呼吸器疾患に伴うADL・QOLの低下と運動器

Osteoporosis and Respiratory Diseases. Reduced ADL, QOL and musculoskeletal dysfunction associated with respiratory disease.

　慢性呼吸器疾患，特に慢性閉塞性肺疾患（COPD）は世界中で健康，経済的損失を引き起こしている。中等症から重症のCOPD患者の下肢筋肉機能障害は重大な呼吸器以外の合併症で運動耐容能力低下，ADLやHRQOL障害，さらには生存までも左右する重要な臨床的意味合いを持つ。また骨粗鬆症は重要な呼吸器以外の合併症であり，経済的損失を含み，換気障害など多彩な症状や合併症を引き起こす。これらの障害に対しては，薬物療法や非薬物療法を含む包括的治療（呼吸リハビリテーション）が推奨される。呼吸リハビリテーションはCOPDの死亡原因の予測因子となる息切れ，ADLやHRQOLの改善，運動耐容能力の上昇をもたらす。

　Chronic respiratory disease, such as chronic obstructive pulmonary disease（COPD）continues to cause a heavy health and economic burden in the world. Lower-limb muscle dysfunction is a prominent and major extrapulmonary features in individuals with moderate-to-very severe COPD and has important clinical implications, such as reduced exercise tolerance, activity of daily living（ADL）, health related quality of life（HRQOL）and even survival. Osteoporosis is also an important systemic feature of COPD. Osteoprotic fracture cause many symptoms and complications, including the impairment of ventilation, and create a heavy economic burden. Comprehensive treatments（drug medication and non-drug treatment）for these impairments, such as pulmonary rehabilitation, are recommended. Pulmonary rehabilitation improves dyspnea, exercise capacity, ADL, and HRQOL, each of which is recognized predictors of mortality.