Aline Gonçalves Nellessen

Analysis of three different equations for predicting quadriceps femoris muscle strength in patients with COPD

Abstract Objective: To compare equations for predicting peak quadriceps femoris (QF) muscle force; to determine the agreement among the equations in identifying QF muscle weakness in COPD patients; and to assess the differences in characteristics among the groups of patients classified as having or not having QF muscle weakness by each equation. Methods: Fifty-six COPD patients underwent assessment of peak QF muscle force by dynamometry (maximal voluntary isometric contraction of knee extension). Predicted values were calculated with three equations: an age-height-weight-gender equation (Eq-AHWG); an age-weight-gender equation (Eq-AWG); and an age-fat-free mass-gender equation (Eq-AFFMG). Results: Comparison of the percentage of predicted values obtained with the three equations showed that the Eq-AHWG gave higher values than did the Eq-AWG and Eq-AFFMG, with no difference between the last two. The Eq-AHWG showed moderate agreement with the Eq-AWG and Eq-AFFMG, whereas the last two also showed moderate, albeit lower, agreement with each other. In the sample as a whole, QF muscle weakness (< 80% of predicted) was identified by the Eq-AHWG, Eq-AWG, and Eq-AFFMG in 59%, 68%, and 70% of the patients, respectively (p > 0.05). Age, fat-free mass, and body mass index are characteristics that differentiate between patients with and without QF muscle weakness. Conclusions: The three equations were statistically equivalent in classifying COPD patients as having or not having QF muscle weakness. However, the Eq-AHWG gave higher peak force values than did the Eq-AWG and the Eq-AFFMG, as well as showing greater agreement with the other equations.

Analysis of different equations to predict quadriceps femoris muscle strength in patients with COPD

Background: It is unknown if there are differences among equations which predict reference values for quadriceps femoris (QF) force in Brazilians patients with COPD Objective: To compare three different equations which predict QF peak muscle force as proposed by three different studies; and to investigate the agreement among these equations to identify QF weakness in patients with COPD. Methods: Fifty-six patients with COPD underwent assessment of QF peak force by dynamometry (maximal voluntary isometric contraction). Predicted values were calculated from the three proposed equations. Results: The proportion of patients who presented QF weakness (peak force Conclusion: The equations did not present differences when classifying patients with COPD with presence or absence of muscle weakness based on the QF peak force. The equation by Neder et al. generated higher percentage of predicted values and better agreement with the equations by Decramer et al. and Seymour et al., which did not agree well with each other.

Do patients with COPD who live alone present better functional status than those who do not

Background: Dyspnea and fatigue are common symptoms in patients with chronic obstructive pulmonary disease (COPD) and often limit the performance of activities of daily living, also known as functional status. However, it is unknown whether patients with COPD who live alone present a better functional status than those who live with their relatives or carers. Objective: To compare the functional status of patients with COPD who live alone with those who do not. Methods: Twenty-eight patients with COPD were divided into two groups: patients who live alone (LA, n=14) and patients who live with their relatives or carers (LRC, n=14). Functional status was evaluated by two questionnaires: London Chest Activity of Daily Living scale (LCADL) and Pulmonary Functional Status and Dyspnea Questionnaire – modified version (PFSDQ-M). Results: No differences were observed in age, lung function, and functional exercise capacity between the groups ( P ≥0.05). Regarding functional status, there were no differences between the groups in any domain of the LCADL [Self-care ( P =0.68); Domestic ( P =0.46); Physical ( P =0.63); Leisure ( P =0.28)], as well as in total score (LA=27 [19-28] vs. LRC=30 [19-37] points; P =0.35). Additionally, no difference was observed in any domain of the PFSDQ-M either: dyspnea ( P =0.31), fatigue ( P =0.25) and symptoms ( P =0.58). Conclusion: Despite not having family support to perform their activities of daily living, patients with COPD who live alone do not present a better functional status than those who live with their relatives and carers, suggesting that physiological mechanisms may play a more important role in patients9 functional limitation than their housing situation.