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(Chest. 2006;129:551-557.)
© 2006 American College of Chest Physicians

Relationship of Upper-Limb and Thoracic Muscle Strength to 6-min Walk Distance in COPD Patients*

Victor Zuniga Dourado, PT, MSc; Letícia Cláudia de Oliveira Antunes, PT MSc; Suzana Erico Tanni, MD; Sergio Alberto Rupp de Paiva, MD, PhD; Carlos Roberto Padovani, PhD and Irma Godoy, MD, PhD

* From the Departamento de Fisioterapia (Mr. Dourado and Ms. Antunes), Faculdade Marechal Rondon; São Manuel; Departamento de Clínica Médica (Drs. Tanni, de Paiva, and Godoy), Faculdade de Medicina de Botucatu, Universidade Estadual Paulista, Botucatu; and Departamento de Bioestatísca (Dr. Padovani), Instituto de Biociências, Universidade Estadual Paulista, Botucatu, Brazil.

Correspondence to: Victor Zuniga Dourado, PT, MSc, Rua Antônio Sabino Santa Rosa, 70. Apto. 13-C, Vila Santana, Botucatu, Brazil CEP: 18606-140; e-mail: vzuniga{at}fmr.edu.br

Abstract

Study objectives: This study was developed to investigate the influence of thoracic and upper-limb muscle function on 6-min walk distance (6MWD) in patients with COPD.

Design: A prospective, cross-sectional study.

Setting: The pulmonary rehabilitation center of a university hospital.

Patients: Thirty-eight patients with mild to very severe COPD were evaluated.

Measurements and results: Pulmonary function and baseline dyspnea index (BDI) were assessed, handgrip strength, maximal inspiratory pressure (PImax), and 6MWD were measured, and the one-repetition maximum (1RM) was determined for each of four exercises (bench press, lat pull down, leg extension, and leg press) performed on gymnasium equipment. Quality of life was assessed using the St. George Respiratory Questionnaire (SGRQ). We found statistically significant positive correlations between 6MWD and body weight (r = 0.32; p < 0.05), BDI (r = 0.50; p < 0.01), FEV1 (r = 0.33; p < 0.05), PImax (r = 0.53; p < 0.01), and all values of 1RM. A statistically significant negative correlation was observed between 6MWD and dyspnea at the end of the 6-min walk test (r = – 0.29; p < 0.05), as well as between 6MWD and the SGRQ activity domain (r = – 0.45; p < 0.01) and impact domain (r = – 0.34; p < 0.05) and total score (r = – 0.40; p < 0.01). Multiple regression analysis selected body weight, BDI, PImax, and lat pull down 1RM as predictive factors for 6MWD (R2 = 0.589).

Conclusions: The results of this study showed the importance of the skeletal musculature of the thorax and upper limbs in submaximal exercise tolerance and could open new perspectives for training programs designed to improve functional activity in COPD patients.

Key Words: 6-min walk distance • COPD • one-repetition maximum • thoracic muscles • upper-limb muscles






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Copyright © 2006 by the American College of Chest Physicians.