PURPOSE: Adults with COPD with a pain co-morbidity may experience strength and power loss, leading to further functional limitations. The objectives were to evaluate the skeletal muscle mass (SMM) of individuals with COPD and chronic non-malignant pain (CNMP) versus in those without pain (asymptomatic elderly adults <AEA>) by using Bioelectric Impedance Analysis (BIA) and to analyze the relationship between SMM, physical performance status, and pain-related impairment (PRI).
METHODS: A retrospective study was done in a Medicare-accredited Comprehensive Outpatient Rehabilitation Facility. The Self-Administered Co-morbidity Questionnaire identified 26 of 100 subjects (12 men; 14 women) with CNMP and 23 AEA (11 men; 12 women). Mean (SD) age was 68 (5) years, and mean CNMP duration greater than five years. BIA measured the SMM calculated using a BIA prediction equation and PRI quantified using the Pain Disability Questionnaire (PDQ), a pain disability assessment from the AMA Guides to Evaluation of Permanent Impairment, 6th Ed. Functional limitations and were assessed with the Physical Performance Tests (PPT): 6-Minute Walk Test (6MWT) and Berg Balance Scale (BBS).
RESULTS: The mean (range) SMM was 20.94 kg. (range 11-40 kg.) in CNMP and 24.58 kg. (12-39 kg.) in AEA. The work performance percentage calculated from 6MWT values averaged 64% (range 48-77%) in CNMP and 62% (44-77%) in AEA. The mean BBS score was 42 of 56 (range 12-56) in CNMP and 49 of 56 (36-55) in AEA. The mean PDQ score was 59 of 150 (mild PRI). The BIA demonstrates lower SMM in subjects with CNMP than in AEA. The PRI tend to affect the SMM, leading to a further decrease in physical performance.
CONCLUSIONS: Individuals with CNMP tend to have lower skeletal muscle mass and poorer balance, but they have a similar work performance capacity as in AEA. Further study on the correlation of the SMM, BBS, and work performance in individuals with COPD and CNMP is suggested.
CLINICAL IMPLICATIONS: Adults with COPD should focus on increasing and maintaining strength, power, and balance to decrease functional limitations.
DISCLOSURE: The following authors have nothing to disclose: Armando Miciano
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