Dynamic hyperinflation and exercise limitations in obese asthmatic women

Autor(es)

Ferreira, Palmira Gabriele ; Freitas, Patricia Duarte ; Silva, Aline Grandi ; Porras, Desiderio Cano ; Stelmach, Rafael ; Cukier, Alberto ; Arrabal Fernandes, Frederico Leon ; Martins, Milton Arruda ; Carvalho, Celso R. F.

• Tipo de documento: Artigo Científico
• Fonte: Journal of Applied Physiology; v. 123, n. 3, p. 585-593, SEP 2017.
• Citações Web of Science: 5

Resumo

Obese individuals and patients with asthma can develop dynamic hyperinflation (DH) during exercise; however, no previous study has investigated DH as a factor associated with reduced exercise capacity in obese asthmatic women. The aim of the present study was to examine the occurrence of DH and exercise limitations in obese asthmatics. Obese grade II {[}obese group (Ob-G); BMI 35-39.9 kg/m(2); n = 36] and nonobese {[}nonobese group (NOb-G); BMI 18.5-29.9 kg/m(2); n = 18] asthmatic patients performed a cardiopulmonary test to quantify peak (V) over dot(O2) and a sub-maximal exercise test to assess DH. Anthropometric measurements, quadriceps endurance, and lung function were also evaluated. A forward stepwise regression was used to evaluate the association between exercise tolerance (wattage) and limiting exercise factors. Fifty-four patients completed the protocol. The Ob-G (n = 36) presented higher peak (V) over dot(O2) values but lower power-to-weight ratio values than the NOb-G (P < 0.05). DH was more common in the Ob-G (72.2%) than in the NOb-G (38.9%, P < 0.05). The Ob-G had a greater reduction in the inspiratory capacity (-18 vs. -4.6%, P < 0.05). Exercise tolerance was associated with quadriceps endurance (r = 0.65; p < 0.001), oxygen pulse (r = 0.52; p = 0.001), and DH (r = -0.46, P = 0.005). The multiple regression analysis showed that the exercise tolerance could be predicted from a linear association only for muscular endurance (r = 0.82 and r(2) = 0.67). This study shows that dynamic hyperinflation is a common condition in obese asthmatics; they have reduced fitness for activities of daily living compared to nonobese asthmatics. However, peripheral limitation was the main factor associated with reduced capacity of exercise in these patients. NEW \& NOTEWORTHY This is the first study to investigate the occurrence of dynamic hyperinflation (DH) in obese asthmatics. Our results demonstrate that obese asthmatics present a higher frequency and intensity of DH than nonobese asthmatics. We also show that physical deconditioning in this population is linearly associated with cardiac (O-2 pulse), respiratory (DH), and peripheral muscle (resistance) limitation. However, multiple linear regression demonstrated that peripheral muscle limitation may explain the exercise limitation in this population. (AU)

• Processo FAPESP: 12/16700-9 - Análise dos fatores limitantes do exercício e efeitos de um programa de exercício físico no controle clínico e nos fatores de saúde relacionados à qualidade de vida em asmáticos obesos
• Beneficiário: Celso Ricardo Fernandes de Carvalho
• Modalidade de apoio: Auxílio à Pesquisa - Regular