Respiratory Muscle Performance in Normal Elderly Subjects and Patients with COPD: Results

In: COPD

13 Oct 2014

There was no difference between the normal elderly subjects and COPD patients in age, sex, height or weight (Table 1). The COPD patients had severe airflow limitation and markedly reduced MW (Table 1). The FEVi, FVC and MW were not different in either group from visit 1 to visit 3.
The MIP was less in COPD patients than normal subjects (p<0.05, Fig 2) at each visit while MEP was not different in the two groups at any visit. The MIP increased at visits 2 and 3 (compared with that at visit 1) in normal subjects (polynominal contrasts, p<0.05) but no difference in MIP was observed between visits in COPD patients. Although in Figure 2 it appears that the MIP of COPD patients increased from visit 1 to visit 2, seven of the eight COPD patients changed very little from visit to visit. However, in one COPD patient the MIP increased from 30 cmH20 on the first visit to 64 cm H20 on visit 2. This patients values tended to decrease the mean MIP for visit 1 compared with that at visit 2 but overall there was no statistical difference between visits. For MEP, no definite visit effect was found in either group. This may be due to the consistency of the data for visits 1 to 3 for all subjects in both groups except for one elderly normal subject in whom MEP increased from 66 cmH20 on the first visit to 96 cmH20 on visit 2 and 112 cmH20 on visit 3.

Three measures of RM endurance — max load, Ppk/ MIP and Pmean —are shown in Figure 3. All three measures were less in COPD patients than in normal subjects at each visit (p<0.05). The mean values of max load and Pmean in the COPD group were only 40 percent of those in the normal elderly group. There was no difference between the three visits for any of the measures of endurance in either group (Fig 3). In addition, there was no difference between visits in either group for Vt, Vi or Ti.
The 02 saturation was higher (p<0.05) in the normal elderly group compared with that in COPD patients at the start of the endurance test (97 ± 1 percent vs 94 ±2 percent) and at the termination of the test (95 ± 2 percent vs 92 ± 3 percent).
Table 1—Anthropometric and Spirometric Data on Normal Elderly Subjects and COPD Patients

Normal Elderly Subjects (n = 8) COPD Patients(n = 8)
Age (yr) 67 ±4 67 ±8
Sex (M:F) 5 : 3 6 : 2
Height (cm) 169 ±8 171 ±7
Weight (kg) 71 ±10 78 ±13
FEVj (% pred) 121±10 33± 14t
FVC (% pred) 108 ±9 66±23t
MW (L/min) 121 ±36 46 ± 181*
MW (% pred) 108 ±13 39 ± 16t
RV (% pred) 204 ±22
TLC (% pred) 125 ±6

 

Figure 2. Respiratory muscle strength for normal subjects and COPD patients. Asterisks indicate a lower value of MIP in COPD patients compared with that in normal subjects for each visit (p<0.05).

Figure 2. Respiratory muscle strength for normal subjects and COPD patients. Asterisks indicate a lower value of MIP in COPD patients compared with that in normal subjects for each visit (p<0.05).

Figure 3. Respiratory muscle endurance for normal subjects and COPD patients. The top panel shows max load in grams; the middle panel, Ppk/MIP at max load; and the bottom panel, Pmean at max load in cm H20. The asterisks indicate that all measures of RM endurance were less in the COPD patients than in the normal subjects at each visit (p<0.05).

Figure 3. Respiratory muscle endurance for normal subjects and COPD patients. The top panel shows max load in grams; the middle panel, Ppk/MIP at max load; and the bottom panel, Pmean at max load in cm H20. The asterisks indicate that all measures of RM endurance were less in the COPD patients than in the normal subjects at each visit (p<0.05).


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