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Background: The six-minute stepper test (6MST) is a self-paced test considered a valid tool to assess functional capacity in stable COPD patients. However, a high floor effect, where a large proportion of participants reach the minimum score when using the measurement instrument, might compromise the test validity in the hospital setting. Therefore, this study aimed at verifying the concurrent validity of 6MST in hospitalized patients with acute exacerbation of COPD (AECOPD). Methods: A cross-sectional study was conducted in a tertiary hospital. Patients who were hospitalized due to AECOPD were considered for inclusion. On the first day, when patients reached minimum clinical criteria considered as the use of non-invasive ventilation less than 2 h for 6 h/period, dyspnea at rest less than 7 (very severe) on the modified Borg scale, a respiratory rate less than 25 breaths per minute, oxygen pulse saturation greater than 88% (considering use of supplemental oxygen) and absence of paradoxical breathing pattern, they underwent a lung function evaluation and answered three questionnaires: Chronic Respiratory Questionnaire (CRQ), Modified Medical Research Council Dyspnea Scale (MMRC), and COPD Assessment Test (CAT). Then, on two consecutive days, patients performed 6MST or six-minute walk test (6MWT), in random order. Each test was performed twice, and the best performance was recorded. Also, the patient's severity was classified according to the BODE index. Inspiratory capacity measurements were performed before and after each test execution. Results: Sixteen patients (69.4 ± 11.4 years) with a mean FEV1 of 49.4 ± 9.9% predicted were included (9 females). There was a strong correlation of the performance in 6MST (number of cycles) with 6MWT (distance walked in meters) in absolute values (r = 0.87, p < 0.001) as well as with the percentage of predicted normal 6MWT (r = 0.86, p < 0.001). There was a strong correlation between the performance in 6MST with the dynamic hyperinflation (r = 0.72, p = 0.002) and a moderate correlation between 6MST with the percentage of reduction of inspiratory capacity (r = 0.68, p = 0.004). We also identified that 6MST showed moderate negative correlations with CAT (r = -0.62, p = 0.01) and BODE index (r = -0.59, p = 0.01). Conclusion: It could be concluded that 6MST is valid for evaluating functional capacity in hospitalized patients with exacerbated COPD.
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BACKGROUND: Exercise intolerance, desaturation, and dyspnea are common features in patients with chronic obstructive pulmonary disease (COPD). At altitude, the barometric pressure (BP) decreases, and therefore the inspired oxygen pressure and the partial pressure of arterial oxygen (PaO2) also decrease in healthy subjects and even more in patients with COPD. Most of the studies evaluating ventilation and arterial blood gas (ABG) during exercise in COPD patients have been conducted at sea level and in small populations of people ascending to high altitudes. Our objective was to compare exercise capacity, gas exchange, ventilatory alterations, and symptoms in COPD patients at the altitude of Bogotá (2,640 m), of all degrees of severity. METHODS: Measurement during a cardiopulmonary exercise test of oxygen consumption (VO2), minute ventilation (VE), tidal volume (VT), heart rate (HR), ventilatory equivalents of CO2 (VE/VCO2), inspiratory capacity (IC), end-tidal carbon dioxide tension (PETCO2), and ABG. For the comparison of the variables between the control subjects and the patients according to the GOLD stages, the non-parametric Kruskal-Wallis test or the one-way analysis of variance test was used. RESULTS: Eighty-one controls and 525 patients with COPD aged 67.5 ± 9.1 years were included. Compared with controls, COPD patients had lower VO2 and VE (p < 0.001) and higher VE/VCO2 (p = 0.001), A-aPO2, and V D /V T (p < 0.001). In COPD patients, PaO2 and saturation decreased, and delta IC (p = 0.004) and VT/IC increased (p = 0.002). These alterations were also seen in mild COPD and progressed with increasing severity of the obstruction. CONCLUSION: The main findings of this study in COPD patients residing at high altitude were a progressive decrease in exercise capacity, increased dyspnea, dynamic hyperinflation, restrictive mechanical constraints, and gas exchange abnormalities during exercise, across GOLD stages 1-4. In patients with mild COPD, there were also lower exercise capacity and gas exchange alterations, with significant differences from controls. Compared with studies at sea level, because of the lower inspired oxygen pressure and the compensatory increase in ventilation, hypoxemia at rest and during exercise was more severe; PaCO2 and PETCO2 were lower; and VE/VO2 was higher.
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Introduction: COPD is characterized by the ventilatory limitation, with reduction of the inspiratory reserve volume and dynamic hyperinflation (DH), which changes the configuration of the thoracic compartment, resulting in a disadvantage in respiratory muscle kinetics, and reduced functional capacity. The optoelectronic plethysmography (OEP) has been used to monitor changes in thoracoabdominal mobility. The Glittre-ADL test is a short battery of functional tests that simulate activities of daily living. In mild and moderate COPD, the effect of Glittre-ADL on thoracoabdominal kinetics and DH is understudied. Objective: The aim of our study was to evaluate the acute effects of the Glittre-ADL test on lung function and thoracoabdominal mobility using OEP in patients with mild and moderate COPD. Materials and methods: Twenty-five male and female patients between 45 and 80 years of age with COPD were submitted to the exercises that simulated Glittre-ADL test. Spirometry and OEP were performed before and after the test. Results: After the Glittre test, increases were found in EV (p=0.005), percentage of contribution of the abdominal compartment (p=0.054) and expiratory reserve volume (ERV) (p=0.006) and reductions were found in the contribution of the upper thoracic compartment (p=0.008) and inspiratory capacity (IC) (p=0.040). Conclusion: The acute effect of ADL was a change in thoracoabdominal kinetics, especially the percentage of contribution of the abdominal compartment, as demonstrated by OEP. These findings, together with the reduction in IC and increase in ERV, after the Glittre-ADL test suggest the occurrence of DH, even in patients with mild to moderate COPD according to the GOLD classification.
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Atividades Cotidianas , Teste de Esforço/métodos , Exercício Físico , Pulmão/fisiopatologia , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Ventilação Pulmonar , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Cinética , Masculino , Pessoa de Meia-Idade , Pletismografia , Valor Preditivo dos Testes , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Índice de Gravidade de Doença , EspirometriaRESUMO
Obese adults with asthma are more likely to develop dynamic hyperinflation (DH) and expiratory flow limitation (EFL) than nonobese asthmatics, and weight-loss seems to improve the breathing mechanics during exercise. However, studies evaluating the effect of weight loss on DH in obese adults with asthma have not been performed. We sought to evaluate the effect of a weight loss program on DH in obese adults with asthma. Forty-two asthma patients were enrolled in a weight loss program (diet, psychological support, and exercise) and were subsequently divided into two groups according to the percentage of weight loss: a ≥5% group ( n = 19) and a <5% group ( n = 23). Before and after the intervention, DH and EFL (constant load exercise), health-related quality of life (HRQoL), asthma control, quadriceps muscle strength and endurance, body composition, and lung function were assessed. Both groups exhibited a decrease of ≥10% in inspiratory capacity (DH) before intervention, and only the ≥5% group showed clinical improvement in DH compared with the <5% group postintervention (-9.1 ± 14.5% vs. -12.5 ± 13.5%, respectively). In addition, the ≥5% group displayed a significant delay in the onset of both DH and EFL and a clinically significant improvement in HRQoL and asthma control. Furthermore, a correlation was observed between reduced waist circumference and increased inspiratory capacity ( r = -0.45, P = 0.05) in the ≥5% group. In conclusion, a weight-loss of ≥5% of the body weight improves DH, which is associated with waist circumference in obese adults with asthma. In addition, the group with greater weight-loss showed a delayed onset of DH and EFL during exercise and improved asthma clinical control and HRQoL. NEW & NOTEWORTHY This is the first study to evaluate dynamic hyperinflation (DH) after a weight loss program in obese patients with asthma. Our results demonstrate that moderate weight loss can improve DH in obese patients with asthma that is associated with a decrease in abdominal fat. Moreover, a minimum of 5% in weight loss delays the onset of DH and expiratory flow limitation besides inducing a clinical improvement in asthma quality of life and clinical control.
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Asma/fisiopatologia , Pulmão/fisiopatologia , Obesidade/terapia , Mecânica Respiratória , Redução de Peso , Gordura Abdominal/fisiopatologia , Adiposidade , Adulto , Asma/complicações , Asma/diagnóstico , Feminino , Humanos , Pessoa de Meia-Idade , Obesidade/complicações , Obesidade/diagnóstico , Obesidade/fisiopatologia , Qualidade de Vida , Recuperação de Função Fisiológica , Fatores de Tempo , Resultado do Tratamento , Circunferência da CinturaRESUMO
This study aimed to better understand how subjects with stable asthma and without exercise-induced bronchoconstriction respond to mild exercise. Breathing pattern, chest wall compartmental and operational volumes, and thoracoabdominal asynchrony were assessed in 11 stable asthmatic subjects and 10 healthy subjects at rest and during exercise in a cycle-ergometer through optoelectronic plethysmography. Dyspnea and sensation of leg effort were assessed through Borg scale. During exercise, with similar minute ventilation, a significant lower chest wall tidal volume (p = 0.003) as well as a higher respiratory rate (p < 0.05) and rapid shallow breathing (p < 0.05) were observed in asthmatic when compared to healthy subjects. Asthmatic subjects exhibited a significantly lower inspiratory (p < 0.05) and expiratory times (p < 0.05). Intergroup analysis found a significant higher end-expiratory chest wall volume in asthmatic subjects, mainly due to a significant increase in volume of the pulmonary ribcage (RCp; 170 ml, p = 0.002), indicating dynamic hyperinflation (DH). Dyspnea and sensation of leg effort were both significantly greater (p < 0.0001) in asthmatic when compared to healthy subjects. In addition to a higher thoracoabdominal asynchrony found between RCp and abdominal (AB) (p < 0.005) compartments in asthmatic subjects, post-inspiratory action of the inspiratory ribcage and diaphragm muscles were observed through the higher expiratory paradox time of both RCp (p < 0.0001) and AB (p = 0.0002), respectively. Our data suggest that a different breathing pattern is adopted by asthmatic subjects without exercise-induced bronchoconstriction during mild exercise and that this feature, associated with DH and thoracoabdominal asynchrony, contributes significantly to exercise limitation.
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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/m2; n=36] and nonobese [nonobese group (NOb-G); BMI 18.5-29.9 kg/m2; n=18] asthmatic patients performed a cardiopulmonary test to quantify peak VÌo2 and a submaximal 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 VÌo2 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 r2 = 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 (O2 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.
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Asma/fisiopatologia , Teste de Esforço/métodos , Tolerância ao Exercício/fisiologia , Volume Expiratório Forçado/fisiologia , Obesidade/fisiopatologia , Atividades Cotidianas , Adulto , Asma/epidemiologia , Asma/reabilitação , Exercício Físico/fisiologia , Feminino , Humanos , Pessoa de Meia-Idade , Obesidade/epidemiologia , Obesidade/reabilitação , Testes de Função Respiratória/métodosRESUMO
The objective of this study was to investigate whether some activities of daily living (ADLs) usually related to dyspnea sensation in patients with chronic obstructive pulmonary disease (COPD) are associated with dynamic lung hyperinflation (DH) and whether the use of simple energy conservation techniques (ECTs) might reduce this possible hyperinflation. Eighteen patients (mean age: 65.8 ± 9.8 years) with moderate-to-severe COPD performed six ADLs (walking on a treadmill, storing pots, walking 56 meters carrying a 5-kilogram weight, climbing stairs, simulating taking a shower, and putting on shoes) and had their inspiratory capacity (IC) measured before and after each task. The patients were moderately obstructed with forced expiratory volume in 1 second (FEV1): 1.4 ± 0.4 L (50% ± 12.4); FEV1/forced vital capacity: 0.4 ± 8.1; residual volume/total lung capacity: 52.7 ± 10.2, and a reduction in IC was seen after all six activities (p < 0.05): (1) going upstairs, 170 mL; (2) walking 56 meters carrying 5 kilogram weight, 150 mL; (3) walking on a treadmill without and with ECT, respectively, 230 mL and 235 mL; (4) storing pots without and with ECT, respectively, 170 mL and 128 mL; (5) taking a shower without and with ECT, respectively, 172 mL and 118 mL; and (6) putting on shoes without and with ECT, respectively, 210 mL and 78 mL). Patients with moderate to severe COPD develop DH after performing common ADLs involving the upper and lower limbs. Simple ECTs may avoid DH in some of these ADLs.
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Atividades Cotidianas , Dispneia/prevenção & controle , Esforço Físico/fisiologia , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Idoso , Dispneia/etiologia , Dispneia/fisiopatologia , Teste de Esforço , Volume Expiratório Forçado , Humanos , Capacidade Inspiratória , Remoção , Pessoa de Meia-Idade , Doença Pulmonar Obstrutiva Crônica/complicações , Índice de Gravidade de Doença , Caminhada/fisiologiaRESUMO
BACKGROUND: Neuromuscular electrical stimulation (NMES) improves muscle performance and exercise tolerance in chronic obstructive pulmonary disease (COPD) patients. In contrast, no study has assessed the effect of NMES on dynamic hyperinflation (DH) in COPD. This study investigated the effect of short-term, high-frequency NMES on DH in patients with COPD. METHODS: Twenty patients were randomly allocated to either a NMES applied bilaterally to the quadriceps muscles (n = 11: 8 weeks, 5 days/week, twice/day, 45 min/session) or a control group (n = 09). All patients received respiratory physical therapy and stretching exercises. Free fat mass, pulmonary function, time to exercise tolerance (Tlim), 6-min walk test distance (6-MWTD), tumor necrosis factor (TNF-α) and ß-endorphin levels, Borg dyspnea and leg score (BDS and BLS) and quality of life by the St. George's Respiratory Questionnaire score (SGRQ) were examined before and after the intervention. RESULTS: Compared with the control group, NMES increased FEV1 and FEV1/FVC, 6-MWD and Tlim (P < 0.01) and reduced BDS and SGRQ (P < 0.01). Additionally, changes in the Tlim were positively correlated with respiratory improvements in FEV1 (rho = 0.48, P < 0.01). Also, NMES reduced TNF-α and increased ß-endorphin levels, compared with the control group (P < 0.001). CONCLUSION: In summary, 8 weeks of NMES promotes reduction of the perceived sensation of dyspnea during exercise in patients with COPD. This finding is accompanied by improvements in FEV1, exercise tolerance and quality of life, and DH. Interestingly, these findings may be associated with enhanced vasodilatory function and a reduction in inflammatory responses. CLINICAL TRIAL REGISTRATION: NCT01695421.
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Terapia por Estimulação Elétrica/métodos , Doença Pulmonar Obstrutiva Crônica/terapia , Adulto , Idoso , Antropometria/métodos , Composição Corporal/fisiologia , Método Duplo-Cego , Teste de Esforço/métodos , Tolerância ao Exercício/fisiologia , Humanos , Capacidade Inspiratória/fisiologia , Masculino , Pessoa de Meia-Idade , Força Muscular/fisiologia , Projetos Piloto , Doença Pulmonar Obstrutiva Crônica/sangue , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Músculo Quadríceps/fisiopatologia , Qualidade de Vida , Mecânica Respiratória/fisiologia , Músculos Respiratórios/fisiopatologia , Fator de Necrose Tumoral alfa/metabolismo , beta-Endorfina/metabolismoRESUMO
CONTEXTUALIZAÇÃO: Pacientes com doença pulmonar obstrutiva crônica (DPOC) queixam-se de dispneia nas atividades de vida diária (AVD) com os membros superiores (MMSS). A hiperinsuflação dinâmica (HD) é um dos mecanismos ventilatórios que contribuem para a dispneia. Para minimizar a HD, propõe-se a utilização de sistemas de ventilação não-invasiva (VNI). OBJETIVOS: Verificar se existe HD e dispneia durante a realização de uma AVD com os MMSS com e sem o uso da VNI. MÉTODOS: Participaram 32 pacientes com DPOC de moderada a muito grave, com idades entre 54 a 87 anos (69,4±7,4). Os pacientes elevaram potes com pesos de 0,5 a 5 kg durante 5 minutos, iniciando a elevação a partir da cintura pélvica em direção a uma prateleira localizada acima da cabeça, com e sem o uso da VNI (BiPAP®; IPAP 10 cmH2O; EPAP 4 cmH2O). Foram avaliadas a capacidade inspiratória (CI) e a dispneia (Escala de Borg). A CI foi mensurada antes e após a simulação da AVD. Na análise dos dados foram utilizados o teste t de Student para amostras dependentes e o teste de Wilcoxon. RESULTADOS: Houve redução significativa da CI após a AVD com e sem VNI (p=0,01). A dispneia aumentou após a AVD com e sem a VNI, mas entre ambos os protocolos não houve diferença. CONCLUSÕES: A simulação da AVD com os MMSS resultou em aumento da HD e dispneia. A VNI ofertada com pressões preestabelecidas não foi suficiente para evitar a HD e a dispneia.
BACKGROUND: Patients with chronic obstructive pulmonary disease (COPD) complain of dyspnea on activities of daily living (ADLs) with the upper limbs. Dynamic hyperinflation (DH) is one of the ventilatory mechanisms that may contribute towards dyspnea. To minimize the DH it is indicated the use of noninvasive ventilation (NIV). OBJECTIVES: To verify whether there is DH and dyspnea during the performance of ADL with the upper limbs with and without the use of NIV. METHODS: 32 patients with moderate-to-severe COPD, aged 54 to 87 years (mean 69.4, SD 7.4) were evaluated. The subjects lift up containers weighing between 0.5 and 5.0 kg over a five-minute period, starting from the waist level and putting them onto a shelf located above head height, with and without the use of NIV (BiPAP®; IPAP 10cmH2O; EPAP 4 cmH2O). The inspiratory capacity (IC) and dyspnea (Borg scale) were evaluated on all the patients. The IC was measured before and after simulation of the ADL. In order to analyze the data, Student's t test for dependent samples and the Wilcoxon test were used. RESULTS: There were statistically significant reductions in IC after the ADL with and without NIV (p=0.01). The dyspnea increased after the ADL with and without the NIV, however between both interventional procedures protocols no between-group difference was observed. CONCLUSIONS: The simulation of an ADL with the upper limbs resulted in an increase in DH and dyspnea. The NIV supplied with pre-established pressure was not enough to prevent the DH and dyspnea.
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Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Atividades Cotidianas , Dispneia/terapia , Doença Pulmonar Obstrutiva Crônica/terapia , Respiração Artificial , Extremidade Superior , Dispneia/etiologia , Doença Pulmonar Obstrutiva Crônica/complicações , Doença Pulmonar Obstrutiva Crônica/fisiopatologiaRESUMO
La enfermedad pulmonar obstructiva crónica (EPOC) es un problema sanitario y económico mundial. En los pacientes que presentan exacerbación aguda y son hospitalizados, alrededor del 8 por ciento requieren soporte ventilatorio. La ventilación no invasiva es el tratamiento de primera línea en la falla respiratoria, no obstante, la ventilación mecánica invasiva también es requerida. Un buen entendimiento de la fisiopatología de la vía aérea y de la mecánica respiratoria es necesario para un mejor manejo de las exacerbaciones y la falla respiratoria. La hiperinsuflación dinámica a nivel pulmonar derivado de una limitación de los flujos espiratorios es un hecho cardinal. Por ello, es necesario una óptima programación del ventilador mecánico que privilegie el vaciamiento espiratorio de los pulmones, mejorar el intercambio gaseoso y minimizar el trabajo respiratorio del paciente. Esta revisión discute las alteraciones fisiopatológicas y mecánicas respiratorias en el paciente con EPOC exacerbado y las técnicas ventilatorias para optimizar el manejo de la falla respiratoria hipercápnica.
Chronic obstructive pulmonary disease (COPD) is a major global healthcare problem. The patients that present acute exacerbation and are hospitalized, about 8 percent needs support ventilator. The noninvasive ventilation is the treatment of the first line in the respiratory failure, nevertheless, the mechanical invasive ventilation also is needed. A good understanding of the airway pathophysiology and lung mechanics in COPD is necessary for a better manage of the acute exacerbations and respiratory failure. The dynamic hyperinflation derived from an expiratory airflow limitation is a cardinal fact. For management, is necessary an appropriate programming of the mechanical ventilator that favors the reducing the amount of air trapping of the lungs, to improve the gas exchange and to minimize the respiratory work of the patient. This review discusses the alterations pathophysiology and lung mechanics in the patient with acute exacerbation of COPD and ventilatory strategies.
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Humanos , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Doença Pulmonar Obstrutiva Crônica/terapia , Respiração Artificial , Doença Aguda , Doença Pulmonar Obstrutiva Crônica/complicações , Doença Pulmonar Obstrutiva Crônica/mortalidade , Insuficiência Respiratória/etiologia , Insuficiência Respiratória/terapia , Respiração por Pressão Positiva Intrínseca , Troca Gasosa Pulmonar , Mecânica Respiratória , Resistência das Vias Respiratórias/fisiologiaRESUMO
INTRODUÇÃO: A hiperinsuflação dinâmica (HD) é um dos mecanismos ventilatórios que podem contribuir para a limitação das atividades de vida diária (AVD) em pacientes com Doença Pulmonar Obstrutiva Crônica (DPOC). Os objetivos deste trabalho foram avaliar a presença da HD, pela capacidade inspiratória (CI), e sua razão CI/CPT (capacidade pulmonar total), e a sensação de dispnéia após uma AVD realizada com os membros superiores (MMSS). MÉTODOS: Participaram 32 pacientes com DPOC de moderada a muito grave, com idades entre 54 a 87 anos (69,4 ± 7,4). Os pacientes selecionados foram submetidos a testes de função pulmonar, espirometria e pletismografia de corpo inteiro. Para as manobras espirométricas e dos volumes pulmonares, foi utilizado um sistema convencional (Vmáx22 Autobox). A CI foi determinada usando um sistema de medidas ventilatórias (Vmáx229d). Foi solicitado elevar potes com pesos de 0,5 a 5,0kg no tempo total de 5 minutos, pegando os potes em cima de uma superfície situada no nível da cintura pélvica e posicionando-os em uma prateleira localizada acima do nível da cabeça. Em todos os pacientes, foram avaliados a CI e a escala de Borg para dispnéia. Para a análise dos dados, foram utilizados o teste t de Student para amostras pareadas, a correlação de Pearson, e o teste de Wilcoxon (p< 0,05). RESULTADOS: Houve diminuição da CI e da CI/CPT (p= 0,0001) após AVD. A dispnéia aumentou após o exercício (p< 0,05). CONCLUSÃO: A AVD com os MMSS resultou em HD evidenciada pela diminuição da CI e da razão CI/CPT e, também, em aumento da dispnéia.
INTRODUCTION: Dynamic hyperinflation (DH) is one of the ventilatory mechanisms that may contribute towards limiting the activities of daily living (ADLs) in patients with chronic obstructive pulmonary disease (COPD). The objectives of this study were to evaluate the presence of DH, by means of inspiratory capacity (IC), IC / total lung capacity (TLC) ratio and by the sensation of dyspnea, following an ADL performed using the upper limbs. METHOD: The participants were 32 individuals aged 54 to 87 years (69.4 ± 7.4) who presented moderate-to-severe COPD. The patients selected underwent pulmonary function tests, spirometry and whole-body plethysmography. For the spirometric and pulmonary volume maneuvers, a conventional system was used (Vmax22 Autobox). The IC was determined using a Vmax229d ventilatory measurement system. The patients were asked to lift up pots weighing between 0.5 and 5.0 kg over a five-minute period, picking up the pots from a surface at waist level and putting them onto a shelf above head height. All the patients were evaluated regarding IC and using the Borg scale for dyspnea. The data were analyzed using Student's t test for paired samples, Pearson's correlation and the Wilcoxon test (p< 0.05). Results: There were reductions in IC and IC/TLC (p= 0.0001) following the ADL. The dyspnea increased after the exercise (p< 0.05). CONCLUSION: The ADL using the upper limbs caused DH, as shown by the reductions in IC and IC/TLC and also by the increase in dyspnea.