Effects of cpap on the physical exercise tolerance of moderate to severe chronic obstructive pulmonary disease

Authors

  • Michel Silva Reis
  • Hugo Reis
  • Daniel Teixeira Sobral
  • Aparecida Maria Catai
  • Audrey Borghi Silva

Keywords:

noninvasive ventilation, COPD, exercise tolerance, CPAP

Abstract

Objective: The aim of this study was to evaluate the effect of continuous positive airway pressure (CPAP) on the exercise tolerance of patients with moderate to severe chronic obstructive pulmonary disease (COPD).

Methods: ten men with COPD (69 ± 9 years), FEV1/FVC (58.90 ± 11.86%) and FEV1 (40.98 ± 10.97% of predict) were submitted to a symptom-limited incremental exercise test (IT) on the cyclo ergometer. Later, on another visit, they were randomized to perform a constant load exercise protocol until maximal tolerance with and without CPAP (5 cm H2O) in the following conditions: i) 50% of the peak workload; and ii) 75% of the peak workload. Heart rate (HR), arterial pressure (AP) and peripheral oxygen saturation were obtained at rest and during the exercise protocols. For statistical procedures, Shapiro-Wilk normality test and two-way ANOVA with Tukey post hoc (p<0.05) were performed.

Results: There was a significant improvement in exercise time tolerance during the 75% of the peak workload protocol with CPAP when compared with spontaneous breath (SB) (438±75 vs. 344±73ms, respectively).

Conclusion: CPAP with 5 cm H2O seems to be useful to improve exercise tolerance in patients with COPD.

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References

Borghi-Silva, A; Mendes, RG; Toledo, AC; Sampaio, LMM; Silva, TP; Kunikushita, LN, et al. Adjuncts to physical training of patients with severe COPD: Oxygen or noninvasive ventilation? RespCare. 2010; 55 (7).

Ambrosino N. Assisted ventilation as an aid to exercise training: a mechanical doping? Eur Respir J. 2006; 27: 3–5.

O`Donnel, DE; Revill, SM; Webb, KA. Dynamic hyperinflation and exercise intolerance in chronic obstructive pulmonar disease. Am J Respir Crit Care Med. 2001; 164: 770-777.

Gosker HR; Wouters EF; van der Vusse GJ; Schols AM. Skeletal muscle dysfunction in chronic obstructive pulmonary disease and chronic heart failure: underlying mechanisms and therapy perspectives. Am J Clin Nutr. 2000;71:1033–47.

Borghi-Silva A; Carrascosa C; Oliveira CC; Barroco AC; Berton DC; Vilaca D, et al. Effects of respiratory muscle unloading on leg muscle oxygenation and blood volume during high-intensity exercise in chronic heart failure. Am J Physiol Heart Circ Physiol. 2008;294:2465-2472.

Scorsone D, Bartolini S, Saporiti R, et al. Does a low-density gas mixture or oxygen supplementation improve exercise training in COPD? Chest 2010;138(5):1133–9.

Dyer F, Callaghan J, Cheema K, et al. Ambulatory oxygen improves the effectiveness of pulmonar rehabilitation in selected patients with chronic obstructive pulmonary disease. Chron Respir Dis. 2012;9(2):83–91.

Scuarcialupi, MEA; Berton, DC; Cordoni, PK; Squassoni, SD; Fiss, E; Neder, JA. Can bronchodilators improve exercise tolerance in COPD patients without dynamics hyperinflation? J Bras Pneumol. 2014; 40(2): 111-118.

Kylie, H; Holland, AE. Strategies to Enhance the Benefits of Exercise Training in the Respiratory Patient. Clin Chest Med. 2014; 323-336 (in press). http://dx.doi.org/10.1016/j.ccm.2014.02.003

Chiappa, GR; Queiroga, F; Meda, E; Ferreira, LF; Diefenthaeler, F; Nunes, M, et al. Heliox improves oxygen delivery and utilization during dynamic exercise in patients with chronic obstructive pulmonar disease. Am J Respir Crit Care Med. 2009; 179: 1004 – 1010.

Laveneziana P, Valli G, Onorati P, et al. Effect of heliox on heart rate kinetics and dynamic hyperinflation during high-intensity exercise in COPD. Eur J Appl Physiol 2011;111(2):225–34.

Vogiatzis I, Habazettl H, Aliverti A, et al. Effect of helium breathing on intercostal and quadríceps muscle blood flow during exercise in COPD patients. Am J Physiol Regul Integr Comp Physiol. 2011;300(6):R1549–59.

Queiroga F Jr, Nunes M, Meda E, et al. Exercise tolerance with helium-hyperoxia versus hyperoxia in hypoxaemic patients with COPD. Eur Respir J. 2013;42(2):362–70.

Dyer, F; Flude, L; Bazari, F; Jolley, C; Englebretsen, C; Lai, D, et al. Non-invasive ventilation (NIV) as na aid to rehabilitation in acute respiratory disease. Pulmonary Medicine. 2011; 11:58.

Hul A, Gosselink R, Hollander P, Postmus P, Kwakkele G. Training with inspiratory pressure support in patients with severe COPD. Eur Respir J 2006; 27: 65–72.

Associação de Medicina Intensiva Brasileira. Diretrizes brasileiras de Ventilação Mecânica. 2013 (versão online).

Reis, HV. Borghi-Silva, A. Catai, AM. Reis, MS. Impact of CPAP in the physical exercise tolerance and sympathetic-vagal balance of patients with chronic heart failure. Braz J Phys Ther. 2014, 18(3): 218-27.

Global initiative for chorinic obstructive lung disease: Global strategy for the diagnosis, management, and prevetion of chronic obstructive pulmonary disease. Medical Communications Resources, Inc. 2009.

Ferrer, M; Alonso, J; Morera, J; Marrades, RM; Khalaf, A; Aguar, MC et al. Chronic obstructive pulmonary disease stage and health-related quality of life. The quality of life of chronic obstructive pulmonary disease study group. Ann Intern Med, 1997; 127(12): 1072-9.

American Thoracic Society. Standardization of spirometry 1994 update. Am J Respir Crit Care Med. 1995;152:1107–1136.

Bianchi L, Foglio K, Pagani M, Vitacca M, Rossi A, Ambrosino N. Effects of proportional assist ventilation on exercise tolerance in COPD patients with chronic hypercapnia. Eur Respir J 1998; 11: 422–427.

SHI Jia-xin, XU Jin, SUN Wen-kui, SU Xin, ZHANG Yan and SHI Yi. Effect of noninvasive, positive pressure ventilation on patients with severe, stable chronic obstructive pulmonary disease: a meta-analysis. Chin Med J 2013;126 (1): 140-146.

van ’t Hul A, Kwakkel G, Gosselink R. The acute effects of noninvasive ventilatory support during exercise on exercise endurance and dyspnea in patients with chronic obstructive pulmonary disease: a systematic review. J Cardiopulm Rehabil. 2002;22(4):290–7.

Dreher M, Storre JH, Windisch W. Noninvasive ventilation during walking in patients with severe COPD: a randomised cross-over trial. Eur Respir J. 2007;29(5):930–6.

Kyroussis D, Polkey MI, Hamnegard CH, et al. Respiratory muscle activity in patients with COPD walking to exhaustion with and without pressure support. Eur Respir J. 2000;15(4):649–55.

Maltais F, Reissmann H, Gottfried SB. Pressure support reduces inspiratory effort and dyspnea during exercise in chronic airflow obstruction. Am J Respir Crit Care Med. 1995;151(4):1027–33.

Takara, LS; Cunha, TM; Barbosa, P; Rodrigues, MK; Oliveira, MF; Neder, JA et al. Dynamics of chest wall volume regulation during constant work rate exercise in patients with chronic obstructive pulmonary disease. Braz J Med Biol Res. 2012, 45 (12): 1276-1283.

Dempsey, JA, Romer, L, Rodman, J, Miller, J, Smith, C. Consequences of exercise-induced respiratory muscle work. Respir Physiol Neurobiol. 2006;151:242–250.

Mitchell, J. H. Wolffe memorial lecture. Neural control of the circulation during exercise. Med Sci Sports Exerc. 1990;22(2):141-54.

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Published

24-08-2017

How to Cite

REIS, M. S.; REIS, H.; SOBRAL, D. T.; CATAI, A. M.; SILVA, A. B. Effects of cpap on the physical exercise tolerance of moderate to severe chronic obstructive pulmonary disease. Journal of Respiratory and CardioVascular Physical Therapy, [S. l.], v. 5, n. 1, p. 13–21, 2017. Disponível em: https://periodicos.ufrn.br/revistadefisioterapia/article/view/10225. Acesso em: 21 dec. 2024.

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