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Prevalence of quadriceps muscle weakness in patients with COPD and its association with disease severity

Authors Kharbanda S, Ramakrishna A, Krishnan S

Received 3 May 2015

Accepted for publication 6 July 2015

Published 1 September 2015 Volume 2015:10(1) Pages 1727—1735


Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Professor Hsiao-Chi Chuang

Peer reviewer comments 2

Editor who approved publication: Dr Richard Russell

Sidharth Kharbanda,1 Anand Ramakrishna,2 Shyam Krishnan3

1Kasturba Medical College, Manipal University, 2Department of Respiratory Medicine, 3Department of Physiotherapy, Kasturba Medical College Hospital, Mangaluru, Karnataka, India

Introduction: COPD presents with an array of extra-pulmonary symptoms of which skeletal muscle dysfunction, particularly of the quadriceps, is well recognized. This contributes to impaired quality of life and increased health care utilization. Work on the quadriceps originated from the observation that a good proportion of COPD patients stop exercise due to the feeling of leg fatigue rather than breathlessness. This study was carried out with the aim of finding the prevalence of quadriceps weakness in a population set and correlate it with severity of COPD.
Methodology: This cross-sectional study was conducted in 75 subjects suffering from COPD aged 45 years or above. COPD severity in the subjects was graded based on the GOLD staging system. A digital hand held dynamometer (HHD) was used to measure quadriceps muscle strength. Descriptive statistics were done, and Pearson’s Correlation Coefficient and ANOVA analysis was used for expressing the results.
Results: Ninety two percent of subjects were suffering from quadriceps muscle weakness. Quadriceps weakness was present in significantly high proportions even in those suffering from mild disease and belonging to a younger age group. The mean quadriceps muscle force value decreased with disease severity and this relation was found to be significant (P<0.01).
Conclusion: Majority of the COPD patients were found to be suffering from quadriceps weakness, which was also present in significant proportions in subjects belonging to younger age groups and suffering from mild disease. These findings indicate that onset of muscle weakness in COPD may precede the onset of symptoms. These findings suggest need for early remedial measure to prevent occurrence of associated systemic diseases.

Keywords: COPD, GOLD staging, Quadriceps muscle strength, hand-held dynamometer, skeletal muscle dysfunction, spirometry, FEV1, FVC

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