Peripheral Muscle Strength and Pulmonary Function Negatively Impact Functional Capacity in Patients With Post-Tuberculosis Lung Disease: A Cross-Sectional Study.
Aline Mendes Leal Rodrigues de Souza, Davi Luiz Olimpio da Silva, Matheus Mello da Silva, Laura Lima da Silva, Ursula Damiana Pereira Vasques da Silva, Alessandro Dos Santos Beserra, Yasmin Oliveira de Freitas, Isabelle da Nobrega Ferreira, Agnaldo José Lopes
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引用次数: 0
Abstract
Background and purpose: Tuberculosis primarily affects the lungs, and many patients experience sequelae, including loss of lung function and a decline in health-related quality of life (HRQoL), despite bacteriological cure. Although post-tuberculosis lung disease (PTLD) is a growing concern worldwide due to poor physical functioning, little is known about peripheral muscle dysfunction. Therefore, the objective of this study was to evaluate patient performance during the Glittre Activities of Daily Living Test (TGlittre) and assess its association with muscle function, lung function, and HRQoL.
Methods: This cross-sectional study included 47 patients with PTLD who underwent the TGlittre. We also assessed patients for respiratory muscle strength, handgrip strength (HGS), quadriceps muscle strength (QMS), and HRQoL using the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36).
Results: HGS and QMS were reduced in 34% and 25.5% of participants, respectively. Spirometry showed an obstructive pattern, a restrictive pattern, and a normal pattern in 46.8%, 31.9% and 21.3% of participants, respectively, while 42.6% of them had reduced diffusion capacity of lung for carbon monoxide (DLCO). The median TGlittre time was 4.43 (3.48-4.96) minutes, about 15% longer than the expected time to complete it. There was a significant correlation between TGlittre time and DLCO (rs = -0.532, p < 0.0002), maximum inspiratory pressure (rs = -0.407, p = 0.005), maximum expiratory pressure (rs = -0.382, p = 0.008), HGS (rs = -0.327, p = 0.024), QMS (rs = -0.314, p = 0.031), and various SF-36 domains. In the regression analysis, DLCO, QMS, and HGS explained 39% of the variability in TGlittre time.
Discussion: PTLD significantly impacts functional capacity, as determined by TGlittre. These patients have muscle dysfunction, deteriorated HRQoL, and impaired lung function. Impaired lung diffusion and reduced peripheral muscle strength (PMS) are independently associated with lower functional capacity. Therefore, rehabilitative strategies are crucial for improving care for this group of patients. This is the first study using the TGlittre to explore PMS in PTLD.
Trial registration: The protocol was registered on ClinicalTrials.gov with the identifier NCT06127641.
期刊介绍：
Physiotherapy Research International is an international peer reviewed journal dedicated to the exchange of knowledge that is directly relevant to specialist areas of physiotherapy theory, practice, and research. Our aim is to promote a high level of scholarship and build on the current evidence base to inform the advancement of the physiotherapy profession. We publish original research on a wide range of topics e.g. Primary research testing new physiotherapy treatments; methodological research; measurement and outcome research and qualitative research of interest to researchers, clinicians and educators. Further, we aim to publish high quality papers that represent the range of cultures and settings where physiotherapy services are delivered. We attract a wide readership from physiotherapists and others working in diverse clinical and academic settings. We aim to promote an international debate amongst the profession about current best evidence based practice. Papers are directed primarily towards the physiotherapy profession, but can be relevant to a wide range of professional groups. The growth of interdisciplinary research is also key to our aims and scope, and we encourage relevant submissions from other professional groups. The journal actively encourages submissions which utilise a breadth of different methodologies and research designs to facilitate addressing key questions related to the physiotherapy practice. PRI seeks to encourage good quality topical debates on a range of relevant issues and promote critical reflection on decision making and implementation of physiotherapy interventions.
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