Can a physical activity similar to activities of daily living cause dynamic hyperinflation and change the thoracoabdominal configuration in patients with chronic obstructive pulmonary disease?

Abstract

Introduction: COPD is characterized by the ventilatory limitation, with reduction of the inspiratory reserve volume and dynamic hyperinflation (DH), which changes the configuration of the thoracic compartment, resulting in a disadvantage in respiratory muscle kinetics, and reduced functional capacity. The optoelectronic plethysmography (OEP) has been used to monitor changes in thoracoabdominal mobility. The Glittre-ADL test is a short battery of functional tests that simulate activities of daily living. In mild and moderate COPD, the effect of Glittre-ADL on thoracoabdominal kinetics and DH is understudied.

Objective: The aim of our study was to evaluate the acute effects of the Glittre-ADL test on lung function and thoracoabdominal mobility using OEP in patients with mild and moderate COPD.

Materials and methods: Twenty-five male and female patients between 45 and 80 years of age with COPD were submitted to the exercises that simulated Glittre-ADL test. Spirometry and OEP were performed before and after the test.

Results: After the Glittre test, increases were found in EV (p=0.005), percentage of contribution of the abdominal compartment (p=0.054) and expiratory reserve volume (ERV) (p=0.006) and reductions were found in the contribution of the upper thoracic compartment (p=0.008) and inspiratory capacity (IC) (p=0.040).

Conclusion: The acute effect of ADL was a change in thoracoabdominal kinetics, especially the percentage of contribution of the abdominal compartment, as demonstrated by OEP. These findings, together with the reduction in IC and increase in ERV, after the Glittre-ADL test suggest the occurrence of DH, even in patients with mild to moderate COPD according to the GOLD classification.

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Keywords:

• COPD
• dynamic hyperinflation
• plethysmography

Acknowledgements

The authors would like to acknowledge grateful to all patients who agreed to participate in this study and to the Respiratory Functional Evaluation Laboratories (LARESP) and the Multidisciplinary Laboratory for the Analysis of the Human Movement (LMAMH), from Post-graduate Program of the Rehabilitation´s Sciences in UNINOVE.

Disclosure

The authors report no conflicts of interest in this work.