A comparative assessment of hand grip exercise and 6-minute walk test in chronic obstructive pulmonary disease patients
DOI:
https://doi.org/10.18203/2320-6012.ijrms20242940Keywords:
COPD, GOLD stages, 6-Minute walk test, Hand grip strength, SpirometryAbstract
Background: Chronic obstructive pulmonary disease (COPD) is a leading disease often under-discussed and underdiagnosed causing persistent and chronic obstruction of upper airways. Patients not only suffer respiratory dysfunctions but also, peripheral muscle dysfunction and atrophy leading to muscle fatigue, reduced muscle strength, and endurance impacting exercise capacity, physical activity levels, and decreased ability to perform daily tasks. The Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines highlight the need to enhance functional status through assessments like Hand Grip Strength and a 6-minute walk test. The study aimed at a comparative assessment of these exercises in COPD patients along with spirometry for diagnosis, and grading and to find out their combined advantages in COPD management.
Methods: This cross-sectional study was conducted on 110 patients at the Department of Physiology, King George’s Medical University, Lucknow, using a questionnaire, and both tests were performed on COPD patients to determine the effectiveness depending on the severity and spirometry results.
Results: The recruited patients were classified as per GOLD stages in 4 categories, as disease severity increased, functional and exercise capacity was reduced. There was a negative correlation between GOLD stages and 6-minute walk strength, maximum grip strength, and mean endurance time of COPD patients with r-values of -5.672, -6.874, and -5.879 respectively.
Conclusion: COPD patients suffer from functional dysfunctions and exercise limitations, early diagnosis is crucial to limit the severity, and functional tests can play a significant role in determining the health outcomes and improving the quality of life.
References
Borel B, Provencher S, Saey D, Maltais, F. Responsiveness of various exercise-testing protocols to therapeutic interventions in COPD. Plum Med. 2013;2:4107-48.
Sun KS, Lin MS, Chen YJ, Chen YY, Chen SCC, Chen W. Is asymptomatic peripheral arterial disease associated with walking endurance in patients with COPD? Int J Chron Obstruct Pulmon Dis. 2015;10:1487-92.
Pepin V, Saey D, Laviolette L, Maltais F. Exercise capacity in chronic obstructive pulmonary disease: mechanisms of limitation. COPD. 2007;4(3):195-204.
Holland AE, Spruit MA, Troosters T, Puhan MA, Pepin V, Saey D, et al. An official European Respiratory Society/ American Thoracic Society technical standard: field walking tests in chronic respiratory disease. Eur Respir J. 2014;44(6):1428-46.
Vilaró J, Ramirez SA, Martínez LJM. Global muscle dysfunction as a risk factor of readmission to hospital due to COPD exacerbations. Respir Med. 2010;104(12):1896-902.
Cortopassi F, Divo M, Pinto-Plata V, Celli B. Resting handgrip force and impaired cardiac function at rest and during exercise in COPD patients. Respir Med. 2011;105(5):748-54.
Puhan MA, Siebeling L, Zoller M, Muggensturm P, Ter Riet G. Simple functional performance tests and mortality in COPD. Eur Respir J. 2013;42(4):956-63.
Kohlbrenner D, Noriane A, Roeder M, Thurnheer R, Leuppi JD, Irani S, et al. Handgrip strength seems not to be affected by copd disease progression: a longitudinal Cohort Study, COPD: J Chr Obst Pulm Dis. 2020;2:150-5.
Guyatt GH, Sullivan MJ, Thompson PJ, Fallen EL, Pugsley SO, Taylor DW, et al. The 6-minute walk: A new measure of exercise capacity in patients with chronic heart failure. Can Med Assoc J. 1985;132:919-23.
Pinto-Plata VM, Cote C, Cabral H, Taylor J, Celli BR. The 6-min walk distance: change over time and value as a predictor of survival in severe COPD. Eur Respir J. 2004;23(1):28-33.
Shah S, Nahar P, Vaidya S, Salvi S. Upper limb muscle strength and endurance in chronic obstructive pulmonary disease. Indian J Med Res. 2013;138(4):492-6.
Clark CJ, Cochrane LM, Mackay E, Paton B. Skeletal muscle strength and endurance in patients with mild COPD and the effects of weight training. Eur Respir J. 2000;15(1):92-7.
Franssen FM, Broekhuizen R, Janssen PP, Wouters EF, Schols AM. Limb muscle dysfunction in COPD: effects of muscle wasting and exercise training. Med Sci Sports Exerc. 2005;37(1):2–9.
Korkmaz C, Demirbas S, Vatansev H, Yildirim E, Teke T, Zamani A. Effects of comprehensive and intensive pulmonary rehabilitation and nutritional support on quality of life and functional status in patients with chronic obstructive pulmonary disease. J Int Med Res. 2020;48(4):30-5.
Kyomoto Y, Asai K, Yamada K, Okamoto A, Watanabe T, Hirata K, Kawaguchi T. Handgrip strength measurement in patients with chronic obstructive pulmonary disease: Possible predictor of exercise capacity. Respir Investig. 2019;57(5):499-505.
Lau CW, Leung SY, Wah SH, Yip CW, Wong WY, Chan KS. Effect on muscle strength after blood flow restriction resistance exercise in early in-patient rehabilitation of post-chronic obstructive pulmonary disease acute exacerbation, a single blinded, randomized controlled study. Chron Respir Dis. 2023;20:147-95.
Ozalevli S, Ozden A, Itil O, Akkoclu A. Comparison of the sit-to-stand test with 6 min walk test in patients with chronic obstructive pulmonary disease. Respir Med. 2007;101:286-93.
GOLD-Global initiative for chronic obstructive lung disease. Global strategy for the diagnoses, management, and prevention of chronic obstructive pulmonary disease. Available at: https://goldcopd.
Pires SR, Oliveira AC, Parreira VF, Britto RR. Teste de caminhada de seis minutos em diferentes faixas etárias e índices de massa corporal. Rev Bras Fisioter. 2007;11(2):147-51.
Rausch-Osthoff AK, Kohler M, Sievi NA, Clarenbach CF, van Gestel AJ. Association between peripheral muscle strength, exercise performance, and physical activity in daily life in patients with chronic obstructive pulmonary disease. Multidiscip Respir Med. 2014;9(1):37.
Kim HC, Mofarrahi M, Hussain SN. Skeletal muscle dysfunction in patients with chronic obstructive pulmonary disease. International Journal of COPD. 2008;3:637-58.
Shi Y, Zheng D, Zhang L. Six-minute walk test predicts all-cause mortality and technique failure in ambulatory peritoneal dialysis patients. Nephrol. 2017;22:118-24.
Hamilton AL, Killian KJ, Summers E, Jones NL. Muscle strength, symptom intensity, and exercise capacity in patients with cardiorespiratory disorders. Am J Respir Crit Care Med. 1995;152:2021-31.
Zattara-Hartmann MC, Badier M, Guillot C, Tomei C, Jammes Y. Maximal force and endurance to fatigue of respiratory and skeletal muscles in chronic hypoxemic patients: the effects of oxygen breathing. Muscle Nerve. 1995;18:495-502.
Bernard S, LeBlanc P, Whittom F, Carrier G, Jobin J, Belleau R, Maltais F. Peripheral muscle weakness in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med 1998;158:629-32.
Rantanen T, Volpato S, Ferrucci L, Heikkinen E, Fried LP, Guralnik JM. Handgrip strength and cause-specific and total mortality in older disabled women: exploring the mechanism. J Am Geriatr Soc. 2003;51:636-41.
Ling CH, Taekema D, de Craen AJ, Gussekloo J, Westendorp RG, Maier AB. Handgrip strength and mortality in the oldest old population: the Leiden 85-plus study. CMAJ. 2010;182:429-35.
Gosselink R, Troosters T, Decramer M. Peripheral muscle weakness contributes to exercise limitation in COPD. Am J Respir Crit Care Med. 1996;153:976-80.
Faludi R, Hajdu M, Vértes V. Diastolic dysfunction is a contributing factor to exercise intolerance in COPD. COPD. 2016;13:345-51.
Martinez CH, Diaz AA, Meldrum CA, McDonald MLN, Murray S, et al. Handgrip strength in chronic obstructive pulmonary disease associations with acute exacerbations and body composition. Annals of the ATS. 2017;14:1638-45.
Dubé B-P, Guerder A, Morelot-Panzini C, Laveneziana P. The clinical relevance of the emphysema-hyperinflated phenotype in COPD. COPD Res Pract. 2015;2:1–11.
Martin FG, Nebuloni CC, Najas MS. Correlação entre estado nutricional e força de preensão palmar em idosos. Rev Bras Geriatr Gerontol. 2012;15(3):493-504.
Mirza S, Clay RD, Koslow MA, Scanlon PD. COPD guidelines: A review of the 2018 GOLD report. Mayo Clin Proc. 2018;93:1488-502.
World Health Organization. The top 10 causes of death. 2018. Available at: https://www.who.int/new. Accessed on 25th March 2019.
Waschki B, Kirsten A, Holz O, Muller KC, Meyer T, Watz H, et al. Physical activity is the strongest predictor of all-cause mortality in patients with COPD: A prospective cohort study. Chest. 2011;140:331-42.
Agrawal MB, Awad NT. Correlation between six-minute walk test and spirometry in chronic pulmonary disease. J Clin Diagn Res. 2015;9:1-4.
Charususin N, Dacha S, Gossenlink R, Decramer M, Von Leupoldt A, Reijnders T, et al. Respiratory muscle function and exercise limitation in patients with chronic obstructive pulmonary disease: A review. Expert Rev Respir Med. 2018;12:67-79.
Hemandez M, Zambom-Ferraresi F, Cebollero P, Hueto J, Cascante JA, Anton MM. The relationships between muscle power and physical activity in older men with chronic obstruction pulmonary disease. J Aging Phys Act. 2017;25:360-6.
Polkey MI, Spruit MA, Edwards LD, et al. Six-minute-walk test in chronic obstructive pulmonary disease: minimal clinically important difference for death or hospitalization. Am J Respir Crit Care Med. 2013;187:382-6
Jensen MT, Marott JL, Lange P, et al. Resting heart rate is a predictor of mortality in COPD. Eur Respir J. 2013;42:341-9.
Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease (2023 report). Available at: https://goldcopd.org. Accessed on 15th November 2022.
Zhao D, Abbasi A, Casaburi R. Identifying a heart rate recovery criterion after a 6-minute walk test in COPD. Int J Chron Obstruct Pulmon Dis. 2021;16:25-45.
Hossain AM, Chakrabortty R. Reference values of 6 minutes’ walk test (6 MWT) in Bangladeshi healthy subjects aged 25-55 years. Bangladesh Med Res Counc Bull. 2014;40:70-3.
Felipe C, Bartolome C, Miguel D, Victor P. Longitudinal changes in handgrip strength, hyperinflation, and 6-minute walk distance in patients with COPD and a control Group. Chest. 2015;148(4):986-94.
Verma A, Gudi N, Yadav UN, Roj MP, Mahmood A, Nagraja R, Nayak P. Prevalence of COPD among population above 30 years in India: A systematic review and meta-analysis. J Glob Health. 2021;11:4038.
Lands LC, Smountas AA, Mesiano G. Maximal exercise capacity and peripheral skeletal muscle function following lung transplantation. J Heart Lung Transplant. 1999;18:113-20.
Decramer M, Gosselink R, Troosters T. Muscle weakness is related to utilization of health care resources in COPD patients. Eur Respir J. 1997;10:417–23.
Montes de Oca M, Torres SH, Gonzalez Y, et al. 2006. Peripheral muscle composition and health status in patients with COPD. Respir Med. 100:1800–6.
Taekema DG, Gussekloo J, Maier AB, Westendorp RGJ, de Craen AJM. Handgrip strength as a predictor of functional, psychological and social health. A prospective population-based study among the oldest old. Age Ageing. 2010;39:331-7.
Batsis JA, Mackenzie TA, Jones JD, Lopez-Jimenez F, Bartels SJ. Sarcopenia, sarcopenic obesity and inflammation: results from the 1999-2004 national health and nutrition examination Survey. Clin Nutr. 2016;35:1472-83.
Jaitovich A, Barreiro E. Skeletal muscle dysfunction in chronic obstructive pulmonary disease. What we know and can do for our patients. American journal of respiratory and critical care medicine. 2018;198(2):175-86.
Schols AM, Ferreira IM, Franssen FM. Nutritional assessment and therapy in COPD: a European Respiratory Society statement. Eur Respir J 2014;44:1504-20.
Laredo-Aguilera JA, Carmona-Torres JM, Cobo-Cuenca AI, García-Pinillos F, Latorre-Román PÁ. Handgrip strength is associated with psychological functioning, mood and sleep in women over 65 years. Int J Environ Res Public Health. 2019;16(5):873.
Rausch-Osthoff AK, Kohler M, Sievi NA, Clarenbach CF, van Gestel AJ. Association between peripheral muscle strength, exercise performance, and physical. Bibliography activity in daily life in patients with chronic obstructive pulmonary disease. Multidiscip Respir Med. 2014;9(1):37.
Luna-Heredia E, Martín-Peña G, Ruiz-Galiana J. Handgrip dynamometry in healthy adults. Clin Nutr. 2005;24(2):250-8.
Silva ALG, Garmatz E, Goulart CL, Carvalho LL, Cardoso DM, Paiva DN. Handgrip and functional capacity in Chronic Obstructive Pulmonary Disease patients. Fisioterapia Em Movimento. 2017;30(3):501-7.
Franke WD, Margrett JA, Heinz M, Martin P. Handgrip strength, positive affect, and perceived health are prospectively associated with fewer functional limitations among centenarians. Aging Hum Dev. 2012;75:351-63.
Vogelmeier CF, Criner GJ, Martinez FJ. Global strategy for the diagnosis, management, and prevention of chronic obstructive lung disease 2017 report. GOLD executive summary. Am J Respir Crit Care Med. 2017;195:557-82.
Celli B, Tetzlaff K, Criner G. The 6-minute-walk distance test as a chronic obstructive pulmonary disease stratification tool. Insights from the COPD biomarker qualification consortium. Am J Respir Crit Care Med. 2016;194:1483-93.