Noninvasive Ventilation as an Important Adjunct to an Exercise Training Program in Subjects With Moderate to Severe COPD

Autor(es)

Marrara, Kamilla Tays ^{[1, 2]} ; Pires Di Lorenzo, Valeria Amorim ^[3] ; Jaenisch, Rodrigo B. ^[1] ; Cabiddu, Ramona ^[1] ; Sato, Tatiana de Oliveira ^[4] ; Mendes, Renata Goncalves ^[1] ; Oliveira, Claudio R. ^[5] ; Costa, Dirceu ^[6] ; Borghi-Silva, Audrey ^[1]

Afiliação do(s) autor(es)

^[1] Univ Fed Sao Carlos, Cardiopulm Physiotherapy Lab, Sao Carlos, SP - Brazil

^[2] Cent Univ Sao Paulo, Sao Carlos, SP - Brazil

^[3] Univ Fed Sao Carlos, Res Lab Spirometry & Resp Physiotherapy, Sao Carlos, SP - Brazil

^[4] Univ Fed Sao Carlos, Prevent Physiotherapy & Ergon Lab, Sao Carlos, SP - Brazil

^[5] Univ Fed Sao Carlos, Dept Med, Sao Carlos, SP - Brazil

^[6] Univ Nove Julho, Sao Paulo - Brazil

• Tipo de documento: Artigo Científico
• Fonte: Respiratory Care; v. 63, n. 11, p. 1388-1398, NOV 1 2018.
• Citações Web of Science: 1

Resumo

BACKGROUND: The primary objective of this study was to investigate whether noninvasive ventilation (NIV) can positively affect exercise capacity, maximum oxygen uptake (V-O2), and symptoms after a 6-week physical training program for subjects with moderate to very severe COPD. METHODS: 47 subjects with COPD who were enrolled in a physical training program were randomized to either physical training alone or NIV + physical training (NIV-Physical training). Physical training consisted of dynamic aerobic exercises on a treadmill 3 times/week for 6 weeks, for a total of 18 sessions. NIV was titrated according to the subject's tolerance at rest and during exercise. Assessments included physiological responses and symptoms at the incremental cardio-pulmonary exercise test peak and during submaximal exercise on a treadmill, 6-min walk distance, maximum inspiratory (P-IMAX) and expiratory pressure (P-EMAX), BODE index, and health-related quality of life. RESULTS: 43 subjects completed the 6-week physical training program. Both groups improved 6-min walk distance, P-IMAX, BODE index, and quality of life, and no differences were found between groups. However, significant improvements were observed for subjects in the NIV-Physical training group with regard to P(EMAX, )maximum V-O2, maximum metabolic equivalents, circulatory power, and maximum S-pO2. CONCLUSIONS: A 6-week physical training program alone can improve tolerance for exercise and quality of life, in addition to reducing the risk of mortality. However, NIV associated with a physical training program was shown to have an additive beneficial effect on powerful prognostic markers (maximum V(O2 )and circulatory power) and to reduce symptoms and improve oxygen saturation in subjects with moderate to very severe COPD. (AU)

• Processo FAPESP: 09/01842-0 - Análise dos ajustes centrais e metabólicos periféricos durante o exercício físico dinâmico versus resistido em pacientes com DAC: efeitos de um programa de treinamento resistido baseado na determinação do limiar anaeróbio por diferentes metodologias
• Beneficiário: Audrey Borghi Silva
• Modalidade de apoio: Auxílio à Pesquisa - Jovens Pesquisadores