Upper Extremity Exercise Capacity in adolescent and young adult with pulmonary arterial hypertension: The Role of Muscle Function

Jan Dik; Ceyhun Topcuoğlu; Naciye Vardar Yaglı; Ebru Aypar; Dursun Alehan; Melda Saglam

Makale detayları

Upper Extremity Exercise Capacity in adolescent and young adult with pulmonary arterial hypertension: The Role of Muscle Function

Yazarlar:

Jan Dik | Ceyhun Topcuoğlu | Naciye Vardar Yaglı | Ebru Aypar | Dursun Alehan | Melda Saglam

Yayıncı:

Hacettepe University

Ana Başlıklar:

Physiotherapy

Dergi:

Journal of Hacettepe University Physical Therapy and Rehabilitation Faculty Vol.3 Issue 3, pp.124-133

Belge Tipi:

Makale

Yayın Tarihi:

10/2025

Belge Dili:

İngilizce

Document ID (Org No.):

2001358209

pISSN:

3023-5073

Anahtar kelimeler:

Özet:

 Background: Pulmonary arterial hypertension PAH impairs aerobic capacity through combined cardiopulmonary and skeletal muscle dysfunction. However, upper extremity aerobic performance and muscle-related parameters correlates have not been widely explored in PAH population. Objective: To investigate the relationship between maximal workload achieved during an arm ergometer test and peripheral muscle parameters in adolescents and young adults with PAH. Methods: Eighteen PAH patients were evaluated; two were excluded due to protocol deviations, resulting in a final sample of 16 participants mean age: 20.4  8.2 years; 9 females. Maximum workload watts was assessed via an arm ergometer test. Handgrip strength was measured using a handgrip dynamometer, and shoulder abduction strength with a digital dynamometer ; both were converted to percent predicted using age- and sex-adjusted normative equations. Fat-free mass FFM was calculated from body composition using bioelectrical impedance analysis. Surface electromyography EMG of the anterior deltoid was recorded during the first and end stage of the exercise and expressed as  maximal voluntary isometric contraction MVIC, in accordance with Surface EMG for the Non-Invasive Assessment of Muscles SENIAM standards. Brain Natriuretic Peptide BNP levels were obtained from recent clinical records. Spearman correlation was used to evaluate associations. Results: Maximal workload was positively correlated with FFM r  0.615, p  0.011, shoulder abduction strength r  0.535, p  0.033, and handgrip strength r  0.648, p  0.014. It was negatively correlated with BNP r  0.728, p  0.005 and the maximum MVIC value of anterior deltoid EMG obtained from the first 15 seconds of the initial arm ergometer test stage r  0.602, p  0.014. A negative correlation was also observed with EMG from the final stage, though it did not reach statistical significance r0.442, p0.086. Conclusion: Upper extremity aerobic performance in PAH is significantly associated with muscle strength, mass, and activation, as well as cardiac stress. These results highlight the clinical relevance of specifically assessing upper extremity aerobic performance as a meaningful indicator of functional status in PAH.

 Background: Pulmonary arterial hypertension PAH impairs aerobic capacity through combined cardiopulmonary and skeletal muscle dysfunction. However, upper extremity aerobic performance and muscle-related parameters correlates have not been widely explored in PAH population. Objective: To investigate the relationship between maximal workload achieved during an arm ergometer test and peripheral muscle parameters in adolescents and young adults with PAH. Methods: Eighteen PAH patients were evaluated; two were excluded due to protocol deviations, resulting in a final sample of 16 participants mean age: 20.4  8.2 years; 9 females. Maximum workload watts was assessed via an arm ergometer test. Handgrip strength was measured using a handgrip dynamometer, and shoulder abduction strength with a digital dynamometer ; both were converted to percent predicted using age- and sex-adjusted normative equations. Fat-free mass FFM was calculated from body composition using bioelectrical impedance analysis. Surface electromyography EMG of the anterior deltoid was recorded during the first and end stage of the exercise and expressed as  maximal voluntary isometric contraction MVIC, in accordance with Surface EMG for the Non-Invasive Assessment of Muscles SENIAM standards. Brain Natriuretic Peptide BNP levels were obtained from recent clinical records. Spearman correlation was used to evaluate associations. Results: Maximal workload was positively correlated with FFM r  0.615, p  0.011, shoulder abduction strength r  0.535, p  0.033, and handgrip strength r  0.648, p  0.014. It was negatively correlated with BNP r  0.728, p  0.005 and the maximum MVIC value of anterior deltoid EMG obtained from the first 15 seconds of the initial arm ergometer test stage r  0.602, p  0.014. A negative correlation was also observed with EMG from the final stage, though it did not reach statistical significance r0.442, p0.086. Conclusion: Upper extremity aerobic performance in PAH is significantly associated with muscle strength, mass, and activation, as well as cardiac stress. These results highlight the clinical relevance of specifically assessing upper extremity aerobic performance as a meaningful indicator of functional status in PAH.

 Background: Pulmonary arterial hypertension PAH impairs aerobic capacity through combined cardiopulmonary and skeletal muscle dysfunction. However, upper extremity aerobic performance and muscle-related parameters correlates have not been widely explored in PAH population. Objective: To investigate the relationship between maximal workload achieved during an arm ergometer test and peripheral muscle parameters in adolescents and young adults with PAH. Methods: Eighteen PAH patients were evaluated; two were excluded due to protocol deviations, resulting in a final sample of 16 participants mean age: 20.4  8.2 years; 9 females. Maximum workload watts was assessed via an arm ergometer test. Handgrip strength was measured using a handgrip dynamometer, and shoulder abduction strength with a digital dynamometer ; both were converted to percent predicted using age- and sex-adjusted normative equations. Fat-free mass FFM was calculated from body composition using bioelectrical impedance analysis. Surface electromyography EMG of the anterior deltoid was recorded during the first and end stage of the exercise and expressed as  maximal voluntary isometric contraction MVIC, in accordance with Surface EMG for the Non-Invasive Assessment of Muscles SENIAM standards. Brain Natriuretic Peptide BNP levels were obtained from recent clinical records. Spearman correlation was used to evaluate associations. Results: Maximal workload was positively correlated with FFM r  0.615, p  0.011, shoulder abduction strength r  0.535, p  0.033, and handgrip strength r  0.648, p  0.014. It was negatively correlated with BNP r  0.728, p  0.005 and the maximum MVIC value of anterior deltoid EMG obtained from the first 15 seconds of the initial arm ergometer test stage r  0.602, p  0.014. A negative correlation was also observed with EMG from the final stage, though it did not reach statistical significance r0.442, p0.086. Conclusion: Upper extremity aerobic performance in PAH is significantly associated with muscle strength, mass, and activation, as well as cardiac stress. These results highlight the clinical relevance of specifically assessing upper extremity aerobic performance as a meaningful indicator of functional status in PAH.

 Background: Pulmonary arterial hypertension PAH impairs aerobic capacity through combined cardiopulmonary and skeletal muscle dysfunction. However, upper extremity aerobic performance and muscle-related parameters correlates have not been widely explored in PAH population. Objective: To investigate the relationship between maximal workload achieved during an arm ergometer test and peripheral muscle parameters in adolescents and young adults with PAH. Methods: Eighteen PAH patients were evaluated; two were excluded due to protocol deviations, resulting in a final sample of 16 participants mean age: 20.4  8.2 years; 9 females. Maximum workload watts was assessed via an arm ergometer test. Handgrip strength was measured using a handgrip dynamometer, and shoulder abduction strength with a digital dynamometer ; both were converted to percent predicted using age- and sex-adjusted normative equations. Fat-free mass FFM was calculated from body composition using bioelectrical impedance analysis. Surface electromyography EMG of the anterior deltoid was recorded during the first and end stage of the exercise and expressed as  maximal voluntary isometric contraction MVIC, in accordance with Surface EMG for the Non-Invasive Assessment of Muscles SENIAM standards. Brain Natriuretic Peptide BNP levels were obtained from recent clinical records. Spearman correlation was used to evaluate associations. Results: Maximal workload was positively correlated with FFM r  0.615, p  0.011, shoulder abduction strength r  0.535, p  0.033, and handgrip strength r  0.648, p  0.014. It was negatively correlated with BNP r  0.728, p  0.005 and the maximum MVIC value of anterior deltoid EMG obtained from the first 15 seconds of the initial arm ergometer test stage r  0.602, p  0.014. A negative correlation was also observed with EMG from the final stage, though it did not reach statistical significance r0.442, p0.086. Conclusion: Upper extremity aerobic performance in PAH is significantly associated with muscle strength, mass, and activation, as well as cardiac stress. These results highlight the clinical relevance of specifically assessing upper extremity aerobic performance as a meaningful indicator of functional status in PAH.

Makale detayları

Upper Extremity Exercise Capacity in adolescent and young adult with pulmonary arterial hypertension: The Role of Muscle Function

Yazarlar:

Jan Dik | Ceyhun Topcuoğlu | Naciye Vardar Yaglı | Ebru Aypar | Dursun Alehan | Melda Saglam

Yayıncı:

Hacettepe University

Ana Başlıklar:

Physiotherapy

Dergi:

Journal of Hacettepe University Physical Therapy and Rehabilitation Faculty Vol.3 Issue 3, pp.124-133

Belge Tipi:

Makale

Yayın Tarihi:

10/2025

Belge Dili:

İngilizce

Document ID (Org No.):

2001358209

pISSN:

3023-5073

Upper Extremity

Motor Activity

Electromyography

Muscle Strength

Pulmonary Hypertension

Sayı

Makale detayları

Upper Extremity Exercise Capacity in adolescent and young adult with pulmonary arterial hypertension: The Role of Muscle Function

Yazarlar: Jan Dik | Ceyhun Topcuoğlu | Naciye Vardar Yaglı | Ebru Aypar | Dursun Alehan | Melda Saglam

Yayıncı: Hacettepe University

Ana Başlıklar: Physiotherapy

Dergi: Journal of Hacettepe University Physical Therapy and Rehabilitation Faculty Vol.3 Issue 3, pp.124-133

Belge Tipi: Makale

Yayın Tarihi: 10/2025

Belge Dili: İngilizce

Document ID (Org No.): 2001358209

pISSN: 3023-5073

Upper Extremity

Motor Activity

Electromyography

Muscle Strength

Pulmonary Hypertension

Sayı

Yazarlar:

Jan Dik | Ceyhun Topcuoğlu | Naciye Vardar Yaglı | Ebru Aypar | Dursun Alehan | Melda Saglam

Yayıncı:

Hacettepe University

Ana Başlıklar:

Physiotherapy

Dergi:

Journal of Hacettepe University Physical Therapy and Rehabilitation Faculty Vol.3 Issue 3, pp.124-133

Belge Tipi:

Makale

Yayın Tarihi:

10/2025

Belge Dili:

İngilizce

Document ID (Org No.):

2001358209

pISSN:

3023-5073