Dynamic hyperinflation and dyspnea during the 6-minute walk test in stable chronic obstructive pulmonary disease patients

Satake, Masahiro; Shioya, Takanobu; Uemura, Sachiko; Takahashi, Hitomi; Sugawara, Keiyu; Kasai, Chikage; Kiyokawa, Noritaka; Watanabe, Tôru; Sato, Sayaka; Kawagoshi, Atsuyoshi

doi:10.2147/copd.s73717

Cited by 25 publications

(27 citation statements)

References 22 publications

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“…The functional consequences of airflow limitation in COPD, especially lung hyperinflation, may provide a physiological basis for sensations of dyspnoea both at rest and during exertion [6,30]. In people with COPD, dynamic hyperinflation has been reported during 6MWTs [31,32], short duration activities of daily living [33][34][35] and controlled strenuous exercise tests [5,6]. While plethysmography has been reported to systematically overestimate static lung volumes in clinical settings [36], in this study the highest significant correlations between static lung function and D-12/MDP scores were between measures of volume/capacity rather than airflow (daily life: inspiratory capacity % pred and MDP-A1 r= −0.27, 95% CI −0.47-−0.04; end of walk test: RV/TLC % pred and D-12 Total r=0.39, 95% CI 0.17-0.57), although the strength of association was modest.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the Dyspnoea-12 and Multidimensional Dyspnoea Profile in people with COPD

2016

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We directly compared convergent, discriminant and concurrent validity of the Dyspnoea-12 (D-12) and Multidimensional Dyspnoea Profile (MDP) in people with chronic obstructive pulmonary disease.Breathlessness measures (D-12, MDP, visual analogue scales and descriptors) were completed for two focal periods (daily life and end of walk test). Instrument structure (D-12 and MDP item grouping) was assessed with factor analysis. Differences between airflow severity stage and focal periods (ANOVA, t-test and Chi-squared test), associations between D-12 and MDP (r, r for static pulmonary function, 6-min walk test and self-reported measures of impairment) and individual consistency for comparable items of the D-12 and MDP (McNemar's test) were assessed.In 84 participants (mean±sd age 70±9 years, 47 males, forced expiratory volume in 1 s 48±17% predicted), item groupings were confirmed for both focal periods. Developer-recommended single and subdomain scores were highly correlated, and demonstrated similar convergent, discriminant and concurrent validity. Individual consistency differed between the D-12 and MDP according to item/item groups.At the level of developer-recommended single and subdomain scores, the D-12 and MDP share similar psychometric properties, but these instruments serve different purposes, do not assess the same sensations or emotions and are not interchangeable.

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Section: Discussionmentioning

confidence: 99%

Comparison of the Dyspnoea-12 and Multidimensional Dyspnoea Profile in people with COPD

2016

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“…Furthermore, the mean Borg score of the COPD subjects after completing our test using the Oxycon mobile system was comparable to COPD subjects completing a 6MWT without the system, as well as another study with subjects using the system (Borg scores 4.8, 5.0, and 4.6, respectively). 12,28 We also explored the subjective tolerability of the test while using the Oxycon mobile device. Despite the relatively small size of the group and a lack of external validation of the questionnaire, the scores provided some useful information.…”

Section: Discussionmentioning

confidence: 99%

“…However, it was demonstrated that the system also showed promise for studying dynamic hyperinflation during steady-state exercise in healthy subjects 11 and during the 6MWT in a cohort of male Asian subjects with COPD. 12 Because these studies lacked evaluating 6MWT in healthy subjects and a comparison between subjects with COPD and healthy subjects, concerns remained about the additional clinical value and tolerability of the device, as well as about the potential to differentiate normal conditions from pathologic conditions.…”

Section: Introductionmentioning

confidence: 99%

Measurement of Dynamic Hyperinflation During the 6-Minute Walk Test Using a Mobile Device

et al. 2018

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BACKGROUND: Dynamic hyperinflation is a major cause of dyspnea in patients with COPD. Dynamic hyperinflation is usually measured with cardiopulmonary exercise testing, but this test requires maximal effort from the patient, and inspiratory capacity (IC) measurements may influence test results. This study investigated another approach by measuring dynamic hyperinflation during the more natural and better-tolerated 6-min walk test (6MWT), using a mobile system for IC measurements. METHODS: Twenty subjects were studied, including 10 healthy subjects and 10 subjects with COPD. Each subject performed a pair of 6MWTs. RESULTS: The study showed that test-retest reliability in healthy subjects was excellent (intraclass correlation coefficient 0.995). In addition, mean resting IC in healthy subjects (3.27 ؎ 0.77 L) was not affected at the end of the 6MWT, whereas mean resting IC in subjects with COPD (2.45 ؎ 0.90 L) decreased to 1.93 L ؎ 0.68 L at the end of the 6MWT (P ‫؍‬ .004). The tolerability of the device for subjects with COPD appeared to be only slightly hampered by an increased sense of dyspnea attributed to wearing a mask. CONCLUSIONS: This study provides a proof of principle for mobile IC measurements during the 6MWT, demonstrating good test performance, reasonable tolerability, and a power to differentiate normal from pathologic conditions.

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“…There is, however, a strong inverse association between daily physical activity and dynamic hyperinflation, which correlates strongly with exertional dyspnea in COPD. 54,55 In contrast to resting lung function testing, performance on lower-limb muscle function tests and field exercise tests correlates better with physical activity in COPD. Daily symptoms (e.g., dyspnea and fatigue) are associated with lower physical activity levels in patients with COPD.…”

Section: Pulmonary Research and Respiratory Medicine Issn 2377-1658mentioning

confidence: 99%

“…Daily symptoms (e.g., dyspnea and fatigue) are associated with lower physical activity levels in patients with COPD. 54,55 Impaired health status is weakly-to-moderately related to physical activity in patients with COPD. 56,57 Interestingly, this association was confirmed in a 5-year longitudinal observational study, showing that a decline in physical activity is associated with a decline in health status in patients with COPD.…”

Section: Pulmonary Research and Respiratory Medicine Issn 2377-1658mentioning

confidence: 99%

Recent Advances in Pulmonary Rehabilitation for Patients with COPD

Shioya¹,

Iwakura²,

Kawagoshi³

et al. 2017

Pulm Res Respir Med Open J

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Pulmonary rehabilitation (PR) is a non-pharmacologic therapy that has emerged as a standard of care for patients with chronic obstructive pulmonary disease (COPD). It is a comprehensive, multidisciplinary, patient-centered intervention that includes patient assessment, exercise training, self-management education, and psychosocial support. PR is usually given in inpatient, outpatient, community-based or home-based setting lasting 8-12 weeks. Positive outcomes from PR include increased exercise tolerance, reduced dyspnea and anxiety, increased selfefficacy, and improvement in health-related quality of life (QoL). Hospital admissions after exacerbations of COPD are also reduced with this intervention. The positive outcomes associated with PR are realized without demonstrable improvements in lung function. This paradox is explained by the fact that PR identifies and treats the systemic effects of the disease. This intervention should be considered in patients who remain symptomatic or have decreased functional status despite optimal medical management. Physical activity in patients with COPD is dependent on many factors, including physiologic, behavioral, social, environmental, and cultural factors. A strong inverse association between daily physical activity and dynamic hyperinflation, which correlates strongly with exertional dyspnea in COPD. Changing physical activity behavior inpatients with COPD needs an interdisciplinary approach, bringing together respiratory medicine, rehabilitation sciences, social sciences, and behavioral sciences. There is a need for more education and learning opportunities for primary care physicians, nurse practitioners, and all allied health care professionals about the process and benefits of PR. There is also a need for the sustainability and the safety of PR in the future study.

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Dynamic hyperinflation and dyspnea during the 6-minute walk test in stable chronic obstructive pulmonary disease patients

Cited by 25 publications

References 22 publications

Comparison of the Dyspnoea-12 and Multidimensional Dyspnoea Profile in people with COPD

Comparison of the Dyspnoea-12 and Multidimensional Dyspnoea Profile in people with COPD

Measurement of Dynamic Hyperinflation During the 6-Minute Walk Test Using a Mobile Device

Recent Advances in Pulmonary Rehabilitation for Patients with COPD

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