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Strandkvist, V. (2019). Hand grip strength and postural control among individuals with and without Chronic Obstructive Pulmonary Disease: Epidemiological and motion laboratory studies. (Doctoral dissertation). Luleå: Luleå University of Technology
Open this publication in new window or tab >>Hand grip strength and postural control among individuals with and without Chronic Obstructive Pulmonary Disease: Epidemiological and motion laboratory studies
2019 (English)Doctoral thesis, comprehensive summary (Other academic)
Alternative title[sv]
Handgreppstyrka och postural kontroll hos personer med och utan kroniskt obstruktiv lungsjukdom : Epidemiologiska och rörelselaborativa studier
Abstract [en]

Background

Chronic obstructive pulmonary disease (COPD) is estimated to affect approximately 8%–10% of all adults. The disease is considered to be a heterogenic syndrome with systemic effects, in which comorbidities including cardiovascular diseases, muscle dysfunction and fatigue are common. The majority of all individuals with COPD have mild to moderate disease (Global Initiative for Chronic Obstructive Lung Disease (GOLD) 1-2), and only a third are identified by health care, and this under-diagnosis contributes to a lack of knowledge of COPD in the population. COPD is related to skeletal muscle dysfunction, where muscle weakness, frequently assessed with hand grip strength (HGS), is one of the components. Evidence of postural control limitations among individuals with severe or very severe COPD has been emerging during the last decade. These limitations are partly related to muscle weakness, however, research of the other underlying systems of postural control is scarce, and an increased knowledge is of importance for the prevention of falls.

Aim

The main objective of the thesis was to increase the population-based knowledge about muscle strength, assessed as hand grip strength, and also postural control among individuals with and without COPD. Another objective was to investigate the value of hand grip strength measurements in relation to lower limb muscle strength and postural control among community-dwelling older adults.

Methods

Paper I and II are based on the population-based Obstructive Lung disease in Northern Sweden (OLIN) COPD study. All individuals with obstructive lung function impairment (n=993) and an age- and sex-matched group without (n=993) (COPD and non-COPD) were identified after re-examination of population based cohorts during 2002-04. They (n=1,986) have been invited to recurrent examinations including structured interviews and spirometry. Paper I (n=1011) and II (n=831) include data from examinations during 2009-2010 and 2014, respectively, where measurements of HGS (Paper I & II) as well as assessment of fatigue and physical activity (Paper II) were included. Paper III and IV are based on the population-based Balancing Human and Robot (BAHRT) study. Randomly selected individuals over 70 years of age were invited to participate in a study of postural control aspects, in their homes and at the 2 Human Health and Performance Lab- Movement Science, at Luleå University of Technology. The examinations included a structured interview as well as measurements of postural control and sensory and motor systems including HGS, lower limb strength, proprioception, pressure sensitivity, visual acuity, vestibular function and reaction time. Participants in Paper III consisted of communitydwelling individuals over 70 years of age (n=45). Paper IV consisted of individuals with COPD recruited from both the OLIN COPD study as well as the BAHRT-study (n=22), as well as a control group without airway obstruction from the BAHRT-study (n=34).

Results

In Paper I, there was no differences in mean HGS between the groups with and without COPD. However, HGS was related to disease severity; HGS was lower among those with severe to very severe COPD (GOLD 3-4) compared to nonCOPD, and HGS was associated with forced expiratory volume during 1 second % of predicted value (FEV1 % predicted) in regression models. Five years later, in Paper II, mean HGS was lower in COPD compared to non-COPD. Further, individuals with COPD and clinically relevant fatigue had lower HGS than those without clinically relevant fatigue, significantly so among men and close to among women. There was no clear association between HGS and level of physical activity. In Paper III, there was a strong and valid model showing association between HGS and lower limb strength, where all tested muscle groups were significantly correlated to hand grip strength. The regression model with HGS and postural control was significant, however, the model was weak. In Paper IV, individuals with COPD had worse postural control than those without COPD, significantly so regarding mediolateral amplitude in quiet stance with eyes open on soft/unstable surface, as well as anteroposterior limits of stability. In the COPD group, mediolateral amplitude was related to eye sight and the burden of tobacco smoking assessed as pack-years. Further, muscle strength associated with anteroposterior amplitude in the limits of stability test.

Conclusions

In the population-based OLIN COPD study in 2009-2010, mean HGS was significantly lower among individuals with severe to very severe COPD (GOLD 3-4) than those without COPD. Five years later, mean HGS was lower among all individuals with COPD (GOLD 1-4) compared to those without COPD, which may indicate altered aging process in COPD. HGS was associated to fatigue among individuals with COPD, while there were no associations between HGS and physical activity. HGS is a valid tool for the estimation of lower limb muscle strength among community-dwelling older adults, however, HGS is not 3 appropriate to use as an estimation of postural control. Postural control was impaired among individuals with COPD and different postural control assessments had different demands on the sensory and motor systems. The burden of tobacco smoking and visual acuity might be important for quiet stance trials with visual input, while muscle strength might be important for the more dynamic limits of stability test. Further research regarding the longitudinal aspects of muscle weakness and postural control among individuals with COPD is needed to gain knowledge for appropriate preventive or rehabilitative interventions.

Abstract [sv]

Bakgrund

Kroniskt Obstruktiv Lungsjukdom (KOL) drabbar uppskattningsvis 8%-10% av alla vuxna. KOL är ett heterogent syndrom med systemiska effekter och komorbiditeter, som kardiovaskulära sjukdomar, muskeldysfunktion och fatigue, är vanliga. Majoriteten av alla individer med KOL har en lindrig till medelsvår sjukdom (Global Initiative for Chronic Obstructive Lung Disease (GOLD) 1-2), men underdiagnostiken är betydande, endast cirka en tredjedel av alla är identifierade via sjukvården. Denna underdiagnostik bidrar till kunskapsluckor om sjukdomen KOL bland personer i befolkningen. KOL är relaterat till muskelsvaghet, vilket vanligtvis har undersökts genom mätningar av handgreppstyrka (HGS). Senaste årtionden har nedsatt postural kontroll hos personer med KOL har varit i fokus. Dessa nedsättningar är delvis relaterade till muskelsvaghet, det saknas emellertid studier av de andra underliggande systemen för postural kontroll, och en ökad kunskap är av värde för fallprevention för denna population.

Syfte

Huvudsyftet med denna avhandling var att öka kunskapen om muskelstyrka, mätt med handgreppstyrka, samt postural kontroll hos individer med och utan KOL i befolkningen. Ett ytterligare syfte var att undersöka handgreppstyrka i relation till benstyrka och postural kontroll hos äldre personer.

Metod

Studie I och II är baserade på den populationsbaserade Obstruktiv Lungsjukdom I Norrbotten (OLIN)-studiernas KOL-studie. Samtliga individer med luftvägsobstruktion (n= 993) identifierades tillsammans med en lika stor åldersoch könsmatchad referensgrupp (KOL respektive icke-KOL) efter kliniska undersökningar av populationsbaserade kohorter 2002-04. De (n=1986) har, alltsedan 2005, blivit inbjudna till återkommande kliniska undersökningar med strukturerad intervju och spirometri. Studie I (n=1011) och II (n=831) inkluderar data från undersökningarna 2009-2010 respektive 2014. HGS mättes vid båda tillfällena, medan fatigue och fysisk aktivitet mättes vid det senare (Studie II). Studie III och IV är baserade på Balancing Human and Robot (BAHRT)-studien. Ett slumpmässigt urval av individer över 70 års ålder har inbjudits till en studie av postural kontroll, där det ingår undersökningar vid såväl hembesök som i rörelselaboratorium, Human Health and Performance Lab – Movement Science, på Luleå Tekniska Universitet. Undersökningarna inkluderade en strukturerad intervju och mätningar av postural kontroll, samt 5 sensoriska- och motoriska system som: HGS, benstyrka, proprioception, tryckkänslighet, synskärpa, vestibular funktion och reaktionstid. Deltagare i studie III bestod av individer över 70 års ålder med självständigt boende (n=45). Studie IV bestod av individer med KOL som rekryterats från OLIN:s KOL-studie samt en referensgrupp utan luftvägsobstruktion från BAHRT-studien (n=34).

Resultat

I Studie I var det ingen skillnad i HGS mellan individer med och utan KOL. Däremot var HGS relaterat till svårighetsgrad av KOL; personer med svår och mycket svår KOL (GOLD 3-4) hade nedsatt HGS än dem utan KOL, och lägre greppstyrka var associerat med forcerad expiratorisk volym under 1 sekund, % av förväntat värde (FEV1% av förväntat). Fem år senare i Studie II hade individer med KOL (GOLD 1-4) lägre HGS än dem utan KOL. Bland individer med KOL hade de med klinisk relevant fatigue lägre HGS jämfört med dem utan klinisk relevant fatigue, dessa skillnader var statistiskt signifikanta bland män och nådde nära signifikans bland kvinnor. Det fanns däremot inte något tydligt samband mellan HGS och fysisk aktivitet hos personer med och utan KOL. I Studie III framkom en stark och valid regressionsmodell som påvisade associationer mellan HGS och benmuskelstyrka, där alla testade muskelgrupper var signifikant korrelerade till HGS. Modellen med HGS och postural kontroll var visserligen signifikant, men den var mycket svag. I Studie IV hade individer med KOL sämre postural kontroll jämfört med individer utan KOL: signifikant gällande mediolateral amplitud i stillastående test med öppna ögon på mjukt/instabilt underlag, samt anteroposterior amplitud i test av stabilitetsgränser. Hos personer med KOL var mediolateral amplitud i stillastående relaterad till synförmåga och tobaksexponering angivet som pack-år. Vidare var muskelstyrka associerat med anteroposterior amplitud i det mer dynamiska testet av stabilitetsgränser.

Konklusion

Vid populationsbaserade undersökningar under 2009-2010 var HGS lägre hos individer med svår till mycket svår KOL (GOLD 3-4) jämfört med dem utan KOL. Fem år senare var HGS lägre i gruppen med KOL jämfört med dem utan KOL, vilket kan indikera förändringar i åldersprocessen vid KOL. HGS var associerat med fatigue, men inte fysisk aktivitet, hos individer med KOL. HGS är ett användbart instrument för att uppskatta benmuskelstyrka hos äldre individer, men HGS är inte lämpligt att använda som en uppskattning av postural kontroll. Postural kontroll var nedsatt hos personer med KOL och olika tester av postural kontroll ställde olika krav på de sensoriska- och motoriska systemen. Under stillastående test där individerna hade öppna ögon var den totala 6 tobaksexponeringen och synskärpa viktigast. I det mer dynamiska testet av stabilitetsgränser var emellertid muskelstyrka viktigt. Det behövs fortsatta studier av de longitudinella aspekterna av muskelsvaghet och postural kontroll hos personer med KOL, för ökad kunskap gällande lämpliga preventiva åtgärder eller rehabiliteringsinterventioner.

Place, publisher, year, edition, pages
Luleå: Luleå University of Technology, 2019
Series
Doctoral thesis / Luleå University of Technology 1 jan 1997 → …, ISSN 1402-1544
National Category
Physiotherapy
Research subject
Physiotherapy
Identifiers
urn:nbn:se:ltu:diva-75508 (URN)978-91-7790-423-6 (ISBN)978-91-7790-424-3 (ISBN)
Public defence
2019-10-18, E632, Luleå University of Technology, Luleå, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2019-08-23 Created: 2019-08-23 Last updated: 2019-10-17Bibliographically approved
Pauelsen, M., Vikman, I., Johansson, V., Larsson, A. & Röijezon, U. (2018). Decline in sensorimotor systems explains reduced falls self-efficacy. Journal of Electromyography & Kinesiology, 42, 104-110
Open this publication in new window or tab >>Decline in sensorimotor systems explains reduced falls self-efficacy
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2018 (English)In: Journal of Electromyography & Kinesiology, ISSN 1050-6411, E-ISSN 1873-5711, Vol. 42, p. 104-110Article in journal (Refereed) Published
Abstract [en]

Physical performance including balance tasks is one of the main factors explaining the variance in falls self-efficacy in older adults. Balance performance is often measured by use of gross assessment scales, which assess the result of integration of all systems involved in postural control. We aimed to investigate which measurements of postural control correlate to falls self-efficacy scores as measured by the FES-I instrument, and which sensory and motor systems best explain them. A cross sectional study was designed, in which 45 older adults performed quiet stance and limits of stability trials during which their center of pressure (CoP) excursion was recorded. Falls self-efficacy was measured using the Falls Efficacy Scale - International. Eyesight, vestibular function, proprioception, reaction time and strength were also measured. Hierarchical orthogonal projection of latent structures was used to model FES-I with the CoP trials and then with the sensory and muscle function data. Fes-I could be explained to 39%, with the eyes open trials and the limits of stability trials loading the heaviest. The base model could be explained to 40% using the sensory and muscle function data, with lower limb strength, leg proprioception, neck proprioception, reaction time and eyesight loading the heaviest.

Place, publisher, year, edition, pages
Elsevier, 2018
National Category
Physiotherapy
Research subject
Physiotherapy
Identifiers
urn:nbn:se:ltu:diva-70143 (URN)10.1016/j.jelekin.2018.07.001 (DOI)000441876400013 ()30015133 (PubMedID)2-s2.0-85049755548 (Scopus ID)
Note

Validerad;2018;Nivå 2;2018-08-08 (andbra)

Available from: 2018-07-20 Created: 2018-07-20 Last updated: 2018-12-03Bibliographically approved
Strandkvist, V., Andersson, M., Backman, H., Larsson, A., Stridsman, C. & Lindberg, A. (2018). Hand grip strength is associated with fatigue among men with COPD: epidemiological data from northern Sweden. Physiotherapy Theory and Practice
Open this publication in new window or tab >>Hand grip strength is associated with fatigue among men with COPD: epidemiological data from northern Sweden
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2018 (English)In: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040Article in journal (Refereed) Epub ahead of print
Abstract [en]

The aim of this study was to investigate if hand grip strength (HGS) is associated with: 1) fatigue, and specifically clinically relevant fatigue (CRF); 2) low physical activity; and 3) fatigue independent of physical activity level, among individuals with and without COPD. Data were collected from the Obstructive Lung Disease in Northern Sweden (OLIN) COPD-study in 2014. HGS was measured with a hand-grip dynamometer, fatigue and physical activity were assessed by questionnaires; FACIT-Fatigue respectively IPAQ. Among individuals with COPD (n = 389), but not without COPD (n = 442), HGS was lower among those with CRF than those without CRF, significantly so among men (p = 0.001) and close to among women (p = 0.051). HGS was not associated with physical activity levels within any of the groups. HGS was associated with fatigue among men, but not women, with COPD independent of physical activity level, age, height, and smoking habits (Beta = 0.190, 95% CI 0.061-0.319, respectively Beta = 0.048, 95% CI-0.056-0.152), while there were no corresponding significant findings among individuals without COPD. In summary, HGS was associated with CRF among individuals with COPD in this population-based study. Among men with COPD, HGS was associated with fatigue independent of physical activity level and common confounders.

Place, publisher, year, edition, pages
Taylor & Francis, 2018
National Category
Physiotherapy Nursing
Research subject
Physiotherapy; Nursing
Identifiers
urn:nbn:se:ltu:diva-69970 (URN)10.1080/09593985.2018.1486490 (DOI)
Available from: 2018-06-28 Created: 2018-06-28 Last updated: 2019-08-23
Stridsman, C., Svensson, M., Johansson Strandkvist, V., Hedman, L., Backman, H. & Lindberg, A. (2018). The COPD Assessment Test (CAT) can screen for fatigue among patients with COPD. Therapeutic advances in respiratory disease, 12, Article ID 1753466618787380.
Open this publication in new window or tab >>The COPD Assessment Test (CAT) can screen for fatigue among patients with COPD
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2018 (English)In: Therapeutic advances in respiratory disease, ISSN 1753-4658, Vol. 12, article id 1753466618787380Article in journal (Refereed) Published
Abstract [en]

Background:

Fatigue is one of the most common symptoms among subjects with chronic obstructive pulmonary disease (COPD), but is rarely identified in clinical practice. The aim of this study was to evaluate the association between fatigue and health-related quality of life (HRQoL) assessed with clinically useful instruments, both among subjects with and without COPD. Further, to investigate the association between fatigue and the COPD Assessment Test (CAT)-energy question.

Methods:

Data were collected in 2014 within the population-based OLIN COPD study. Subjects with (n = 367) and without (n = 428) COPD participated in clinical examinations including spirometry and completed questionnaires about fatigue (FACIT-Fatigue, clinically relevant fatigue ⩽43), and HRQoL (EQ-5D-VAS, lower score = worse health; CAT, lower score = fewer symptoms/better health).

Results:

Subjects with clinically relevant fatigue had worse HRQoL measured with EQ-5D-VAS, regardless of having COPD or not. Decreasing EQ-5D-VAS scores, any respiratory symptoms and anxiety/depression were associated with clinically relevant fatigue also when adjusted for confounders. Among subjects with COPD, clinically relevant fatigue was associated with increasing total CAT score, and CAT score ⩾10. The proportion of subjects with clinically relevant fatigue increased significantly, with a higher score on the CAT-energy question, and nearly 50% of those with a score of 2, and 70% of those with a score of ⩾3, had clinically relevant fatigue.

Conclusions:

Fatigue was associated with respiratory symptoms, anxiety/depression and worse HRQoL when using the clinically useful instruments EQ-5D-VAS and CAT. The CAT-energy question can be used to screen for fatigue in clinical practice, using a cut-off of ⩾2.

Place, publisher, year, edition, pages
SAGE Open, 2018
National Category
Nursing Physiotherapy
Research subject
Nursing; Physiotherapy
Identifiers
urn:nbn:se:ltu:diva-70212 (URN)10.1177/1753466618787380 (DOI)000455407900001 ()30035671 (PubMedID)2-s2.0-85054592561 (Scopus ID)
Note

Validerad;2018;Nivå 2;2018-08-06 (andbra)

Available from: 2018-08-06 Created: 2018-08-06 Last updated: 2019-01-28Bibliographically approved
Johansson Strandkvist, V., Backman, H., Röding, J., Stridsman, C. & Lindberg, A. (2016). Hand grip strength is associated with forced expiratory volume in 1 second among subjects with COPD: report from a population-based cohort study.. The International Journal of Chronic Obstructive Pulmonary Disease, 11(1), 2527-2534
Open this publication in new window or tab >>Hand grip strength is associated with forced expiratory volume in 1 second among subjects with COPD: report from a population-based cohort study.
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2016 (English)In: The International Journal of Chronic Obstructive Pulmonary Disease, ISSN 1176-9106, E-ISSN 1178-2005, Vol. 11, no 1, p. 2527-2534Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Cardiovascular diseases and skeletal muscle dysfunction are common comorbidities in COPD. Hand grip strength (HGS) is related to general muscle strength and is associated with cardiovascular disease and all-cause mortality, while the results from small selected COPD populations are contradictory. The aim of this population-based study was to compare HGS among the subjects with and without COPD, to evaluate HGS in relation to COPD severity, and to evaluate the impact of heart disease.

SUBJECTS AND METHODS: Data were collected from the Obstructive Lung disease in Northern Sweden COPD study, where the subjects with and without COPD have been invited to annual examinations since 2005. In 2009-2010, 441 subjects with COPD (postbronchodilator forced expiratory volume in 1 second [FEV1]/vital capacity <0.70) and 570 without COPD participated in structured interviews, spirometry, and measurements of HGS.

RESULTS: The mean HGS was similar when comparing subjects with and without COPD, but those with heart disease had lower HGS than those without. When compared by Global Initiative for Chronic Obstructive Lung Disease (GOLD) grades, the subjects with GOLD 3-4 had lower HGS than those without COPD in both sexes (females 21.4 kg vs 26.9 kg, P=0.010; males 41.5 kg vs 46.3 kg, P=0.038), and the difference persisted also when adjusted for confounders. Among the subjects with COPD, HGS was associated with FEV1% of predicted value but not heart disease when adjusted for height, age, sex, and smoking habits, and the pattern was similar among males and females.

CONCLUSION: In this population-based study, the subjects with GOLD 3-4 had lower HGS than the subjects without COPD. Among those with COPD, HGS was associated with FEV1% of predicted value but not heart disease, and the pattern was similar in both sexes.

National Category
Physiotherapy Nursing
Research subject
Physiotherapy; Nursing
Identifiers
urn:nbn:se:ltu:diva-60022 (URN)10.2147/COPD.S114154 (DOI)000385205700001 ()27785009 (PubMedID)2-s2.0-84991628464 (Scopus ID)
Note

Validerad; 2016; Nivå 2; 2016-11-07 (andbra)

Available from: 2016-10-28 Created: 2016-10-28 Last updated: 2019-08-23Bibliographically approved
Johansson Strandkvist, V., Backman, H., Röding, J., Stridsman, C. & Lindberg, A. (2016). Impact of heart disease on hand grip strength in COPD: epidemiological data. In: : . Paper presented at European Respiratory Society International Congress 2016 London, 3-7 September 2016.
Open this publication in new window or tab >>Impact of heart disease on hand grip strength in COPD: epidemiological data
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2016 (English)Conference paper, Poster (with or without abstract) (Refereed)
Abstract [en]

Background: Hand grip strength (HGS) and heart disease (HD) are related to mortality. Peripheral muscle dysfunction and HD are both frequently observed among subjects with COPD, but the relationship between HGS and HD in COPD is unclear.

Aim: To evaluate HGS and the impact of HD among subjects with and without COPD.Methods: Data was collected from the OLIN (Obstructive Lung Disease in Northern Sweden) COPD study, where subjects with COPD have been invited to annual examinations since 2005 together with age- and sex-matched subjects without COPD. During 2009, 441 subjects with COPD and 570 without COPD participated in examinations including structured interviews, spirometry and measurements of HGS. COPD was defined as post-bronchodilator FEV1/VC<0.70.

Results: Both among subjects with and without COPD, and in both sexes, those with HD had significantly lower HGS. The proportion of subjects below estimated normal value for HGS was similar in subjects with and without COPD and in both sexes; among women (35.4 vs. 33.4%, p=0.714) and men (19.1 vs 15.9%, p=0.315). In a linear regression model among subjects with COPD only, HGS was significantly associated with age, beta coefficient (B) = -0.46 (p<0.001), sex, B=19.85 (p<0.001) and FEV1 % of predicted normal value, B=0.06 (p=0.007), but not with HD or smoking habits. When a similar model was estimated among subjects without COPD, HGS was only associated with age and sex.

Conclusions: In this population-based study, subjects with heart disease had lower hand grip strength regardless if they had COPD or not. Among COPD subjects, hand grip strength was associated with age, sex and FEV1, but not with heart disease.

National Category
Medical and Health Sciences Physiotherapy Nursing
Research subject
Physiotherapy; Nursing
Identifiers
urn:nbn:se:ltu:diva-60888 (URN)
Conference
European Respiratory Society International Congress 2016 London, 3-7 September 2016
Available from: 2016-12-02 Created: 2016-12-02 Last updated: 2018-04-24Bibliographically approved
Johansson Strandkvist, V., Nyberg, L., Larsson, A., Röijezon, U., Stridsman, C. & Lindberg, A. (2016). Project: Physical function and postural control among subjects with Chronic Obstructive Pulmonary Disease – epidemiological and laboratory studies. Paper presented at .
Open this publication in new window or tab >>Project: Physical function and postural control among subjects with Chronic Obstructive Pulmonary Disease – epidemiological and laboratory studies
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2016 (English)Other (Other (popular science, discussion, etc.))
National Category
Physiotherapy
Research subject
Physiotherapy
Identifiers
urn:nbn:se:ltu:diva-36074 (URN)5a5a2cc5-876c-40d5-b493-d23e1c49d521 (Local ID)5a5a2cc5-876c-40d5-b493-d23e1c49d521 (Archive number)5a5a2cc5-876c-40d5-b493-d23e1c49d521 (OAI)
Note

Status: Pågående; Period: 01/11/2015 → …

Available from: 2016-09-30 Created: 2016-09-30 Last updated: 2018-04-24Bibliographically approved
Qvist, L., Nilsson, U., Johansson, V., Larsson, K., Rönmark, E., Langrish, J., . . . Lindberg, A. (2015). Central arterial stiffness is increased among subjects with severe and very severe COPD: report from a population-based cohort study (ed.). Paper presented at . European Clinical Respiratory Journal, 2, Article ID 27023.
Open this publication in new window or tab >>Central arterial stiffness is increased among subjects with severe and very severe COPD: report from a population-based cohort study
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2015 (English)In: European Clinical Respiratory Journal, ISSN 2001-8525, Vol. 2, article id 27023Article in journal (Refereed) Published
Abstract [en]

ReferencesFootnoteAbout the AuthorsArticle MetricsRelated ContentDownload Article PDF EPUB XML Download ArticleCite Article Share Keywordsallergic rhinitis allergy asthma bacteria bronchoscopy cancer chronic obstructive pulmonary disease computed tomography copd eib endothelin endotypes epidemiology exercise-induced asthma genetic epidemiology idiopathic pulmonary fibrosis interstitial lung disease mortality respiratory failure sports vegf +Article ToolsPublish with UsSubmit a Manuscript Author Benefits Sign Up for eAlertsSearch Journal ContentRelated Tweets ORIGINAL RESEARCH ARTICLECentral arterial stiffness is increased among subjects with severe and very severe COPD: report from a population-based cohort studyLinnea Qvist1†, Ulf Nilsson2†, Viktor Johansson3, Kjell Larsson1, Eva Rönmark3, Jeremy Langrish4, Anders Blomberg2 and Anne Lindberg2*1Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; 2Department of Public Health and Clinical Medicine, Division of Medicine, Umeå University, Umeå, Sweden; 3OLIN Unit, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, Umeå, Sweden; 4BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United KingdomAbstractIntroduction: Cardiovascular disease (CVD) is common in chronic obstructive pulmonary disease (COPD) and is, as productive cough, related to poorer prognosis in COPD. Central arterial stiffness is a marker of early atherosclerosis, but the association between COPD, productive cough, and arterial stiffness as a possible indicator of CVD is unclear.Objectives: To compare both arterial stiffness among subjects with and without COPD and the impact of productive cough in a population-based cohort.Methods: A population-based cohort, including 993 COPD and 993 non-COPD subjects, has been invited to annual examination since 2005. In 2010, 947 subjects, of which 416 had COPD (according to the GOLD spirometric criteria), participated in examinations including structured interview, spirometry, and measurements of central arterial stiffness as pulse wave velocity (PWV).Results: PWV was higher in GOLD 3–4 compared to non-COPD (10.52 vs. 9.13 m/s, p=0.042). CVD and age ≥60 were both associated with significantly higher PWV in COPD as well as in non-COPD. In COPD, those with productive cough had higher PWV than those without, significantly so in GOLD 1 (9.59 vs. 8.92 m/s, p=0.024). In a multivariate model, GOLD 3–4 but not productive cough was associated with higher PWV, when adjusted for sex, age group, smoking habits, blood pressure, CVD, and pulse rate.Conclusions: GOLD 3–4, age ≥60, and CVD were associated with increased arterial stiffness, and also increased in COPD subjects with productive cough compared to those without. Of importance, GOLD 3–4 but not productive cough remained associated with increased central arterial stiffness when adjusted for confounders.

National Category
Physiotherapy
Research subject
Physiotherapy
Identifiers
urn:nbn:se:ltu:diva-16048 (URN)10.3402/ecrj.v2.27023 (DOI)fa14139f-cf5b-4e42-8934-7dcd41aaf7cb (Local ID)fa14139f-cf5b-4e42-8934-7dcd41aaf7cb (Archive number)fa14139f-cf5b-4e42-8934-7dcd41aaf7cb (OAI)
Note
Upprättat; 2015; 20160512 (joikvh)Available from: 2016-09-29 Created: 2016-09-29 Last updated: 2018-04-24Bibliographically approved
Strandkvist, V., Pauelsen, M., Larsson, A., Nyberg, L., Vikman, I., Lindberg, A., . . . Röijezon, U.Hand grip strength is strongly associated with lower limb strength but only weakly with postural control in community-dwelling older adults.
Open this publication in new window or tab >>Hand grip strength is strongly associated with lower limb strength but only weakly with postural control in community-dwelling older adults
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(English)Manuscript (preprint) (Other academic)
National Category
Physiotherapy
Research subject
Physiotherapy
Identifiers
urn:nbn:se:ltu:diva-75669 (URN)
Available from: 2019-08-23 Created: 2019-08-23 Last updated: 2019-08-23
Strandkvist, V., Lindberg, A., Larsson, A., Pauelsen, M., Stridsman, C., Nyberg, L., . . . Röijezon, U.Postural control among individuals with and without chronic obstructive pulmonary disease: A study of motor and sensory systems..
Open this publication in new window or tab >>Postural control among individuals with and without chronic obstructive pulmonary disease: A study of motor and sensory systems.
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(English)Manuscript (preprint) (Other academic)
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Physiotherapy
Research subject
Physiotherapy
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urn:nbn:se:ltu:diva-75668 (URN)
Available from: 2019-08-23 Created: 2019-08-23 Last updated: 2019-08-23
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ORCID iD: ORCID iD iconorcid.org/0000-0002-5948-6880

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