Breathing pattern and thoracoabdominal motion during exercise in chronic obstructive pulmonary disease

Abstract

Subjects with chronic obstructive pulmonary disease (COPD) present breathing pattern and thoracoabdominal motion abnormalities that may contribute to exercise limitation. Twenty-two men with stable COPD (FEV 1 = 42.6 ± 13.5% predicted; age 68 ± 8 years; mean ± SD) on usual medication and with at least 5 years of diagnosis were evaluated at rest and during an incremental cycle exercise test (10 watts/2 min). Changes in respiratory frequency, tidal volume, rib cage and abdominal motion contribution to tidal volume and the phase angle that measures the asynchrony were analyzed by inductive respiratory plethysmography at rest and during three levels of exercise (30-50, 70-80, and 100% maximal work load). Repeated measures ANOVA followed by pre-planned contrasts and Bonferroni corrections were used for analyses. As expected, the greater the exercise intensity the higher the tidal volume and respiratory frequency. Abdominal motion contributed to the tidal volume increase (rest: 49.82 ± 11.19% vs exercise: 64.15 ± 9.7%, 63.41 ± 10%, and 65.56 ± 10.2%, respectively, P < 0.001) as well as the asynchrony [phase angle: 11.95 ± 7.24° at rest vs 22.2 ± 15° (P = 0.002), 22.6 ± 9° (P < 0.001), and 22.7 ± 8° (P < 0.001), respectively, at the three levels of exercise]. In conclusion, the increase in ventilation during exercise in COPD patients was associated with the major motion of the abdominal compartment and with an increase in the asynchrony independent of exercise intensity. It suggests that cycling exercise is an effective way of enhancing ventilation in COPD patients.

Lower-limb endurance training program influences thoracoabdominal motion of patients with COPD?

“…PhAng is the TAM variable most often reported in these patients (5,7,8). It was observed a large variability in PhAng mean values among these studies and important variability among…”

“…According to the literature, these patients present more thoracoabdominal asynchrony compared to healthy subjects, both at rest (5,8) and during exercise (9). Exercise may reinforce the asynchrony in patients with COPD (7,9), and the presence of asynchronous TAM in these patients was associated with higher severity of the disease, increased risk of respiratory failure and worse prognosis (1)(2)(3). However, in most of the studies objective measurements were not used (1)(2)(3)9).…”

“…1-Phase Angle (PhAng): it reflects the delay between RC and AB excursions and has been studied in patients with COPD (5,7,8). It ranges from 0° (perfect synchrony) to 180° (paradoxical movement) (26).…”

Padrão respiratório e movimento toracoabdominal em indivíduos saudáveis: influência da idade e do sexo

“…To evaluate the breathing pattern and thoracoabdominal motion, respiratory inductive plethysmography was used (Respitrace ® , Nims, Miami, FL, USA). This is a noninvasive method that requires little exertion by the participant; it has been shown to be accurate [22][23][24] and has been used in previous studies 3,5,7,[10][11][12][14][15][16][17][25][26][27][28][29][30][31][32] . Respiratory inductive plethysmography measurements are based on changes to the cross-sectional area detected by two inductance bands.…”

“…The presence of greater thoracoabdominal asynchrony observed among the elderly participants may have been due to structural modifications to the rib cage, weakness of the respiratory muscles, and changes to the respiratory drive 41 , given that these factors may increase respiratory overload 25 . The influence of age on thoracoabdominal asynchrony was previously evaluated among 18 elderly individuals 7 .…”