title: Skeletal muscle atrophy in advanced interstitial lung disease.
abstract: OBJECTIVE
  A limited number of studies examine skeletal muscle dysfunction in individuals with interstitial lung disease (ILD). We compared upper and lower limb muscle size and strength in individuals with advanced ILD with healthy controls. Second, the relationships of muscle size to muscle strength and function were explored.
  
  
  METHODS
  Individuals with advanced ILD listed for lung transplant and healthy control subjects were studied. B-mode ultrasound was performed to assess cross-sectional area (CSA) of rectus femoris and thickness of gastrocnemius and soleus and biceps brachii. Subjects performed isometric muscle strength testing, Short Physical Performance Battery, Timed Up and Go, and Unsupported Upper Limb Exercise Test.
  
  
  RESULTS
  Twenty-six individuals with advanced ILD (61 ± 8 years; 73% males; forced vital capacity: 2 ± 0.8 L, 49 ± 13% predicted; diffusing capacity of carbon monoxide: 9.3 ± 4 mL/min/mm Hg, 51 ± 20% predicted) and 12 healthy age and gender-matched controls (56 ± 9.5 years; 50% males) were included. Compared with controls, people with ILD had a smaller CSA of rectus femoris (7.6 ± 2.1 vs 9.4 ± 2.4 cm(2) ; P = 0.03) and lower strength of knee extensors (119 ± 35 vs 147 ± 39 Nm; P = 0.02) and plantarflexors (37 ± 19 vs 50 ± 15 Nm; P = 0.02), but not of biceps. Individuals with ILD also had impaired performance on all functional tests (P < 0.02). Moderate correlations were found between rectus femoris CSA and knee extensor strength (r = 0.63; P < 0.01) and biceps thickness and elbow flexor strength (r = 0.78; P < 0.01) in the ILD group.
  
  
  CONCLUSIONS
  Individuals with advanced ILD presented with lower limb muscle atrophy and weakness. Future studies should evaluate the effectiveness of exercise training on muscle function in advanced ILD.
authors.affiliation: Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Polyana
authors.initials: P
authors.lastname: Mendes
authors.affiliation: Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada.|Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada.|Toronto Lung Transplant Program, Toronto, Ontario, Canada.
authors.forename: Lisa
authors.initials: L
authors.lastname: Wickerson
authors.affiliation: Toronto Lung Transplant Program, Toronto, Ontario, Canada.
authors.forename: Denise
authors.initials: D
authors.lastname: Helm
authors.affiliation: Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada.|Respiratory Medicine, West Park Healthcare Centre, Toronto, Ontario, Canada.
authors.forename: Tania
authors.initials: T
authors.lastname: Janaudis-Ferreira
authors.affiliation: Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada.|Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Dina
authors.initials: D
authors.lastname: Brooks
authors.affiliation: Department of Medicine, University of Toronto, Toronto, Ontario, Canada.|Toronto Lung Transplant Program, Toronto, Ontario, Canada.
authors.forename: Lianne G
authors.initials: LG
authors.lastname: Singer
authors.affiliation: Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada.|Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Sunita
authors.initials: S
authors.lastname: Mathur
mesh_terms: D000328:Adult; D000368:Aged; D001284:Atrophy; D005260:Female; D006801:Humans; D035002:Lower Extremity / Q000473:pathology; D017563:Lung Diseases, Interstitial / Q000473:pathology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D018482:Muscle, Skeletal / Q000473:pathology* / Q000503:physiopathology; D052097:Quadriceps Muscle / Q000000981:diagnostic imaging; D012129:Respiratory Function Tests; D014463:Ultrasonography; D034941:Upper Extremity / Q000473:pathology
keywords: interstitial lung disease; muscle atrophy; muscle strength; ultrasound