Turk Kardiyol Dern Ars. 2017; 45(5): 434-440 | DOI: 10.5543/tkda.2017.24557

Effect of disease severity on upper extremity muscle strength, exercise capacity, and activities of daily living in individuals with pulmonary arterial hypertension

Buse Özcan Kahraman¹, İsmail Özsoy¹, Serap Acar¹, Ebru Özpelit², Bahri Akdeniz², Can Sevinç³, Sema Savcı^1
1School of Physical Therapy and Rehabilitation, Dokuz Eylul University, Izmir, Turkey
²Department of Cardiology, Dokuz Eylül University Faculty of Medicine, Izmir, Turkey
³Department of Chest Diseases, Dokuz Eylül University Faculty of Medicine, Izmir, Turkey

OBJECTIVE
Pulmonary arterial hypertension (PAH) is a rare disease. Although muscle strength, exercise capacity, quality of life, and activities of daily living of patients with PAH are affected, it is not known how they are affected by disease severity. The purpose of the present study was to investigate effects of disease severity on upper extremity muscle strength, exercise capacity, and performance of activities of daily living in patients with PAH.

METHODS
Twenty-five patients with disease severity classified according to the New York Heart Association (NYHA) as functional class II (n=14) or class III (n=11) were included in the study. Upper-extremity exercise capacity and limitations in performing activities of daily living were assessed with 6-minute pegboard and ring test (6PBRT) and the Milliken activities of daily living scale (MAS), respectively. Shoulder flexion, elbow extension, elbow flexion muscle strength, and handgrip
strength were measured with dynamometer.

RESULTS
There were no significant differences in age, gender, body mass index, or mean pulmonary artery pressure between groups (p>0.05). The 6PBRT, MAS, and elbow flexion (right) and grip strength (right and left) results were significantly lower in NYHA III group than in NYHA II group (p=0.004, p=0.002, p=0.043, p=0.002 and p=0.003, respectively). There was no significant difference in shoulder flexion, elbow flexion (left), or elbow extension between groups (p>0.05).

CONCLUSION
Results suggest that upper extremity exercise capacity, elbow flexion muscle strength (right), and handgrip strength decrease and that limitations in activities of daily living grow as disease severity increases in patients with PAH. When planning rehabilitation programs, disease severity should be considered and evaluations and treatments for the upper extremities should be included.

Keywords: Pulmonary arterial hypertension, upper extremity exercise capacity, upper extremity muscle strength, upper extremity activities of daily living

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