Abstract
Purpose:
A high body mass index (BMI) provides an advantage for survival in patients with chronic obstructive pulmonary disease (COPD). The aim of this study was to investigate the effects of obesity on respiratory muscle strength, exercise capacity, and physical activity level in patients with COPD.
Materials and Methods:
Twenty-eight male COPD patients (age: 63.07±6.32 years, FEV1: 36.9±11.0%) participated in this study. The subjects were divided into two groups as overweight/obese (25≤BMI≤34.9 kg/m2, n=14) and normal (18.5≤BMI≤24.9 kg/m2, n=14). Pulmonary function testing and six-minute walk test were performed. Respiratory muscle strength was evaluated using a portable mouth pressure device. Physical activity level of the subjects was determined using an accelerometer.
Results:
Airway obstruction level was similar in both groups (p>0.05). Overweight/obese COPD patients’ inspiratory muscle strength (94.57±18.72 cmH2O), expiratory muscle strength (155.07±42.86 cmH2O), and physical activity level (319.3 kcal/day) were statistically higher than patients with a normal BMI (inspiratory muscle strength: 79.64±26.14 cmH2O, expiratory muscle strength: 124.36±23.70 cmH2O, and physical activity level: 275.9 kcal/days, p<0.05). There was no significant difference in 6-minute walk distance between both groups, however work done during the test was significantly higher in overweight/obes group (3037.0±8662.91 kg/m ve 4240.3±10372.59 kg/m, p<0.05).
Conclusion:
Being overweight or obese preserves respiratory muscle strength in COPD. Although physical activity level of obese/overweight patients was higher than those of normal weight group, both groups had an insufficient physical activity levels. The clinical condition caused by being overweight or obese patients with COPD can provide a better prognosis.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
Kaynaklar
Calle EE, Thun MJ, Petrelli JM, et al. Body-mass index and mortality in a prospective cohort of U.S. adults. N Engl J Med. 1999;341(15):1097–1105.
McAuley PA, Kokkinos PF, Oliveira RB, et al. Obesity paradox and cardiorespiratory fitness in 12,417 male veterans aged 40 to 70 years. Mayo Clin Proc. 2010;85(2):115–121.
İnal İnce D, Arikan H, Savcı S, ve diğerleri. Kronik Obstrüktif Akciğer Hastalığında Metabolik Sendrom. Fizyoter Rehabil. 2006;17:82.
Gray-Donald K, Carrey Z and Martin JG. Postprandial dyspnea and malnutrition in patients with chronic obstructive pulmonary disease. Clin Invest Med. 1998;21(3):135–141.
Ferreira IM, Brooks D, Lacasse Y, et al. Nutritional support for individuals with COPD: a meta-analysis. Chest. 2000;117(3):672–678.
Agusti AG, Sauleda J, Miralles C, et al. Skeletal muscle apoptosis and weight loss in chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2002;166(4):485–489.
Schols AM, Broekhuizen R, Weling-Scheepers CA, et al. Body composition and mortality in chronic obstructive pulmonary disease. Am J Clin Nutr. 2005;82(1):53–59.
Vestbo J, Prescott E, Almdal T, et al. Body mass, fat-free body mass, and prognosis in patients with chronic obstructive pulmonary disease from a random population sample: findings from the Copenhagen City Heart Study. Am J Respir Crit Care Med. 2006;173(1):79–83.
Landbo C, Prescott E, Lange P, et al. Prognostic value of nutritional status in chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 1999;160(6):1856–1861.
Zutler M, Singer JP, Omachi TA, et al. Relationship of obesity with respiratory symptoms and decreased functional capacity in adults without established COPD. Prim Care Respir J. 2012;21(2):194–201.
Leone N, Courbon D, Thomas F, et al. Lung function impairment and metabolic syndrome: the critical role of abdominal obesity. Am J Respir Crit Care Med. 2009;179(6):509–516.
Rabe KF, Hurd S, Anzueto A, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. Am J Respir Crit Care Med. 2007;176(6):532–555.
İnal İnce D, Savcı S, Sağlam M, ve diğerleri. Kronik obstrüktif akciğer hastalarında sigara öyküsü ve fonksiyonel kapasite arasındaki ilişki. Fizyoter Rehabil. 2011;22:39–43.
Pepin V, Saey D, Laviolette L, et al. Exercise capacity in chronic obstructive pulmonary disease: mechanisms of limitation. COPD. 2007;4(3):195–204.
Eisner MD, Blanc PD, Sidney S, et al. Body composition and functional limitation in COPD. Respir Res. 2007;8:7.
Cote CG, Pinto-Plata V, Kasprzyk K, et al. The 6-min walk distance, peak oxygen uptake, and mortality in COPD. Chest. 2007;132(6):1778–1785.
Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ Tech Rep Ser. 2000; 894; i-xii, 1–253.
Quanjer PH, Tammeling GJ, Cotes JE, et al. 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.
Schols AM, Wouters EF, Soeters PB, et al. Body composition by bioelectrical-impedance analysis compared with deuterium dilution and skinfold anthropometry in patients with chronic obstructive pulmonary disease. Am J Clin Nutr. 1991;53(2):421–424.
ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med. 2002;166(1):111–117.
Borg GA. Psychophysical bases of perceived exertion. Med Sci Sports Exerc. 1982;14(5):377–381.
Fox EL, Bowers RW, Foss ML. The Physiological Basis of Physical Education and Athletics.c. Dubuque: Wm C Brown Publishers. 1989:269–313.
Carter R, Holiday DB, Nwasuruba C, et al. 6-minute walk work for assessment of functional capacity in patients with COPD. Chest. 2003;123(5):1408–1415.
ATS/ERS Statement on respiratory muscle testing. Am J Respir Crit Care Med. 2002;166(4):518–624.
Pitta F, Troosters T, Probst VS, et al. Quantifying physical activity in daily life with questionnaires and motion sensors in COPD. Eur Respir J. 2006;27(5):1040–1055.
Green SB, Salkind NJ, Akey TM. Using SPSS for Windows: Analyzing and Understanding Data. bs. 2nd ed, c. New Jersey: Prentice Hall. 2000:70–110.
Magnani KL and Cataneo AJ. Respiratory muscle strength in obese individuals and influence of upper-body fat distribution. Sao Paulo Med J. 2007;125(4):215–219.
Sabino PG, Silva BM and Brunetto AF. Nutritional status is related to fat-free mass, exercise capacity and inspiratory strength in severe chronic obstructive pulmonary disease patients. Clinics (Sao Paulo). 2010;65(6):599–605.
Kelly TM, Jensen RL, Elliott CG, et al. Maximum respiratory pressures in morbidly obese subjects. Respiration. 1988;54(2):73–77.
O’Donnell DE, O’Donnell CD, Webb KA, et al. Respiratory Consequences of Mild-to-Moderate Obesity: Impact on Exercise Performance in Health and in Chronic Obstructive Pulmonary Disease. Pulm Med. 2012; 818925.
Pazzianotto-Forti EM, Peixoto-Souza FS, Piconi-Mendes C, et al. Behavior of respiratory muscle strength in morbidly obese women by using different predictive equations. Rev Bras Fisioter. 2012;16(6):479–486.
Bautista J, Ehsan M, Normandin E, et al. Physiologic responses during the six minute walk test in obese and non-obese COPD patients. Respir Med. 2011;105(8):1189–1194.
Monteiro F, Camillo CA, Vitorasso R, et al. Obesity and physical activity in the daily life of patients with COPD. Lung. 2012;190(4):403–410.
Kyle UG, Gremion G, Genton L, et al. Physical activity and fat-free and fat mass by bioelectrical impedance in 3853 adults. Med Sci Sports Exerc. 2001;33(4):576–584.
Cao C, Wang R, Wang J, et al. Body mass index and mortality in chronic obstructive pulmonary disease: a meta-analysis. PLoS One. 2012; 7(8):e43892.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
Open Access This article is distributed under the terms of the Creative Commons Attribution 2.0 International License ( https://creativecommons.org/licenses/by/2.0 ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
About this article
Cite this article
Sağlam, M., Savcı, S., Vardar Yağlı, N. et al. Relationship between obesity and respiratory muscle strength, functional capacity, and physical activity level in patients with chronic obstructive pulmonary disease. Turk J Physiother Rehabil 24, 1 (2013). https://doi.org/10.7603/s40680-013-0001-6
Received:
Accepted:
Published:
DOI: https://doi.org/10.7603/s40680-013-0001-6