Kronik obstrüktif akciğer hastalarında obezitenin solunum kas kuvveti, fonksiyonel kapasite ve fiziksel aktivite düzeyi ile ilişkisi
Amaç: Vücut kitle indeksinin (VKİ) fazla olması kronik obstrüktif akciğer hastalarında (KOAH) yaşam süresi için avantajlıdır. Çalışmanın amacı, KOAH’ta obezitenin solunum kas kuvveti, egzersiz kapasitesi ve fiziksel aktivite üzerine etkisini araştırmaktı. Gereç ve Yöntem: Yirmi sekiz KOAH’lı erkek hasta (Yaş: 63.07±6.32 yıl, FEV1: % 36.9±11.0) çalışmaya alındı. Olgular aşırı kilolu/obes (25≤VKİ≤34.9 kg/m2, n=14) ve normal (18.5≤VKİ≤24.9 kg/m2, n=14) olarak iki gruba ayrıldı. Solunum fonksiyon testi ve altı dakika yürüme testi yapıldı. Solunum kas kuvveti taşınabilir ağız basıncı ölçüm cihazı ve fiziksel aktivite düzeyi akselerometre ile değerlendirildi. Sonuçlar: İki grubun havayolu obstrüksiyon düzeyi benzerdi (p>0.05). Aşırı kilolu/obes KOAH’lı hastaların inspiratuar kas kuvveti (94.57±18.72 cmHO), ekspiratuar kas kuvveti (155.07±42.86 cmH2O) ve fiziksel aktivite düzeyleri (319.3 kcal/gün), VKİ normal olan olguların değerlerinden (inspiratuar kas kuvveti: 79.64±26.14 cmH2O, ekspiratuar kas kuvveti: 124.36±23.70 cmH2O ve fiziksel aktivite düzeyi: 275.9 kcal/gün) anlamlı olarak daha yüksekti (p<0.05). İki grubun altı dakika yürüme testi mesafesi arasında anlamlı bir fark saptanmamakla birlikte, test sırasında yapılan iş istatistiksel olarak aşırı kilolu/obes grupta (3037.0±8662.91 kg/m ve 4240.3±10372.59 kg/m, p<0.05) daha yüksekti. Tartışma: KOAH’ta aşırı kilolu veya obes olmak solunum kas kuvvetini korumaktadır. Fiziksel aktivite düzeyi ise aşırı kilolu/obes grupta daha iyi olmasına rağmen, her iki grupta da düşüktür. KOAH’lı hastalarda aşırı kilolu veya obes olmanın yarattığı klinik durum, daha iyi prognoz sağlayabilir
Relationship between obesity and respiratory muscle strength, functional capacity, and physical activity level in patients with chronic obstructive pulmonary disease
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 cmHO), 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
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