Respiratory care · 2026
Acute Effects of Positive Expiratory Pressure on Breathing Pattern and Chest Wall Volumes During Cycle Exercise in COPD Patients.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Silva Lailane S, Fregonezi Guilherme A F, Pereira Hugo L A, Fagundes Marina L C, Parreira Verônica F, Lomauro Antonella, Vilaró Jordi, da Fonseca Jessica D M, Resqueti Vanessa R, Aliverti Andrea, Lima Íllia N D F
Аннотация
BACKGROUND: Patients with COPD experience air flow limitation, reduced expiratory capacity, and dynamic hyperinflation (DH), which causes dyspnea and decreased exercise tolerance. Expiratory positive airway pressure (EPAP) is a potential intervention that can reduce DH and improve respiratory muscle efficiency, but its impact on exercise tolerance remains unclear. The aim was to evaluate the acute effects of EPAP during exercise on the respiratory pattern, chest wall volumes, thoracoabdominal asynchrony (TAA), and DH in individuals with COPD using optoelectronic plethysmography.
METHODS: This is a cross-sectional, multi-center study in which the participants were divided in two moments EPAP versus SHAM doing exercise protocols on a cycle ergometer. The protocol consisted of two conditions (a) EPAP-2 min of calm breathing followed by cycling at 80% of maximum load with a 7.5 cm H2O EPAP mask until exhaustion; and (b) SHAM-the same procedure without EPAP. Effects of EPAP on chest wall volumes, breathing pattern, index of respiratory muscles shortening velocity, the TAA, and paradoxical movements were analyzed. Distribution of the data were tested using Shapiro-Wilk. The Wilcoxon test was used for between-group assessments, and two-way ANOVA or Friedman test was used to compare both groups and phases the protocol. A significance level of P < .05 was used.
RESULTS: In COPD subjects exercising at 80% of maximum load, both EPAP and SHAM increased chest wall volumes, with EPAP showing greater recovery values and higher abdominal volume (0.74 ± 0.4 L vs 0.58 ± 0.2 L). EPAP maintained higher TI, TE, and Ttot at 50%Tlim (Time to Limitation) and Tlim but had lower minute ventilation (Tlim 29.6 ± 11.7 vs 34.7 ± 13.1 L/min, P < .001) and reduced exercise tolerance (P = .001) with greater dyspnea (P = .001). It also increased end-inspiratory chest wall volume at 50% Tlim and recovery (P < .001), sustained rib cage expansion, and reduced diaphragm shortening velocity during exercise. Phase angle differences indicated more TAA with EPAP at Tlim (P = .002), although paradoxical movements increased similarly in both groups during exercise.
CONCLUSIONS: The use of EPAP during exercise in subjects with COPD tended to increase dyspnea, increase TAA, and reduce exercise tolerance without significant improvement in DH.
METHODS: This is a cross-sectional, multi-center study in which the participants were divided in two moments EPAP versus SHAM doing exercise protocols on a cycle ergometer. The protocol consisted of two conditions (a) EPAP-2 min of calm breathing followed by cycling at 80% of maximum load with a 7.5 cm H2O EPAP mask until exhaustion; and (b) SHAM-the same procedure without EPAP. Effects of EPAP on chest wall volumes, breathing pattern, index of respiratory muscles shortening velocity, the TAA, and paradoxical movements were analyzed. Distribution of the data were tested using Shapiro-Wilk. The Wilcoxon test was used for between-group assessments, and two-way ANOVA or Friedman test was used to compare both groups and phases the protocol. A significance level of P < .05 was used.
RESULTS: In COPD subjects exercising at 80% of maximum load, both EPAP and SHAM increased chest wall volumes, with EPAP showing greater recovery values and higher abdominal volume (0.74 ± 0.4 L vs 0.58 ± 0.2 L). EPAP maintained higher TI, TE, and Ttot at 50%Tlim (Time to Limitation) and Tlim but had lower minute ventilation (Tlim 29.6 ± 11.7 vs 34.7 ± 13.1 L/min, P < .001) and reduced exercise tolerance (P = .001) with greater dyspnea (P = .001). It also increased end-inspiratory chest wall volume at 50% Tlim and recovery (P < .001), sustained rib cage expansion, and reduced diaphragm shortening velocity during exercise. Phase angle differences indicated more TAA with EPAP at Tlim (P = .002), although paradoxical movements increased similarly in both groups during exercise.
CONCLUSIONS: The use of EPAP during exercise in subjects with COPD tended to increase dyspnea, increase TAA, and reduce exercise tolerance without significant improvement in DH.