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Limitations in physical performance in people with chronic obstructive pulmonary disease

University of British Columbia

People with chronic obstructive pulmonary disease (COPD) show deficits in physical performance, including skeletal muscle dysfunction (atrophy, weakness), and activity limitation due to fatigue, dyspnea, and pain. Little is known about the pattern of pain and muscle dysfunction and how they impact physical performance in people with COPD. Based on the components of the International Classification of Functioning, Disability and Health (i.e. body structure, body function, and activity limitation), the purposes of this thesis were to examine patients with COPD to determine: 1) thigh muscle shape and size changes; 2) the severity, interference, and characteristics of pain; 3) how comorbidities relate to pain; 4) the relationships between pain and physical performance (muscle strength, walk distance, and daily physical activity). Methods and Results: Three sets of cross-sectional experiments were performed. Study 1: Size and shape descriptors derived from magnetic resonance imaging of thighs were compared in COPD patients to healthy people. Muscle atrophy and shape changes were common and non-uniformly distributed among individual thigh muscles compared to healthy people (Chapter 2). Study 2: A survey study demonstrated that pain severity and interference (measured by the McGill Pain Questionnaire and Brief Pain Inventory) were higher in people with COPD compared to age- and gender-matched controls (n=47 per group). The number of comorbidities was an independent correlate of pain severity in COPD (Chapter 3). A second analysis of the survey data was performed on a larger sample of COPD patients who experienced pain (n=54) further explored the pattern of comorbidities and pain. The number of comorbidities was associated with pain severity and interference; musculoskeletal and endocrine conditions contribute to pain severity; and people with COPD were under-treated for pain (Chapter 4). Study 3: This cross-sectional study demonstrated that pain was associated with a lower six-minute walk test, shorter active and standing times, and longer sedentary times (measured by three-dimensional accelerometry), and increased body mass index (Chapter 5). In summary, regional muscle atrophy might contribute to deficits in muscle performance in people with COPD. In addition, pain is significant in people with COPD and can be considered as an activity-limiting factor in COPD.

Text

2013-10-31

Attribution-NonCommercial-NoDerivatives 4.0 International

http://hdl.handle.net/2429/44157

Rehabilitation Sciences

University of British Columbia

UBCV

http://creativecommons.org/licenses/by-nc-nd/4.0/