File
Dantas Gomes E.L.1, Costa D.2, Feitoza C.L.2
1Nove de Julho University, Health III, São Paulo, Brazil, 2Nove de Julho University, São Paulo, Brazil
Background: Chronic obstructive pulmonary disease (COPD) is characterized by persistent obstruction which is usually progressive and associated with an inflammatory response in the airways and lungs caused by particles or gases.
Thoracoabdominal mobility of patients with COPD changes due process that causes permanent pulmonary obstructive hyperinflation, altering muscle mechanics also. Because of that, physical activity may increase the minute ventilation, reducing the time to expiration, increasing this hyperinflation.
Expiratory positive airway pressure (EPAP) is a physical therapy feature that assists in reducing the air trapping during exacerbations of COPD patients, but little is known about the effects of the EPAP on pulmonary hyperinflation.
Thoracoabdominal mobility of patients with COPD changes due process that causes permanent pulmonary obstructive hyperinflation, altering muscle mechanics also. Because of that, physical activity may increase the minute ventilation, reducing the time to expiration, increasing this hyperinflation.
Expiratory positive airway pressure (EPAP) is a physical therapy feature that assists in reducing the air trapping during exacerbations of COPD patients, but little is known about the effects of the EPAP on pulmonary hyperinflation.
Purpose: Evaluate the effects of physical effort and EPAP on pulmonary hyperinflation and Thoracoabdominal mobility through opto-eletronic plethysmography (OEP) in patients with COPD and in healthy individuals.
Methods: Thoracoabdominal mobility was assessed by OEP in 30 subjects; 15 with COPD level IIA of GOLD and 15 healthy, before and after performing a battery of exercise going up and down stairs, by two minutes and after conducting a battery of exercise with EPAP (8cmH2O). The OEP Protocol was made rest, after 2 minutes step and after EPAP.
Results: The groups were composed of 15 patients with COPD, that the feature of the sample were classified as GOLD IIA and 15 healthy subjects (CG). The anthropometric data of the population studied as weight and height showed no difference.
Already, the spirometry variables showed significant difference as expected. The average age was of 58.1 ± 11 years. With regard to the variables of the OEP there were no significant differences at rest between the groups with the exception of Ti/Ttot COPD group with median of 0.77 characterizing obstruction/fatigue.
After the 2-minute step the COPD group present an increase in abdominal participation greater than the CG (52.2 ± 12.6% x 41.1 ± 14.6%, p = 0.02). After EPAP an increase of the intermediate compartment in CG (19.9 ± 5.08% x 26.4 ± 9%, p = 0.02) and abdominal compartment of the COPD group (50.5 ± 19.1% X 36.9 ± 16.4%, p = 0.04). After the EPAP had a normalization of Ti/Ttot in COPD group with median 0.41.
Conclusion(s): The physical effort and the use of EPAP alter the participation of thoracic and abdominal compartments differently between the groups and EPAP in COPD appears to contribute to the reduction of the hyperinflation.
Implications: The better understanding of COPD respiratory mechanics by precise technologies helps us understand the effect of commonly used interventions for a new optics.
Funding acknowledgements: FAPES, CNPq, Capes
Topic: Cardiorespiratory
Ethics approval: UNINOVE Comithee Board:779133/2016
All authors, affiliations and abstracts have been published as submitted.
