Abstract
Background: The impact of exacerbations of chronic obstructive pulmonary disease (COPD) upon skeletal muscle dysfunction is unclear.
Aims: We sought to examine the effects of a COPD exacerbation upon quadriceps maximal voluntary contraction (QMVC) and the 6 minute walk distance (6MWD).
Methods: In subjects with COPD as part of the COPDMAP consortium spirometry, COPD assessment test (CAT) score, C reactive protein (CRP), QMVC and 6MWD were recorded at a stable visit, an exacerbation requiring oral corticosteroids and/or antibiotics (excluding 6MWD), and at two weeks post exacerbation.
Results: At exacerbation compared to stable state (n=72) there was a significant increase in the mean (SEM) CAT (20.2[0.8] vs. 25.1[0.7]; p<0.01) and the median (IQR) CRP (3[3-8] vs. 10[3-22]mg/L; p<0.01), and a reduction in the mean (SEM) FEV1% (54[2] vs. 48[2]%; p<0.01) and QMVC (27.7 [1.4] vs. 25.8[1.3]kg; p=0.02, n=52). There was no significant difference in FEV1%, CAT, QMVC or 6MWD between stable state and 2 week post exacerbation visits(n=54).
Conclusions: COPD exacerbations are associated with impaired muscle strength. Two weeks post exacerbation QMVC and 6MWD are not significantly different to stable state, suggesting that skeletal muscle dysfunction does not persist following a moderate, community managed COPD exacerbation.
- © 2014 ERS
