Investigation of Pectoralis Muscle Strength in Elderly With Interstitial Lung Disease

The Effect of Pectoralis Muscle Strength on Pulmonary Function in Elderly With Interstitial Lung Disease

Interstitial lung disease (ILD) is a restrictive lung disease characterized by impaired lung function, exercise limitation and skeletal muscle dysfunction. There is limited data on skeletal muscle function in ILD, most of which are focused on the lower limb muscles. The aim of this study were to evaluated the change of pectoralis muscle strength and relationship of pulmonary function with pectoralis muscle strength.

Study Overview

• Status: Completed
• Conditions: Idiopathic Pulmonary Fibrosis; Interstitial Lung Disease; Sarcoidosis, Pulmonary; Geriatric
• Intervention / Treatment: Other: Assessment of pulmonary function and pectoralis muscle strength

Detailed Description

This study consisted of intervention and control groups. Thirty one patients with ILD were included in the patient's group and 37 healthy volunteers in the control group. All participants were selected from the geriatric population. Demographic and cardiopulmonary physiotherapy assessment of all participants were performed. Lung function test, maximal inspiratory and expiratory pressure and pectoralis muscle strength were measured in participants of both groups. All measurements were performed once.

• Study Type: Observational
• Enrollment (Actual): 68

Contacts and Locations

Study Locations

• Turkey
  • Giresun, Turkey
    • Giresun University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 65 years to 85 years (Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

The patient's group was selected from among the patients who applied to Süreyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital.

The control group was selected among volunteers invited from the local community.

Description

Inclusion Criteria:

• Diagnosed with ILD by a multidisciplinary team according to the 2011 ATS/ERS guidelines for ILD
• Aged 65-85

Exclusion Criteria:

• Uncontrolled/active cardiovascular, metabolic, systemic or cancerous disease
• Significant orthopedic, neurologic or musculoskeletal comorbidity that limited functional independence
• No being able to cooperate
• Refuse to participate in the current study

Study Plan

How is the study designed?

Design Details

• Observational Models: Case-Control
• Time Perspectives: Prospective

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Patient's group; geriatric patients with interstitial lung disease	Other: Assessment of pulmonary function and pectoralis muscle strength; In both groups, forced vital capacity (FVC), forced expiratory volume in one second (FEV1) and FEV1 / FVC ratio were measured with portable spirometer according to the guidelines of the American Thoracic Society (ATS) and the European Respiratory Society (ERS). Maximal inspiratory (MIP) and expiratory pressure (MEP) were evaluated with mouth pressure device as per ATS/ERS guidelines. Sensation of dyspnea was assessed with Modified medical council research scale. Pectoralis muscle strength were measured isometrically using with digital hand held dynamometer.
Control group; healthy volunteers selected from the geriatric population	Other: Assessment of pulmonary function and pectoralis muscle strength; In both groups, forced vital capacity (FVC), forced expiratory volume in one second (FEV1) and FEV1 / FVC ratio were measured with portable spirometer according to the guidelines of the American Thoracic Society (ATS) and the European Respiratory Society (ERS). Maximal inspiratory (MIP) and expiratory pressure (MEP) were evaluated with mouth pressure device as per ATS/ERS guidelines. Sensation of dyspnea was assessed with Modified medical council research scale. Pectoralis muscle strength were measured isometrically using with digital hand held dynamometer.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Pectoralis muscle strength test	The pectoralis muscle strength were measured with handheld dynamometer in supine position. The shoulder joint of participant was positioned at 90º abducted and at 0º internal/external rotation and the elbow joint was flexed at 90º. The other shoulder joint was fixed by the physiotherapist. While the participant performed isometrically horizontal adduction movement, the measurement was performed on the distal part of the upper arm and the contraction was sustained for at least 5 seconds by the participant. The test was performed three times and with 60 seconds rest between tests. The mean of the best value on both sides was recorded.	15 minute

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
FEV1	FEV1 value was measured with portable spirometer according to ATS/ ERS guidelines for pulmonary function test. Results of the measurements were recorded as percentanges of predicted values.	5 minute
FVC	FVC value was measured with portable spirometer according to ATS/ ERS guidelines for pulmonary function test. Results of the measurements were recorded as percentanges of predicted values.	5 minute
FEV1/FVC	The ratio of FEV1/FVC was calculated by measuring device according to measured FEV1 and FVC values	5 minute
Respiratory muscle strength test	Maximal mouth pressures were measured to evaluate respiratory muscle strength. The test was performed with mouth pressure device in sitting position. Participants breathed through a flanged mouthpiece inside the lips at near residual volume for the MIP value and near total lung capacity for MEP value . The maximum effort was sustained for at least one second. The test was repeated at least 3 times until no more than 10% difference was present between highest and previous measurements . The higest value and percentage value of predicted highest value were recorded	15 minute
Dyspnea assessment	Modified Medical Council Research Dyspnea scale were used to assess sensation of dyspnea	3 minute

Collaborators and Investigators

• Sponsor: Habibedurdu
• Investigators: Principal Investigator: Habibe DURDU, MSc, Giresun University

Publications and helpful links

General Publications

• Raghu G, Collard HR, Egan JJ, Martinez FJ, Behr J, Brown KK, Colby TV, Cordier JF, Flaherty KR, Lasky JA, Lynch DA, Ryu JH, Swigris JJ, Wells AU, Ancochea J, Bouros D, Carvalho C, Costabel U, Ebina M, Hansell DM, Johkoh T, Kim DS, King TE Jr, Kondoh Y, Myers J, Muller NL, Nicholson AG, Richeldi L, Selman M, Dudden RF, Griss BS, Protzko SL, Schunemann HJ; ATS/ERS/JRS/ALAT Committee on Idiopathic Pulmonary Fibrosis. An official ATS/ERS/JRS/ALAT statement: idiopathic pulmonary fibrosis: evidence-based guidelines for diagnosis and management. Am J Respir Crit Care Med. 2011 Mar 15;183(6):788-824. doi: 10.1164/rccm.2009-040GL.
• Hirano M, Katoh M, Kawaguchi S, Uemura T. Intrarater reliabilities of shoulder joint horizontal adductor muscle strength measurements using a handheld dynamometer for geriatric and stroke patients. J Phys Ther Sci. 2016 Jan;28(1):51-5. doi: 10.1589/jpts.28.51. Epub 2016 Jan 30.
• Panagiotou M, Polychronopoulos V, Strange C. Respiratory and lower limb muscle function in interstitial lung disease. Chron Respir Dis. 2016 May;13(2):162-72. doi: 10.1177/1479972315626014. Epub 2016 Jan 14.
• Hanada M, Sakamoto N, Ishimatsu Y, Kakugawa T, Obase Y, Kozu R, Senjyu H, Izumikawa K, Mukae H, Kohno S. Effect of long-term treatment with corticosteroids on skeletal muscle strength, functional exercise capacity and health status in patients with interstitial lung disease. Respirology. 2016 Aug;21(6):1088-93. doi: 10.1111/resp.12807. Epub 2016 May 13.
• Durdu H, Yurdalan SU, Ozmen I. Clinical significance of pectoralis muscle strength in elderly patients with idiopathic pulmonary fibrosis. Sarcoidosis Vasc Diffuse Lung Dis. 2022;39(1):e2022009. doi: 10.36141/svdld.v39i1.12094. Epub 2022 Mar 31.

Study record dates

Study Major Dates

• Study Start (Actual): January 23, 2017
• Primary Completion (Actual): June 23, 2017
• Study Completion (Actual): June 23, 2017

Study Registration Dates

• First Submitted: March 13, 2021
• First Submitted That Met QC Criteria: March 16, 2021
• First Posted (Actual): March 17, 2021

Study Record Updates

• Last Update Posted (Actual): March 17, 2021
• Last Update Submitted That Met QC Criteria: March 16, 2021
• Last Verified: March 1, 2021

More Information

Terms related to this study

• Keywords: respiratory muscle strength; lung function test; pectoralis muscle strength; horizontal adduction
• Additional Relevant MeSH Terms: Respiratory Tract Diseases; Lymphoproliferative Disorders; Lymphatic Diseases; Lung Diseases; Pulmonary Fibrosis; Idiopathic Pulmonary Fibrosis; Lung Diseases, Interstitial; Sarcoidosis, Pulmonary; Sarcoidosis
• Other Study ID Numbers: Pectoralismajor

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: No
• IPD Plan Description: The data sets collected and analyzed during this study could be provided from corresponding author upon reasonable request

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No