COMPARISON OF THE EFFECTS OF QUADRICEPS AND GASTROCNEMIUS MUSCLE TRAINING ON ACTIVITIES OF DAILY LIVING IN COPD

Year 2024, , 502 - 509, 21.10.2024

Ahmet Payas , Hüseyin Çelik , Ayla Çağlayan Türk , Mübeccel Nur Karaduman , Deniz Ozkan Vardar , Sertaç Arslan

https://doi.org/10.18229/kocatepetip.1393254

Abstract

OBJECTIVE: Chronic Obstructive Pulmonary Disease (COPD) has symptoms such as impaired exercise tolerance and decreased quality of life. In this study, the effects on exercise performance and quality of life in COPD patients were compared when the quadriceps femoris (QF) and gastrocnemius (GC) muscles were strengthened by neuromuscular electrical stimulation (NMES) in stable COPD patients.
MATERIAL AND METHODS: Forty-five patients with COPD were randomly divided into three groups as control, gastrocnemius muscle (GC Group) and quadriceps femoris muscle (QF Group). The control group received pulmonary rehabilitation only, the GC group received NMES to the GC muscle in addition to pulmonary rehabilitation, and the QF group received NMES to the QF muscle in addition to pulmonary rehabilitation. Patients were evaluated with Visual Analog Scale (VAS), Six Minute Walk Test, St. George's Respiratory Questionnaire (SGRQ), Short Form-36 (SF-36) and Beck Depression Inventory before and after treatment. Statistical analysis was performed in IBM SPSS 23.0 program and p<0.05 was considered significant.
RESULTS: While there was no difference in VAS, physical function, Beck Depression, six-minute walk and fatigue test data before and after treatment in the control group (p>0.05), a statistically significant difference was found in the GC and QF groups (p<0.05). There was no significant difference between the groups in the pre and posttreatment values of all tests (p>0.05).
CONCLUSIONS: Strengthening the QF or GC muscles seems to improve exercise performance and quality of life in patients with COPD. However, QF and GC muscle training in COPD were not superior to each other in terms of their effect on quality of life.

Keywords

Pulmonary Disease, Transcutaneous Electric Nerve Stimulation, Quadriceps Muscle, Gastrocnemius Muscle, Exercise.

Project Number

SMYO19002.16.0.

KOAH'TA QUADRİCEPS FEMORİS VE GASTROCNEMİUS KAS EĞİTİMİNİN GÜNLÜK YAŞAM AKTİVİTELERİNE ETKİSİNİN KARŞILAŞTIRILMASI

Abstract

AMAÇ: Kronik Obstrüktif Akciğer Hastalığı (KOAH), egzersiz toleransında bozulma ve yaşam kalitesinde azalma gibi semptomlara sahiptir. Bu çalışmada stabil KOAH hastalarında quadriseps femoris (QF) ve gastrocnemius (GC) kasları nöromüsküler elektriksel stimülasyon (NMES) ile güçlendirildiğinde KOAH hastalarında egzersiz performansı ve yaşam kalitesi üzerine etkileri karşılaştırıldı.
GEREÇ VE YÖNTEM: KOAH'lı 45 hasta kontrol, gastrocnemius kas (GC Grubu) ve quadriseps femoris kas (QF Grubu) olmak üzere rastgele üç gruba ayrıldı. Kontrol grubuna sadece pulmoner rehabilitasyon, GC grubuna pulmoner rehabilitasyona ek olarak GC kasına NMES ve QF grubuna pulmoner rehabilitasyona ek olarak QF kasına NMES uygulandı. Hastalar tedavi öncesi ve sonrasında Görsel Analog Skala (VAS), Altı Dakika Yürüme Testi, St. George's Respiratory Questionnaire anketi (SGRQ), Kısa Form-36 (SF-36) ve Beck Depresyon Envanteri ile değerlendirilmiştir. İstatistiksel analiz IBM SPSS 23.0 programında yapıldı ve p<0.05 anlamlı kabul edildi.
BULGULAR: VAS, fiziksel fonksiyon, Beck Depresyon, altı dakika yürüme ve yorgunluk test verilerinde tedavi öncesi ve sonrası arasında kontrol grubunda fark bulunmazken (p>0,05), GC ve QF gruplarında ise istatistiksel olarak anlamlı fark tespit edildi (p<0,05). Tüm testlerin tedavi öncesi ve sonrası değerlerinde gruplar arasında anlamlı fark yoktu (p>0,05).
SONUÇ: KOAH'lı hastalarda QF veya GC kaslarının güçlendirilmesinin egzersiz performansını ve yaşam kalitesine katkı sağladığı görünmektedir. Ancak KOAH’ta QF ve GC kas eğitiminin yaşam kalitesine etkisi bakımında birbirine üstünlüğü yoktu.

Keywords

Pulmoner Hastalık, Transkütanöz Elektriksel Sinir Stimulasyonu, Kuadriseps Kası, Gastroknemius Kası, Egzersiz.

Ethical Statement

Hiti Üniversitesi Tıp Fakültesi Klinik Araştırmalar Etik Kurulu

Supporting Institution

Bu çalışma Hitit Üniversitesi Bilimsel Araştırma Projeleri Birimi tarafından SMYO19002.16.0 proje koduyla desteklenmiştir.

Project Number

SMYO19002.16.0.

Thanks

Hitit Üniversitesi Bilimsel Araştırma Projeleri Birimine çalışmaya vermiş oldukları destekler için teşekkür ederiz.

References

• 1. Sun L, Chen Y, Wu R, Lu M, Yao W. Changes in definition lead to changes in the clinical characteristics across COPD categories according to GOLD 2017: a national cross-sectional survey in China. Int J Chron Obstruct Pulmon Dis. 2017;12:3095-3102.
• 2. Seymour JM, Spruit MA, Hopkinson NS, et al. The prevalence of quadriceps weakness in COPD and the relationship with disease severity. Eur Respir J. 2010;36(1):81-8.
• 3. Swallow EB, Reyes D, Hopkinson NS, et al. Quadriceps strength predicts mortality in patients with moderate to severe chronic obstructive pulmonary disease. Thorax. 2007;62(2):115-20.
• 4. Pepin V, Saey D, Laviolette L, Maltais F. Exercise capacity in chronic obstructive pulmonary disease: mechanisms of limitation. COPD. 2007;4(3):195-204.
• 5. Gosker HR, Zeegers MP, Wouters EF, Schols AM. Muscle fibre type shifting in the vastus lateralis of patients with COPD is associated with disease severity: a systematic review and meta-analysis. Thorax. 2007;62(11):944-49.
• 6. Gosselink R, Troosters T, Decramer M. Distribution of muscle weakness in patients with stable chronic obstructive pulmonary disease. J Cardiopulm Rehabil. 2000;20(6):353-60.
• 7. Levine D, Richards J, Whittle MW (Edited by). Whittle's gait analysis. 5th Edition, China: Elsevier. 2012;1-125.
• 8. Zajac FE, Neptune RR, Kautz SA. Biomechanics and muscle coordination of human walking. Part I: introduction to concepts, power transfer, dynamics and simulations. Gait Posture. 2002;16(3):215-32.
• 9. Mesfar W, Shirazi-Adl A. Biomechanics of the knee joint in flexion under various quadriceps forces. Knee. 2005;12(6):424-34.
• 10. Davison EA, Anderson CT, Ponist BH, et al. Inhibitory effect of the Kinesio taping method on the gastrocnemius muscle. American Journal of Sports Science and Medicine. 2016;4(2):33-8.
• 11. Nussbaum EL, Houghton P, Anthony J, et al. Neuromuscular Electrical Stimulation for Treatment of Muscle Impairment: Critical Review and Recommendations for Clinical Practice. Physiother Can. 2017;69(5):1-76.
• 12. Vivodtzev I, Pépin JL, Vottero G, et al. Improvement in quadriceps strength and dyspnea in daily tasks after 1 month of electrical stimulation in severely deconditioned and malnourished COPD. Chest. 2006;129(6):1540- 1548.
• 13. Fabbri LM, Hurd SS; GOLD Scientific Committee. Global Strategy for the Diagnosis, Management and Prevention of COPD: 2003 update. Eur Respir J. 2003;22(1):1-2.
• 14. Delgado DA, Lambert BS, Boutris N, et al. Validation of Digital Visual Analog Scale Pain Scoring With a Traditional Paper-based Visual Analog Scale in Adults. J Am Acad Orthop Surg Glob Res Rev. 2018;2(3):e088.
• 15. Johnson EW. Visual analog scale (VAS). American Journal of Physical Medicine & Rehabilitation. 2001;80(10):717.
• 16. McGavin CR, Gupta SP, McHardy GJ. Twelve-minute walking test for assessing disability in chronic bronchitis. Br Med J. 1976; 1(6013):822-3.
• 17. Paneroni M, Simonelli C, Vitacca M, Ambrosino N. Aerobic Exercise Training in Very Severe Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis. Am J Phys Med Rehabil. 2017;96(8):541-48.
• 18. Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Arch Gen Psychiatry. 1961;4:561-571.
• 19. Ozalevli S, Karaali H, Cankurtaran F, Kilinc O, Akkoclu A. Comparison of Short Form-36 Health Survey and Nottingham Health Profile in moderate to severe patients with COPD. J Eval Clin Pract. 2008;14(4):493-99.
• 20. Nici L, Donner C, Wouters E, et al. American Thoracic Society/European Respiratory Society statement on pulmonary rehabilitation. Am J Respir Crit Care Med. 2006;173(12):1390-1413.
• 21. Selkowitz DM. Improvement in isometric strength of the quadriceps femoris muscle after training with electrical stimulation. Phys Ther. 1985;65(2):186-96.
• 22. Jones S, Man WD, Gao W, Higginson IJ, Wilcock A, Maddocks M. Neuromuscular electrical stimulation for muscle weakness in adults with advanced disease. Cochrane Database Syst Rev. 2016;10(10):CD009419.
• 23. Nelson MR, Currier DP (Edited by). Neuromuscular stimulation for ımproving muscular strength and blood flow and ınfluencing changes. Clinical Electrotherapy 2nd Edition, California, Appletone and Lange. 1991;171:199.
• 24. Kamiya K, Mezzani A, Hotta K, et al. Quadriceps isometric strength as a predictor of exercise capacity in coronary artery disease patients. Eur J Prev Cardiol. 2014;21(10):1285-91.
• 25. Hurley MV, Scott DL, Rees J, Newham DJ. Sensorimotor changes and functional performance in patients with knee osteoarthritis. Ann Rheum Dis. 1997;56(11):641-48.
• 26. Antonios T, Adds PJ. The medial and lateral bellies of gastrocnemius: a cadaveric and ultrasound investigation. Clin Anat. 2008;21(1):66-74.
• 27. Lamontagne A, Malouin F, Richards CL. Locomotor-specific measure of spasticity of plantarflexor muscles after stroke. Arch Phys Med Rehabil. 2001;82(12):1696-1704.
• 28. Lichtwark GA, Wilson AM. Interactions between the human gastrocnemius muscle and the Achilles tendon during incline, level and decline locomotion. J Exp Biol. 2006;209(Pt 21):4379-88.
• 29. Cleather DJ, Southgate DF, Bull AM. The role of the biarticular hamstrings and gastrocnemius muscles in closed chain lower limb extension. J Theor Biol. 2015;365:217-25.
• 30. Bourjeily-Habr G, Rochester CL, Palermo F, Snyder P, Mohsenin V. Randomised controlled trial of transcutaneous electrical muscle stimulation of the lower extremities in patients with chronic obstructive pulmonary disease. Thorax. 2002;57(12):1045-49.
• 31. Neder JA, Sword D, Ward SA, Mackay E, Cochrane LM, Clark CJ. Home based neuromuscular electrical stimulation as a new rehabilitative strategy for severely disabled patients with chronic obstructive pulmonary disease (COPD). Thorax. 2002;57(4):333-37.
• 32. Maddocks M, Nolan CM, Man WD, et al. Neuromuscular electrical stimulation to improve exercise capacity in patients with severe COPD: a randomised double-blind, placebo-controlled trial. Lancet Respir Med. 2016;4(1):27-36.
• 33. Vieira PJ, Chiappa AM, Cipriano G Jr, Umpierre D, Arena R, Chiappa GR. Neuromuscular electrical stimulation improves clinical and physiological function in COPD patients. Respir Med. 2014;108(4):609-20.