Effect of a Conical-PEP Mask on Exercise in Subjects With COPD.
BACKGROUND: Dynamic hyperinflation (DH) is a major pathophysiology of COPD that is directly related to dyspnea and exercise intolerance. Positive expiratory pressure (PEP) might reduce DH and dyspnea during exercise, but at present, there is insufficient evidence to conclude whether it is beneficial...
| Publicado en: | Respiratory Care Vol. 69; no. 2; pp. 191 - 202 |
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| Autores principales: | , , , , , |
| Formato: | CEU pictorial research tables/charts randomized controlled trial Journal Article |
| Publicado: |
Mary Ann Liebert, Inc.
Feb2024
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=174985105&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 174985105 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00201324 4GG jtl: Respiratory Care issn: 00201324 maglogo: N pubinfo: dt: Feb2024 vid: 69 iid: 2 pid: 1365 pub: Mary Ann Liebert, Inc. place: New Rochelle, New York artinfo: ui: 174985105 174985105 174985105 10.4187/respcare.11016 174985105 ppf: 191 ppct: 11 formats: fmt: @attributes: type: P tig: atl: Effect of a Conical-PEP Mask on Exercise in Subjects With COPD. aug: au: Chulee Ubolsakka-Jones Jones, David A. Malipron Pukdeechat Watchara Boonsawat Wilaiwan Khrisanapant Chatchai Phimphasak affil: School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand sug: subj: Pulmonary Disease, Chronic Obstructive Masks Evaluation Positive End-Expiratory Pressure Exercise Dyspnea Training Effect (Physiology) Cardiopulmonary Physiology Human Thailand Female Male Middle Age Aged Education, Continuing (Credit) Professional Development Randomized Controlled Trials Random Assignment Crossover Design Forced Expiratory Volume Scales Clinical Assessment Tools Peak Expiratory Flow Rate Inspiration, Respiratory Spirometry Electrocardiography Blood Pressure Determination Outcome Assessment Comparative Studies T-Tests Wilcoxon Signed Rank Test Data Analysis Software Descriptive Statistics Middle Aged: 45-64 years Aged: 65+ years Female Male ab: BACKGROUND: Dynamic hyperinflation (DH) is a major pathophysiology of COPD that is directly related to dyspnea and exercise intolerance. Positive expiratory pressure (PEP) might reduce DH and dyspnea during exercise, but at present, there is insufficient evidence to conclude whether it is beneficial for DH, dyspnea, and exercise capacity in COPD. METHODS: A randomized crossover trial with concealed allocation was conducted in 37 moderate to very severe subjects with COPD (34 males, age 66.6 ± 7.4 y, FEV1% of predicted 56.3 ± 13.7). The experimental condition was conical-PEP breathing with a PEP of around 5 cm H2O during a spot marching exercise at a constant speed, inducing 71 6 9% age-predicted maximum heart rate to symptom limit or 25 min. The control condition was usual breathing. Exercise endurance time and end-exercise symptoms were recorded. Inspiratory capacity (IC) was measured pre-exercise and immediately post exercise. Cardiopulmonary function and breathlessness were monitored throughout the test and after 10 min of recovery. RESULTS: There were no complications or adverse effects during exercise with a conical-PEP mask. Conical-PEP showed longer exercise times than control (median 11.0 [interquartile range 7.7-17.0] min vs 8 [6.0-11.5] min, respectively, P < .001). Most stopped exercising because of breathlessness and leg fatigue. At the end of exercise, IC and breathlessness showed non-significant differences between the conditions, but breathlessness was significantly lower in conical-PEP (median 4 [1.5-5.0] than control 5 [3-6] on Borg scale at isotime for control [8 min]). CONCLUSIONS: Breathing with a 5 cm H2O conical-PEP mask improved exercise time (median 27.1% [0.6-52.9]) in subjects with COPD. The improvement in exercise with the conical-PEP mask was associated with slower development of breathlessness, possibly due to delays in DH development. pubtype: Academic Journal doctype: CEU pictorial research tables/charts randomized controlled trial Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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