Kronik Obstrüktif Akciğer Hastalığında Solunum Kas Enduransının Değerlendirilmesi

Abstract

In chronic obstructive pulmonary disease (COPD) local and systemic factors increasing work of breathing are caused by a mismatch between demand and the capacity of the respiratory system. This results in deficiency of respiratory muscle strength and endurance. The aim of the study was to compare respiratory muscle endurance assessment methods in patients with COPD. Thirty four patients diagnosed with COPD were included in the study. Physical and demographic characteristics of the subjects were recorded. Pulmonary function testing, inspiratory and expiratory muscle strength (MIP and MEP) measurement, respiratory muscle endurance test (sustainable inspiratory pressure and incremental threshold loading) and a six-minute walk test (6MWT) were used to assess the subjects. Modified Medical Research Council (MMRC) dyspnea scale was used to determine the dyspnea perception. Sustainable inspiratory pressure was administered 60% of maximal inspiratory pressure. Incremental threshold loading was started with 20% of MIP and pressure was raised at two min intervals. The tests were repeated two times in the same day. There was a positive weak correlation between sustainable inspiratory pressure and incremental threshold loading tests (r=0.39, p˂0.05). When test-retest reliability was assessed, it was seen that both of tests were reproducible (r1=0.735, r2=0.768, p<0.05). Finding no differences between repeated tests showed that tests are not affected by learning effect. Sustainable inspiratory pressure and incremental threshold loading tests are used for the same purpose but with different characteristics. Regarding the relationship between the other parameters and tests, it is seen that incremental threshold loading is well tolerated and reflects the differences in respiratory muscle endurance better.