Correlation between Hand Grip Strength and Peak Inspiratory Flow Rate in Patients with Stable Chronic Obstructive Pulmonary Disease
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Procedures
2.3. Outcomes
2.4. Statistical Analysis
3. Results
3.1. Participants
3.2. Prevalence of Suboptimal PIFR
3.3. Association between HGS and PIFR
3.4. HGS Cutoff Value for Predicting Optimal Accuhaler and Turbuhaler PIFR
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Characteristic | N = 81 |
---|---|
Age, years | 73.3 ± 8.9 |
Male | 70 (86.4) |
Body mass index, kg/m2 | 22.5 ± 3.9 |
Active smoking | 4 (4.9) |
Smoking, pack-years | 24.9 ± 22.2 |
Dominant right hand | 72 (88.9) |
Maximal Accuhaler PIFR, L/min | 63.7 ± 18.9 |
Maximal Turbuhaler PIFR, L/min | 52.4 ± 15.4 |
HGS, kg | 29.2 ± 8.0 |
Comorbidity | |
Hypertension | 44 (54.3) |
Diabetes mellitus | 21 (25.9) |
Coronary artery disease | 14 (17.3) |
Congestive heart failure | 5 (6.2) |
Atrial fibrillation | 4 (4.9) |
Lung cancer | 4 (4.9) |
Bronchiectasis | 4 (4.9) |
Depression | 1 (1.2) |
Vital sign | |
Systolic blood pressure, mmHg | 128.4 ± 21.5 |
Diastolic blood pressure, mmHg | 71.3 ± 12.2 |
Pulse rate, beats/min | 81.4 ± 14.3 |
Breathing frequency, breaths/min | 17.0 ± 1.9 |
Oxygen saturation, % | 96.4 ± 4.0 |
Spirometric data | |
Post-BD FEV1, L | 1.45 ± 0.60 |
Post-BD FEV1, % predicted | 65.3 ± 23.7 |
Post-BD FVC, L | 2.50 ± 0.90 |
Post-BD FVC, % predicted | 82.7 ± 22.1 |
Post-BD FEV1/FVC, % | 58.0 ± 11.0 |
Functional performance | |
CAT scores | 9.5 ± 6.5 |
CAT score < 10 | 40 (49.4) |
CAT score ≥ 10 | 41 (50.6) |
mMRC scores | 1.5 ± 1.1 |
mMRC < 2 | 42 (51.9) |
mMRC ≥ 2 | 39 (48.1) |
Spirometry grading | |
1 | 32 (39.5) |
2 | 24 (29.6) |
3 | 16 (19.8) |
4 | 9 (11.1) |
GOLD classification | |
A | 35 (43.2) |
B | 39 (48.1) |
C | 0 (0) |
D | 7 (8.6) |
Medication | |
SABD | 25 (30.9) |
SABD dose, puffs/day | 1.0 ± 1.9 |
Inhaled LABA | 2 (2.5) |
LAMA | 43 (53.1) |
LABA/LAMA | 21 (25.9) |
ICS/LABA | 36 (44.4) |
Xanthine | 30 (37.0) |
Phosphodieterase-4 inhibitor | 4 (4.9) |
Oral beta-2 agonist | 5 (6.2) |
Azithromycin | 5 (6.2) |
Acetylcysteine | 36 (44.4) |
Variable | Accuhaler | Turbuhaler | ||||
---|---|---|---|---|---|---|
Optimal | Suboptimal | p-Value | Optimal | Suboptimal | p-Value | |
Patients | 50 (61.7) | 31 (38.3) | NA | 33 (40.7) | 48 (59.3) | NA |
Maximal PIFR, L/min | 75.6 ± 12.3 | 44.7 ± 9.9 | <0.001 | 67.4 ± 6.7 | 42.2 ± 10.5 | <0.001 |
HGS, kg | 33.2 ± 6.9 | 22.8 ± 4.7 | <0.001 | 35.1 ± 6.3 | 25.3 ± 6.4 | <0.001 |
Gender | ||||||
Male | 49 (98.0) | 21 (67.7) | <0.001 | 33 (100) | 37 (77.1) | 0.002 |
Female | 1 (2.0) | 10 (32.3) | 0 (0) | 11 (22.9) | ||
Age, years | 70.0 ± 8.8 | 78.7 ± 6.2 | <0.001 | 67.9 ± 8.6 | 77.0 ± 7.2 | <0.001 |
Height, cm | 165.7 ± 6.1 | 158.6 ± 8.0 | <0.001 | 166.8 ± 5.1 | 160.4 ± 8.1 | <0.001 |
BMI, kg/m2 | 22.8 ± 4.0 | 22.0 ± 3.7 | 0.372 | 23.2 ± 3.6 | 22.1 ± 4.0 | 0.190 |
Active smoking | 3 (6.0) | 1 (3.2) | 1.000 | 2 (6.1) | 2 (4.2) | 1.000 |
Smoking, pack-years | 27.5 ± 22.4 | 20.7 ± 21.7 | 0.182 | 25.3 ± 18.1 | 24.6 ± 24.9 | 0.892 |
Dominant hand | ||||||
Left | 7 (14.0) | 2 (6.5) | 0.471 | 3 (9.1) | 6 (12.5) | 0.731 |
Right | 43 (86.0) | 29 (93.5) | 30 (90.9) | 42 (87.5) | ||
Comorbidity | ||||||
Diabetes mellitus | 12 (24.0) | 9 (29.0) | 0.615 | 8 (24.2) | 13 (27.1) | 0.774 |
Hypertension | 28 (56.0) | 16 (51.6) | 0.700 | 21 (63.6) | 23 (47.9) | 0.163 |
Coronary artery disease | 6 (12.0) | 8 (25.8) | 0.110 | 5 (15.2) | 9 (18.8) | 0.674 |
Congestive heart failure | 3 (6.0) | 2 (6.5) | 1.000 | 2 (6.1) | 3 (6.3) | 1.000 |
Atrial fibrillation | 2 (4.0) | 2 (6.5) | 0.635 | 2 (6.1) | 2 (4.2) | 1.000 |
Lung cancer | 1 (2.0) | 3 (9.7) | 0.154 | 1 (3.0) | 3 (6.3) | 0.642 |
Bronchiectasis | 1 (2.0) | 3 (9.7) | 0.154 | 0 (0.0) | 4 (8.3) | 0.142 |
Vital sign | ||||||
SBP, mmHg | 126.9 ± 24.4 | 130.9 ± 15.9 | 0.424 | 130.2 ± 16.0 | 127.3 ± 24.7 | 0.554 |
DBP, mmHg | 73.0 ± 12.9 | 68.8 ± 10.7 | 0.126 | 74.6 ± 13.0 | 69.1 ± 11.2 | 0.044 |
Pulse rate, beats/min | 81.3 ± 14.2 | 81.6 ± 14.6 | 0.932 | 80.7 ± 13.2 | 81.9 ± 15.1 | 0.713 |
Respiratory rate, breaths/min | 16.6±1.8 | 17.6±1.96 | 0.031 | 16.3±1.6 | 17.4±2.0 | 0.007 |
SpO2, % | 96.6±4.5 | 96.1±3.1 | 0.578 | 96.3±5.3 | 96.5±2.8 | 0.837 |
Spirometry data | ||||||
Post-BD FEV1, % | 70.6 ± 20.2 | 56.8 ± 26.6 | 0.010 | 75.2 ± 18.4 | 58.5 ± 24.7 | 0.001 |
Post-BD FVC, % | 88.5 ± 18.1 | 73.4 ± 24.9 | 0.002 | 93.0 ± 17.9 | 75.7 ± 22.0 | <0.001 |
Spirometric grade 3 and 4 | 12 (24.0) | 13 (16.0) | 0.089 | 5 (15.2) | 20 (41.7) | 0.011 |
Functional performance | ||||||
CAT scores | 7.8 ± 6.3 | 12.2 ± 6.0 | 0.003 | 5.5 ± 5.1 | 12.2 ± 5.9 | <0.001 |
CAT ≥ 10 | 20 (40.0) | 21 (67.7) | 0.015 | 7 (21.2) | 34 (70.8) | <0.001 |
mMRC scores | 1.2 ± 1.1 | 2.0 ± 0.9 | 0.001 | 0.9 ± 0.9 | 2.0 ± 1.0 | <0.001 |
mMRC ≥ 2 | 17 (34.0) | 22 (71.0) | 0.001 | 6 (18.2) | 33 (68.8) | <0.001 |
GOLD group D | 5 (10.0) | 2 (6.5) | 0.702 | 1 (3.0) | 6 (12.5) | 0.136 |
Medication | ||||||
SABD | 11 (22.0) | 14 (45.2) | 0.028 | 5 (15.2) | 20 (41.7) | 0.014 |
SABD dose, puffs/day | 0.6±1.3 | 1.6±2.6 | 0.043 | 0.4±1.1 | 1.4±2.3 | 0.008 |
LABA | 1 (2.0) | 1 (3.2) | 1.000 | 1 (3.0) | 1 (2.1) | 1.000 |
LAMA | 28 (56.0) | 15 (48.4) | 0.505 | 15 (45.5) | 28 (58.3) | 0.254 |
LABA/LAMA | 10 (20.0) | 11 (35.5) | 0.122 | 10 (30.3) | 11 (22.9) | 0.456 |
ICS/LABA | 25 (50.0) | 11 (35.5) | 0.201 | 14 (42.4) | 22 (45.8) | 0.762 |
Theophylline | 10 (20.0) | 5 (16.1) | 0.663 | 6 (18.2) | 9 (18.8) | 0.948 |
Doxophylline | 7 (14.0) | 8 (25.8) | 0.184 | 7 (21.2) | 8 (16.7) | 0.605 |
Roflumilast | 3 (6.0) | 1 (3.2) | 1.000 | 1 (3.0) | 3 (6.3) | 0.642 |
Oral beta2 agonist | 3 (6.0) | 2 (6.5) | 1.000 | 2 (6.1) | 3 (6.3) | 1.000 |
Azithromycin | 2 (4.0) | 3 (9.7) | 0.366 | 0 (0) | 5 (10.4) | 0.076 |
Acetylcysteine | 18 (36.0) | 18 (58.1) | 0.052 | 11 (33.3) | 25 (52.1) | 0.095 |
Factor | Correlation Coefficient | p-Value |
---|---|---|
Accuhaler PIFR | 0.591 | <0.001 |
Turbuhaler PIFR | 0.614 | <0.001 |
Variables | Regression Coefficients | 95% CI of Coefficients | p-Value |
---|---|---|---|
Accuhaler | |||
Intercept | −30.340 | −114.534, 53.853 | 0.475 |
Hand grip strength, kg | 0.274 | 0.132, 1.170 | 0.015 |
Age, years | −0.206 | −0.847, −0.025 | 0.038 |
Height, cm | 0.219 | 0.063, 1.019 | 0.027 |
Forced vital capacity, % | 1.019 | 0.099, 0.389 | 0.001 |
Short-acting bronchodilator dose, puffs/day | −0.148 | −3.118, 0.238 | 0.091 |
Turbuhaler | |||
Intercept | 56.196 | 20.715, 91.676 | 0.002 |
Hand grip strength, kg | 0.321 | 0.210, 1.032 | 0.004 |
Female | −0.196 | −16.718, −0.850 | 0.030 |
Age, years | −0.224 | −0.717, −0.058 | 0.022 |
Forced vital capacity, % | 0.304 | 0.096, 0.330 | 0.001 |
Short-acting bronchodilator dose, puffs/day | −0.147 | −2.508, 0.173 | 0.087 |
Variable | Cutoff Value | AUC | 95% CI | Sensitivity (%) | Specificity (%) | PPV (%) | NPV (%) | p-Value |
---|---|---|---|---|---|---|---|---|
HGS for Accuhaler, kg | 26.75 | 0.892 | 0.824–0.961 | 82.00 | 83.90 | 89.14 | 74.32 | <0.001 |
HGS for Turbuhaler, kg | 31.90 | 0.862 | 0.779–0.945 | 78.80 | 89.60 | 83.87 | 86.03 | <0.001 |
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Suriyakul, A.; Saiphoklang, N.; Barjaktarevic, I.; Cooper, C.B. Correlation between Hand Grip Strength and Peak Inspiratory Flow Rate in Patients with Stable Chronic Obstructive Pulmonary Disease. Diagnostics 2022, 12, 3050. https://doi.org/10.3390/diagnostics12123050
Suriyakul A, Saiphoklang N, Barjaktarevic I, Cooper CB. Correlation between Hand Grip Strength and Peak Inspiratory Flow Rate in Patients with Stable Chronic Obstructive Pulmonary Disease. Diagnostics. 2022; 12(12):3050. https://doi.org/10.3390/diagnostics12123050
Chicago/Turabian StyleSuriyakul, Apisara, Narongkorn Saiphoklang, Igor Barjaktarevic, and Christopher B. Cooper. 2022. "Correlation between Hand Grip Strength and Peak Inspiratory Flow Rate in Patients with Stable Chronic Obstructive Pulmonary Disease" Diagnostics 12, no. 12: 3050. https://doi.org/10.3390/diagnostics12123050