ACUTE EFFECT OF POSITIVE EXPIRATORY PRESSURE ON VOLUMES OF THE CHEST WALL AND DYNAMIC HYPERINFLATION IN COPD PATIENTS
Chronic Obstructive Pulmonary Disease, Respiratory Mechanics, Exercise.
Introduction: Chronic obstructive pulmonary disease (COPD) is a multisystemic disease characterized by slow airflow obstruction, characterized by slow progression, irreversibility and limitation of exercise capacity. One of the phenomena involved in exercise limitation is dynamic hyperinflation (DH), which
occurs in situations of increased ventilatory demand. Currently any rehabilitation technique can prevent or minimize the effects of HD. Objective: The objective of this study is to evaluate the acute effect of EPAP on HD and chest wall volumes in patients with COPD. Methodology: This is a cross-over study. WE assess: lung function and respiratory muscle strength, the level of physical activity through the Human Activity Profile, dyspnea as limiting of AVDs - Medical Research Council scale, exercise capacity with the Incremental Shuttle Walking Test (ISWT). The effect of PEP on HD and chest wall volumes where assessed during an exercise protocol of constant-load performed on an cycloergometric concomitant with the evaluation of the chest wall kinematics with Opetoeletronic Pletismography system. Results: Five patients with a mean age of 63.6 ± 7.7 years, FEV1 (% pred.) were evaluated: 44.6 ± 11.9, FEV1/ FVC: 0.48 ± 0.06, with diagnosed COPD and classification moderate to severe (GOLD criteria). Conclusions: Preliminary results showed an improvement in
the breathing pattern during PEP use at the time of exercise, however with a tendency to DH in the chest wall compartment.