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Quadriceps and Respiratory Muscle Fatigue Following High-Intensity Cycling in COPD Patients

Exercise intolerance in COPD seems to combine abnormal ventilatory mechanics, impaired O(2) transport and skeletal muscle dysfunction. However their relatie contribution and their influence on symptoms reported by patients remain to be clarified. In order to clarify the complex interaction between v...

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Autores principales: Bachasson, Damien, Wuyam, Bernard, Pepin, Jean-Louis, Tamisier, Renaud, Levy, Patrick, Verges, Samuel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3855800/
https://www.ncbi.nlm.nih.gov/pubmed/24324843
http://dx.doi.org/10.1371/journal.pone.0083432
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author Bachasson, Damien
Wuyam, Bernard
Pepin, Jean-Louis
Tamisier, Renaud
Levy, Patrick
Verges, Samuel
author_facet Bachasson, Damien
Wuyam, Bernard
Pepin, Jean-Louis
Tamisier, Renaud
Levy, Patrick
Verges, Samuel
author_sort Bachasson, Damien
collection PubMed
description Exercise intolerance in COPD seems to combine abnormal ventilatory mechanics, impaired O(2) transport and skeletal muscle dysfunction. However their relatie contribution and their influence on symptoms reported by patients remain to be clarified. In order to clarify the complex interaction between ventilatory and neuromuscular exercise limiting factors and symptoms, we evaluated respiratory muscles and quadriceps contractile fatigue, dynamic hyperinflation and symptoms induced by exhaustive high-intensity cycling in COPD patients. Fifteen gold II-III COPD patients (age = 67±6 yr; BMI = 26.6±4.2 kg.m(-2)) performed constant-load cycling test at 80% of their peak workload until exhaustion (9.3±2.4 min). Before exercise and at exhaustion, potentiated twitch quadriceps strength (Q(tw)), transdiaphragmatic (P(di,tw)) and gastric (P(ga,tw)) pressures were evoked by femoral nerve, cervical and thoracic magnetic stimulation, respectively. Changes in operational lung volumes during exercise were assessed via repetitive inspiratory capacity (IC) measurements. Dyspnoea and leg discomfort were measured on visual analog scale. At exhaustion, Q(tw) (-33±15%, >15% reduction observed in all patients but two) and P(di,tw) (-20±15%, >15% reduction in 6 patients) were significantly reduced (P<0.05) but not P(ga,tw) (-6±10%, >15% reduction in 3 patients). Percentage reduction in Q(tw) correlated with the percentage reduction in P(di,tw) (r=0.66; P<0.05). Percentage reductions in P(di,tw) and P(ga,tw) negatively correlated with the reduction in IC at exhaustion (r=-0.56 and r=-0.62, respectively; P<0.05). Neither dyspnea nor leg discomfort correlated with the amount of muscle fatigue. In conclusion, high-intensity exercise induces quadriceps, diaphragm and less frequently abdominal contractile fatigue in this group of COPD patients. In addition, the rise in end-expiratory lung volume and diaphragm flattening associated with dynamic hyperinflation in COPD might limit the development of abdominal and diaphragm muscle fatigue. This study underlines that both respiratory and quadriceps fatigue should be considered to understand the complex interplay of factors leading to exercise intolerance in COPD patients.
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spelling pubmed-38558002013-12-09 Quadriceps and Respiratory Muscle Fatigue Following High-Intensity Cycling in COPD Patients Bachasson, Damien Wuyam, Bernard Pepin, Jean-Louis Tamisier, Renaud Levy, Patrick Verges, Samuel PLoS One Research Article Exercise intolerance in COPD seems to combine abnormal ventilatory mechanics, impaired O(2) transport and skeletal muscle dysfunction. However their relatie contribution and their influence on symptoms reported by patients remain to be clarified. In order to clarify the complex interaction between ventilatory and neuromuscular exercise limiting factors and symptoms, we evaluated respiratory muscles and quadriceps contractile fatigue, dynamic hyperinflation and symptoms induced by exhaustive high-intensity cycling in COPD patients. Fifteen gold II-III COPD patients (age = 67±6 yr; BMI = 26.6±4.2 kg.m(-2)) performed constant-load cycling test at 80% of their peak workload until exhaustion (9.3±2.4 min). Before exercise and at exhaustion, potentiated twitch quadriceps strength (Q(tw)), transdiaphragmatic (P(di,tw)) and gastric (P(ga,tw)) pressures were evoked by femoral nerve, cervical and thoracic magnetic stimulation, respectively. Changes in operational lung volumes during exercise were assessed via repetitive inspiratory capacity (IC) measurements. Dyspnoea and leg discomfort were measured on visual analog scale. At exhaustion, Q(tw) (-33±15%, >15% reduction observed in all patients but two) and P(di,tw) (-20±15%, >15% reduction in 6 patients) were significantly reduced (P<0.05) but not P(ga,tw) (-6±10%, >15% reduction in 3 patients). Percentage reduction in Q(tw) correlated with the percentage reduction in P(di,tw) (r=0.66; P<0.05). Percentage reductions in P(di,tw) and P(ga,tw) negatively correlated with the reduction in IC at exhaustion (r=-0.56 and r=-0.62, respectively; P<0.05). Neither dyspnea nor leg discomfort correlated with the amount of muscle fatigue. In conclusion, high-intensity exercise induces quadriceps, diaphragm and less frequently abdominal contractile fatigue in this group of COPD patients. In addition, the rise in end-expiratory lung volume and diaphragm flattening associated with dynamic hyperinflation in COPD might limit the development of abdominal and diaphragm muscle fatigue. This study underlines that both respiratory and quadriceps fatigue should be considered to understand the complex interplay of factors leading to exercise intolerance in COPD patients. Public Library of Science 2013-12-06 /pmc/articles/PMC3855800/ /pubmed/24324843 http://dx.doi.org/10.1371/journal.pone.0083432 Text en © 2013 Bachasson et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Bachasson, Damien
Wuyam, Bernard
Pepin, Jean-Louis
Tamisier, Renaud
Levy, Patrick
Verges, Samuel
Quadriceps and Respiratory Muscle Fatigue Following High-Intensity Cycling in COPD Patients
title Quadriceps and Respiratory Muscle Fatigue Following High-Intensity Cycling in COPD Patients
title_full Quadriceps and Respiratory Muscle Fatigue Following High-Intensity Cycling in COPD Patients
title_fullStr Quadriceps and Respiratory Muscle Fatigue Following High-Intensity Cycling in COPD Patients
title_full_unstemmed Quadriceps and Respiratory Muscle Fatigue Following High-Intensity Cycling in COPD Patients
title_short Quadriceps and Respiratory Muscle Fatigue Following High-Intensity Cycling in COPD Patients
title_sort quadriceps and respiratory muscle fatigue following high-intensity cycling in copd patients
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3855800/
https://www.ncbi.nlm.nih.gov/pubmed/24324843
http://dx.doi.org/10.1371/journal.pone.0083432
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