C, Jobin J: Peripheral muscle endurance and the oxidative profile of the quadriceps in patients with COPD. Thorax. 2004, 59: 673-678. 10.1136/thx.2003.020636.PubMedCentralCrossRefPubMed
4.
go back to reference Inal-Ince D, Savci S, Saglam M, Calik E, Arikan H, Bosnak-Guclu M, Vardar-Yagli N, Coplu L: Fatigue and multidimensional disease severity in chronic obstructive pulmonary disease. Multidiscip Respir Med. 2010, 5: 162-167.PubMedCentralCrossRefPubMed Inal-Ince D, Savci S, Saglam M, Calik E, Arikan H, Bosnak-Guclu M, Vardar-Yagli N, Coplu L: Fatigue and multidimensional disease severity in chronic obstructive pulmonary disease. Multidiscip Respir Med. 2010, 5: 162-167.PubMedCentralCrossRefPubMed
5.
go back to reference King PT, Holdsworth SR, Freezer NJ, Villanueva E, Gallagher M, Holmes PW: Outcome in adult bronchiectasis. COPD. 2005, 2: 27-34. 10.1081/COPD-200050685.CrossRefPubMed King PT, Holdsworth SR, Freezer NJ, Villanueva E, Gallagher M, Holmes PW: Outcome in adult bronchiectasis. COPD. 2005, 2: 27-34. 10.1081/COPD-200050685.CrossRefPubMed
6.
go back to reference Koulouris NG, Retsou S, Kosmas E, Dimakou K, Malagari K, Mantzikopoulos G, Koutsoukou A, Milic-Emili J, Jordanoglou J: Tidal expiratory flow limitation, dyspnoea and exercise capacity in patients with bilateral bronchiectasis. Eur Respir J. 2003, 21: 743-748. 10.1183/09031936.03.00301103.CrossRefPubMed Koulouris NG, Retsou S, Kosmas E, Dimakou K, Malagari K, Mantzikopoulos G, Koutsoukou A, Milic-Emili J, Jordanoglou J: Tidal expiratory flow limitation, dyspnoea and exercise capacity in patients with bilateral bronchiectasis. Eur Respir J. 2003, 21: 743-748. 10.1183/09031936.03.00301103.CrossRefPubMed
7.
go back to reference O’Leary CJ, Wilson CB, Hansell DM, Cole PJ, Wilson R, Jones PW: Relationship between psychological well-being and lung health status in patients with bronchiectasis. Respir Med. 2002, 96: 686-692. 10.1053/rmed.2002.1330.CrossRefPubMed O’Leary CJ, Wilson CB, Hansell DM, Cole PJ, Wilson R, Jones PW: Relationship between psychological well-being and lung health status in patients with bronchiectasis. Respir Med. 2002, 96: 686-692. 10.1053/rmed.2002.1330.CrossRefPubMed
8.
go back to reference Lee AL, Button BM, Ellis S, Stirling R, Wilson JW, Holland AE, Denehy L: Clinical determinants of the 6–minute walk test in bronchiectasis. Respir Med. 2009, 103: 780-785. 10.1016/j.rmed.2008.11.005.CrossRefPubMed Lee AL, Button BM, Ellis S, Stirling R, Wilson JW, Holland AE, Denehy L: Clinical determinants of the 6–minute walk test in bronchiectasis. Respir Med. 2009, 103: 780-785. 10.1016/j.rmed.2008.11.005.CrossRefPubMed
9.
go back to reference Newall C, Stockley RA, Hill SL: Exercise training and inspiratory muscle training in patients with bronchiectasis. Thorax. 2005, 60: 943-948. 10.1136/thx.2004.028928.PubMedCentralCrossRefPubMed Newall C, Stockley RA, Hill SL: Exercise training and inspiratory muscle training in patients with bronchiectasis. Thorax. 2005, 60: 943-948. 10.1136/thx.2004.028928.PubMedCentralCrossRefPubMed
10.
go back to reference Durnin JV, Womersley J: Body fat assessed from total body density and its estimation from skinfold thickness: measurements on 481 men and women aged from 16 to 72 years. Br J Nutr. 1974, 32: 77-97. 10.1079/BJN19740060.CrossRefPubMed Durnin JV, Womersley J: Body fat assessed from total body density and its estimation from skinfold thickness: measurements on 481 men and women aged from 16 to 72 years. Br J Nutr. 1974, 32: 77-97. 10.1079/BJN19740060.CrossRefPubMed
11.
go back to reference Quanjer PH, Tammeling GJ, Cotes JE, Pedersen OF, Peslin R, Yernault JC: Lung volumes and forced ventilatory flows. Report Working Party Standardization of Lung Function Tests, European Community for Steel and Coal. Official Statement of the European Respiratory Society. Eur Respir J Suppl. 1993, 16: 5-40.CrossRefPubMed Quanjer PH, Tammeling GJ, Cotes JE, Pedersen OF, Peslin R, Yernault JC: Lung volumes and forced ventilatory flows. Report Working Party Standardization of Lung Function Tests, European Community for Steel and Coal. Official Statement of the European Respiratory Society. Eur Respir J Suppl. 1993, 16: 5-40.CrossRefPubMed
12.
go back to reference Black LF, Hyatt RE: Maximal respiratory pressures: normal values and relationship to age and sex. Am Rev Respir Med. 1969, 99: 696-702. Black LF, Hyatt RE: Maximal respiratory pressures: normal values and relationship to age and sex. Am Rev Respir Med. 1969, 99: 696-702.
13.
go back to reference Crisafulli E, Clini EM: Measures of dyspnea in pulmonary rehabilitation. Multidiscip Resp Med. 2010, 5: 202-210.CrossRef Crisafulli E, Clini EM: Measures of dyspnea in pulmonary rehabilitation. Multidiscip Resp Med. 2010, 5: 202-210.CrossRef
14.
go back to reference Adams GM: Exercise physiology laboratory manual. 1990, Wm C Brown, Dubuque (IA), USA Adams GM: Exercise physiology laboratory manual. 1990, Wm C Brown, Dubuque (IA), USA
15.
go back to reference ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories: ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med. 2002, 166: 111-117.CrossRef ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories: ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med. 2002, 166: 111-117.CrossRef
16.
go back to reference Borg GA: Psychophysical bases of perceived exertion. Med Sci Sports Exerc. 1982, 14: 377-381.PubMed Borg GA: Psychophysical bases of perceived exertion. Med Sci Sports Exerc. 1982, 14: 377-381.PubMed
17.
go back to reference Enright PL, Sherrill DL: Reference equations for the six-minute walk in healthy adults. Am J Respir Crit Care Med. 1998, 158: 1384-1387.CrossRefPubMed Enright PL, Sherrill DL: Reference equations for the six-minute walk in healthy adults. Am J Respir Crit Care Med. 1998, 158: 1384-1387.CrossRefPubMed
18.
go back to reference Armutlu K, Korkmaz NC, Keser I, Sumbuloglu V, Akbiyik DI, Guney Z, Karabudak R: The validity and reliability of the Fatigue Severity Scale in Turkish multiple sclerosis patients. Int J Rehabil Res. 2007, 30: 81-85. 10.1097/MRR.0b013e3280146ec4.CrossRefPubMed Armutlu K, Korkmaz NC, Keser I, Sumbuloglu V, Akbiyik DI, Guney Z, Karabudak R: The validity and reliability of the Fatigue Severity Scale in Turkish multiple sclerosis patients. Int J Rehabil Res. 2007, 30: 81-85. 10.1097/MRR.0b013e3280146ec4.CrossRefPubMed
19.
go back to reference Kalpaklioglu AF, Kara T, Kurtipek E, Kocyigit P, Ekici A, Ekici M: Evaluation and impact of chronic cough: comparison of specific vs generic quality-of-life questionnaires. Ann Allergy Asthma Immunol. 2005, 94: 581-585. 10.1016/S1081-1206(10)61137-4.CrossRefPubMed Kalpaklioglu AF, Kara T, Kurtipek E, Kocyigit P, Ekici A, Ekici M: Evaluation and impact of chronic cough: comparison of specific vs generic quality-of-life questionnaires. Ann Allergy Asthma Immunol. 2005, 94: 581-585. 10.1016/S1081-1206(10)61137-4.CrossRefPubMed
20.
go back to reference Green SB, Salkind NJ: Using SPSS for Windows and Macintosh: analyzing and understanding data. 2008, Uppersaddle River, Prentice Hall Green SB, Salkind NJ: Using SPSS for Windows and Macintosh: analyzing and understanding data. 2008, Uppersaddle River, Prentice Hall
21.
go back to reference Shapiro SS, Wilk MB: An analysis of variance test for normality (complete samples). Biometrika. 1965, 52: 591-611.CrossRef Shapiro SS, Wilk MB: An analysis of variance test for normality (complete samples). Biometrika. 1965, 52: 591-611.CrossRef
22.
go back to reference Drain M, Elborn JS: Assessment and investigation of adults with bronchiectasis. Eur Respir Mon. 2011, 52: 32-43. Drain M, Elborn JS: Assessment and investigation of adults with bronchiectasis. Eur Respir Mon. 2011, 52: 32-43.
23.
go back to reference Goddard M: Histopathology of bronchiectasis. Eur Respir Mon. 2011, 52: 22-31. Goddard M: Histopathology of bronchiectasis. Eur Respir Mon. 2011, 52: 22-31.
24.
go back to reference King P, Holdsworth S, Freezer N: Holmes P. Bronchiectasis. Intern Med J. 2006, 36: 729-737.PubMed King P, Holdsworth S, Freezer N: Holmes P. Bronchiectasis. Intern Med J. 2006, 36: 729-737.PubMed
25.
go back to reference Murray MP, Pentland JL, Hill AT: A randomised crossover trial of chest physiotherapy in non-cystic fibrosis bronchiectasis. Eur Respir J. 2009, 34: 1086-1092. 10.1183/09031936.00055509.CrossRefPubMed Murray MP, Pentland JL, Hill AT: A randomised crossover trial of chest physiotherapy in non-cystic fibrosis bronchiectasis. Eur Respir J. 2009, 34: 1086-1092. 10.1183/09031936.00055509.CrossRefPubMed
26.
go back to reference Moran F, Piper A, Elborn JS, Bradley JM: Respiratory muscle pressures in non-CF bronchiectasis: repeatability and reliability. Chron Respir Dis. 2010, 7: 165-171. 10.1177/1479972310375595.CrossRefPubMed Moran F, Piper A, Elborn JS, Bradley JM: Respiratory muscle pressures in non-CF bronchiectasis: repeatability and reliability. Chron Respir Dis. 2010, 7: 165-171. 10.1177/1479972310375595.CrossRefPubMed
27.
go back to reference Martínez-García MA, Perpiñá-Tordera M, Soler-Cataluña JJ, Román-Sánchez P, Lloris-Bayo A, González-Molina A: Dissociation of lung function, dyspnea ratings and pulmonary extension in bronchiectasis. Respir Med. 2007, 101: 2248-2253. 10.1016/j.rmed.2007.06.028.CrossRefPubMed Martínez-García MA, Perpiñá-Tordera M, Soler-Cataluña JJ, Román-Sánchez P, Lloris-Bayo A, González-Molina A: Dissociation of lung function, dyspnea ratings and pulmonary extension in bronchiectasis. Respir Med. 2007, 101: 2248-2253. 10.1016/j.rmed.2007.06.028.CrossRefPubMed
28.
go back to reference Buchman AS, Boyle PA, Leurgans SE, Evans DA, Bennett DA: Pulmonary function, muscle strength, and incident mobility disability in elders. Proc Am Thorac Soc. 2009, 6: 581-587. 10.1513/pats.200905-030RM.PubMedCentralCrossRefPubMed Buchman AS, Boyle PA, Leurgans SE, Evans DA, Bennett DA: Pulmonary function, muscle strength, and incident mobility disability in elders. Proc Am Thorac Soc. 2009, 6: 581-587. 10.1513/pats.200905-030RM.PubMedCentralCrossRefPubMed
29.
go back to reference Gosselink R, Troosters T, Decramer M: Peripheral muscle weakness contributes to exercise limitation in COPD. Am J Respir Crit Care Med. 1996, 153: 976-980.CrossRefPubMed Gosselink R, Troosters T, Decramer M: Peripheral muscle weakness contributes to exercise limitation in COPD. Am J Respir Crit Care Med. 1996, 153: 976-980.CrossRefPubMed
30.
go back to reference Vilaró J, Ramirez-Sarmiento A, Martínez-Llorens JM, Mendoza T, Alvarez M, Sánchez-Cayado N, Vega A, Gimeno E, Coronell C, Gea J, Roca J, Orozco-Levi M: Global muscle dysfunction as a risk factor of readmission to hospital due to COPD exacerbations. Respir Med. 2010, 104: 1896-1902. 10.1016/j.rmed.2010.05.001.CrossRefPubMed Vilaró J, Ramirez-Sarmiento A, Martínez-Llorens JM, Mendoza T, Alvarez M, Sánchez-Cayado N, Vega A, Gimeno E, Coronell C, Gea J, Roca J, Orozco-Levi M: Global muscle dysfunction as a risk factor of readmission to hospital due to COPD exacerbations. Respir Med. 2010, 104: 1896-1902. 10.1016/j.rmed.2010.05.001.CrossRefPubMed
31.
go back to reference King PT, Holdsworth SR, Freezer NJ, Villanueva E, Holmes PW: Characterisation of the onset and presenting clinical features of adult bronchiectasis. Respir Med. 2006, 100: 2183-2189. 10.1016/j.rmed.2006.03.012.CrossRefPubMed King PT, Holdsworth SR, Freezer NJ, Villanueva E, Holmes PW: Characterisation of the onset and presenting clinical features of adult bronchiectasis. Respir Med. 2006, 100: 2183-2189. 10.1016/j.rmed.2006.03.012.CrossRefPubMed
32.
go back to reference Wilson CB, Jones PW, O’Leary CJ, Cole PJ, Wilson R: Validation of the St. George’s Respiratory Questionnaire in bronchiectasis. Am J Respir Crit Care Med. 1997, 156: 536-541.CrossRefPubMed Wilson CB, Jones PW, O’Leary CJ, Cole PJ, Wilson R: Validation of the St. George’s Respiratory Questionnaire in bronchiectasis. Am J Respir Crit Care Med. 1997, 156: 536-541.CrossRefPubMed
33.
go back to reference Martínez-García MA, Perpiñá-Tordera M, Román-Sánchez P, Soler-Cataluña JJ: Quality-of-life determinants in patients with clinically stable bronchiectasis. Chest. 2005, 128: 739-745. 10.1378/chest.128.2.739.CrossRefPubMed Martínez-García MA, Perpiñá-Tordera M, Román-Sánchez P, Soler-Cataluña JJ: Quality-of-life determinants in patients with clinically stable bronchiectasis. Chest. 2005, 128: 739-745. 10.1378/chest.128.2.739.CrossRefPubMed
34.
go back to reference Courtney JM, Kelly MG, Watt A, Garske L, Bradley J, Ennis M, Elborn JS: Quality of life and inflammation in exacerbations of bronchiectasis. Chron Respir Dis. 2008, 5: 161-168. 10.1177/1479972308091823.CrossRefPubMed Courtney JM, Kelly MG, Watt A, Garske L, Bradley J, Ennis M, Elborn JS: Quality of life and inflammation in exacerbations of bronchiectasis. Chron Respir Dis. 2008, 5: 161-168. 10.1177/1479972308091823.CrossRefPubMed
35.
go back to reference Murray MP, Turnbull K, MacQuarrie S, Pentland JL, Hill AT: Validation of the Leicester Cough Questionnaire in non-cystic fibrosis bronchiectasis. Eur Respir J. 2009, 34: 125-131. 10.1183/09031936.00160508.CrossRefPubMed Murray MP, Turnbull K, MacQuarrie S, Pentland JL, Hill AT: Validation of the Leicester Cough Questionnaire in non-cystic fibrosis bronchiectasis. Eur Respir J. 2009, 34: 125-131. 10.1183/09031936.00160508.CrossRefPubMed
36.
go back to reference Lee AL, Cecins N, Hill CJ, Holland AE, Rautela L, Stirling RG, Thompson PJ, McDonald CF, Jenkins S: The effects of pulmonary rehabilitation in patients with non-cystic fibrosis bronchiectasis: protocol for a randomised controlled trial. BMC Pulm Med. 2010, 10: 5-10.1186/1471-2466-10-5.PubMedCentralCrossRefPubMed Lee AL, Cecins N, Hill CJ, Holland AE, Rautela L, Stirling RG, Thompson PJ, McDonald CF, Jenkins S: The effects of pulmonary rehabilitation in patients with non-cystic fibrosis bronchiectasis: protocol for a randomised controlled trial. BMC Pulm Med. 2010, 10: 5-10.1186/1471-2466-10-5.PubMedCentralCrossRefPubMed
37.
go back to reference Raj AA, Pavord DI, Birring SS: Clinical cough IV: what is the minimal important difference for the Leicester Cough Questionnaire?. Handb Exp Pharmacol. 2009, 187: 311-320. 10.1007/978-3-540-79842-2_16.CrossRefPubMed Raj AA, Pavord DI, Birring SS: Clinical cough IV: what is the minimal important difference for the Leicester Cough Questionnaire?. Handb Exp Pharmacol. 2009, 187: 311-320. 10.1007/978-3-540-79842-2_16.CrossRefPubMed
Metadata
Title
Extrapulmonary features of bronchiectasis: muscle function, exercise capacity, fatigue, and health status
Authors
Ozge Ozalp
Deniz Inal-Ince
Ebru Calik
Naciye Vardar-Yagli
Melda Saglam
Sema Savci
Hulya Arikan
Meral Bosnak-Guclu
Lutfi Coplu
Publication date
01-12-2012
Publisher
BioMed Central
Published in
Multidisciplinary Respiratory Medicine / Issue 1/2012
Electronic ISSN: 2049-6958
DOI
https://doi.org/10.1186/2049-6958-7-3

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