lSonographic Measurement of the Quadriceps Muscle in Patients With Chronic Obstructive Pulmonary Disease Functional and Clinical Implications

Objectives-The purpose of this study was to determine the association between functionality as assessed by the 6-minute walking test (6MWT), maximal voluntary contraction of the quadriceps (MVCQ), and quadriceps thickness and echo intensity as measured by sonography, in patients with chronic obstructive pulmonary disease (COPD). Methods-Maximal voluntary contraction of the quadriceps and the thickness and echo intensity of the rectus femoris and vastus intermedius were evaluated in 20 patients with COPD. Functionality was assessed by the 6MWT. Differences between the evaluated muscles were determined by the Student t test. Pearson and Spearman rank correlation coefficients were used to analyze relationships between variables of interest, according to data characteristics. Finally, multivariate regression models were applied. Results-There was a positive correlation between MVCQ and rectus femoris and vastus intermedius thickness (r=0.427; P=.030; r=0.469; P=.018, respectively) and a negative correlation between MVCQ and rectus femoris and vastus intermedius echo intensity (r=-0.500; P=.012; r=-0.482; P=.016). No correlation was found between MVCQ and the 6MWT (r=0.319; P=.085). Multivariate regression analysis showed that the rectus femoris echo intensity, vastus intermedius echo intensity, and vastus intermedius thickness explained 70% of the variance in the distance walked during the 6MWT. Conclusions-These results indicate that, in patients with COPD, both quadriceps force and exercise capacity are associated with quantitative (thickness) and qualitative (echo intensity) characteristics of the quadriceps. Consequently, comprehensive assessments of peripheral muscles should simultaneously include both measurements.