title: Respiratory muscle strength in patients with pulmonary hypertension: The relationship with exercise capacity, physical activity level, and quality of life.
abstract: BACKGROUND
  Pulmonary hypertension (PH) is characterized by exertional dyspnea, fatigue, chest pain, dizziness, and syncope. Physical activity, peripheral, and respiratory muscle strength reduces in pateints with PH. Little is known about respiratory muscle weakness and related outcomes.
  
  
  OBJECTIVE
  The aims of the study were to determine respiratory muscle strength and to investigate the relationship between respiratory muscle strength and spirometric measurements, exercise capacity, physical activity level, quality of life, and pulmonary hemodynamics in patients with PH.
  
  
  METHODS
  In total, 33 patients aged 25-80 years who were diagnosed as having PH and 24 healthy volunteers were included in the study. To measure respiratory function, spirometry, maximal inspiratory (MIP), and expiratory pressures (MEP) were used. Physical activity level was determined with activity monitoring (SenseWear Armband) and the International Physical Activity Questionnaire-Short Form. Exercise capacity was determined using the 6-minute walk test. Quality of life was evaluated with the Minnesota Living with Heart Failure Questionnaire (MLHFQ).
  
  
  RESULTS
  Maximal inspiratory pressure and MEP values of the patients with PH were significantly lower than the age- and sex-matched healthy controls (P < .0001). Significant relationships were found between the MIP and six MWD (r = .40, P = .02), vigorous physical activity (r = .38, P = .03), moderate physical activity (r = 61, P < .001), and arm band-average metabolic equivalent (r = .39, P = .02).
  
  
  CONCLUSIONS
  The relationship between maximum inspiratory pressure, exercise capacity, and physical activity level showed that a decrease in exercise capacity or physical activity level may be a predictor for decreased MIP.
authors.affiliation: Faculty of Health Sciences, Division of Physiotherapy and Rehabilitation, Istanbul University, Istanbul, Turkey.
authors.forename: Goksen Kuran
authors.initials: GK
authors.lastname: Aslan
authors.affiliation: Faculty of Health Sciences, Division of Physiotherapy and Rehabilitation, Biruni University, Istanbul, Turkey.
authors.forename: Buket
authors.initials: B
authors.lastname: Akinci
authors.affiliation: Faculty of Health Sciences, Division of Physiotherapy and Rehabilitation, Istanbul University, Istanbul, Turkey.
authors.forename: Ipek
authors.initials: I
authors.lastname: Yeldan
authors.affiliation: Istanbul Faculty of Medicine, Department of Chest Disease, Istanbul University, Istanbul, Turkey.
authors.forename: Gulfer
authors.initials: G
authors.lastname: Okumus
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D017079:Exercise Tolerance / Q000502:physiology; D005260:Female; D005540:Forced Expiratory Flow Rates; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications* / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength / Q000502:physiology; D018908:Muscle Weakness / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy*; D010809:Physical Fitness / Q000502:physiology; D011237:Predictive Value of Tests; D011788:Quality of Life; D012132:Respiratory Muscles / Q000503:physiopathology*; D018570:Risk Assessment; D012720:Severity of Illness Index; D013147:Spirometry / Q000379:methods; D018709:Statistics, Nonparametric
keywords: physical activity; pulmonary hypertension; quality of life; respiratory muscles