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

Abstract

INTRODUCTION: Thoracoabdominal-TA asynchrony is an important sign of Chronic Obstructive Pulmonary Disease (COPD). Studies investigating the influence of endurance training on TA asynchrony have not been found. OBJECTIVE: To analyze lower-limb endurance training effects on TA asynchrony in patients with COPD. MATERIALS AND METHODS: Two patients with severe COPD were evaluated in a single-subject design AB (A-baseline for six weeks, B-training on cycle ergometer with intensity of 70% of baseline peak load, for 12 weeks) with repeated measures of variables: phase inspiratory relation (PhRIB), phase expiratory relation (PhREB) and phase angle (PhAng). These variables were assessed by respiratory inductive plethysmography during incremental exercise tests on a cycle ergometer (same load and peak load of each test). Statistical methods included visual analysis, two-standard deviation band test and split middle line test, considering significant p < 0.05. It was considered the results for variables with agreement of at least two analyses. Data are presented as mean ± SD for phases A and B. RESULTS: During phase B, Patient 1 presented significant decrease of PhRIB (22.7 ± 3.4 x 17.0 ± 4.9) and PhAng (16.5 ± 5.1 x 13.2 ± 2.1) for same load and PhREB (16.8 ± 3.1 x 13.3 ± 3.1) and PhAng (23.4 ± 1.7 x 20.1 ± 2.3) at peak load. Patient 2 showed significant decrease of PhRIB for same load and (14.4 ± 3.8 x 13.9 ± 3.9) at peak load (19.1 ± 2.5 x 15.7 ± 2.7). CONCLUSIONS: These results suggest that lower-limb endurance training reduced TA asynchrony in patients with severe COPD. The findings may be related, according to the literature, to the lower ventilatory demand and greater exercise capacity of patients with COPD undergoing endurance training.

Effects of Diaphragmatic Breathing With and Without Pursed-Lips Breathing in Subjects With COPD

“…This finding corroborated reports of some studies of subjects with COPD that found increases in asynchrony during diaphragmatic breathing, 10,13,29,30 which seem to be related to (1) the sitting position assumed for the evaluation (a higher trunk elevation favors greater asynchrony in subjects with COPD), 29 (2) the voluntary changes in the breathing pattern assumed during the breathing exercises (even for healthy subjects, the spontaneous breathing pattern presents asynchrony), 38 and (3) the greater focus on the use of the diaphragm (according to the instructions for diaphragmatic breathing and diaphragmatic breathing plus pursed-lips breath-ing) performed by subjects with biomechanical impairment of this muscle when considering that they have a respiratory overload while performing any type of exercise. 30,39 Both breathing exercises promoted a decrease in the breathing frequency due to the increase of inspiratory time and expiratory time. Those changes in breathing pattern supported the findings of previous studies of the effects of diaphragmatic breathing and pursed-lips breathing assessed separately.…”

The Effect of Threshold Loading Training and an Innovative Respiratory Training Devices with Lower Torso Sports Training in Asthma Patients: A Randomized Trial

“…Lower torso training in asthma patients is essential to improve the respiratory system and muscle function and reduce dyspnea. Some studies showed that training a lower limb reflects thoracoabdominal motion and significantly decreases dyspnea and other variables [ 13 ]. There is strong evidence that leg exercise performance decreases dyspnea and leg fatigue in patients with a respiratory system.…”