The Effects of a Positive Expiratory Pressure (PEP) on Dyspnea and Dynamic Hyperinflation During Exercise in COPD Patients
Trial Snapshot
- Phase
- Not Applicable
- Sponsor
- Khon Kaen University
- Enrollment
- 11
- Locations
- 2
- Primary Endpoint
- Inspiratory Capacity
Study Overview
Brief Summary
From the relationship between pathophysiology of chronic obstructive pulmonary disease (COPD), dyspnea, and dynamic hyperinflation during ventilatory increasing, the investigators hypothesize that
- Positive expiratory pressure (PEP) breathing will reduce dyspnea more than normal breathing during exercise in mild to moderate COPD patients.
- PEP breathing will improve dynamic hyperinflation during exercise more than normal breathing in mild to moderate COPD patients.
- PEP breathing will improve cardiorespiratory function during exercise than normal breathing in mild to moderate COPD patients.
Detailed Description
Expiratory airflow limitation is the pathophysiological hallmark of chronic obstructive pulmonary disease (COPD) that leads to air trapping and increases in dynamic hyperinflation (DH) and consequently causes dyspnea during exercise. Although pursed lips breathing is a simple technique that provides a positive back pressure may retard the airway collapsed, but previous studies showed an unsuccessful reduction of DH which might cause by insufficient back pressure. And thereby a conical positive expiratory pressure (C-PEP) has been developed in our laboratory to generate back pressure higher than pursed lips breathing. Moreover, an effect of PEP on DH has not carried out in patient with COPD. Therefore, the objective of the present study was to examine effects of a C-PEP on DH and respiratory response during exercise in patient with COPD.
Study Design
- Study Type
- Interventional
- Allocation
- Non Randomized
- Intervention Model
- Crossover
- Primary Purpose
- Supportive Care
- Masking
- None
Eligibility Criteria
- Ages
- — to 70 Years (Child, Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Patients with stable mild-to-moderate COPD (Both stages: FEV1/FVC < 70%. Mild stage: FEV1 ≥ 80% predicted; Moderate stage: 50% ≤ FEV1 < 80% predicted according to Global Initiative Obstructive Lung Disease (GOLD) guideline).
- •Free of exacerbations for more than 4 weeks (as defined by a change to pharmacological therapy, admission to hospital or ER or unscheduled clinic visit).
- •Good communication
Exclusion Criteria
- •Older than 70 years old
- •Musculoskeletal problems that limit mobility
- •Cardiovascular disease
- •Neurological or psychiatric illness
- •Patient on long term oxygen or domiciliary noninvasive positive pressure ventilation
- •Any other comorbidities which would affect ability to undertake exercise test
Outcomes
Primary Outcomes
Inspiratory Capacity
Time Frame: at 0th, 5th, ~20th minutes of exercises
Borg scale
Time Frame: at 0th and 20th minutes of exercises
Secondary Outcomes
- Heart Rate(every minutes of exercise and recovery periods)
- Exercise time(at the times when participants stop exercises)
- Recovery time(the periods between end of symptomatic limited constance workload exercises to full recovery heart rate)
- Respiratory rate(every minutes of exercise and recovery periods)
- Inspiratory time(every minutes of exercise and recovery periods)
- Expiratory time(every minutes of exercise and recovery periods)
- Sp02(every minutes of exercise and recovery periods)
- PetCO2(every minutes of exercise and recovery periods)
- Mouth pressure(every minutes of exercise periods)
- Flow rate(every minutes of exercise periods)