Chest
Clinical InvestigationsCOPDChest Wall Kinematics and Breathlessness During Pursed-Lip Breathing in Patients With COPD
Section snippets
Patients
Twenty-two clinically stable patients with COPD and mild-to-severe airway obstruction participated in the study (Table 1). Eleven patients were truly hyperinflated (functional residual capacity [FRC]; range, 141 to 212% of the predicted value). They were selected to take part in an outpatient pulmonary rehabilitation program involving regular exercise on a bicycle and several evaluations of pulmonary function, and entered the pulmonary rehabilitation program after satisfying the following
Breathing Pattern
With PLB, Vt, Ti, Te, Ttot, and Vt/Ti all increased, whereas Rf and Ti/Ttot decreased (p < 0.02 to 0.000004) [Table 2].
CW Kinematics
The time course of Vcw compartment changes during QB and PLB in a representative patient is shown in Figure 1. With PLB, changes in Vcwee, Vabee, end-expiratory Vrc (Vrcee), and in end-inspiratory Vcw (Vcwei) and end-inspiratory Vrc (Vrcei) were significant (p < 0.03 to 0.000004) [Table 2]. These changes are shown in Figure 2.
Relationships
ΔVcwee (p < 0.02) and ΔVabee (p < 0.03) related to
Discussion
As shown, ΔVcwee related to baseline FEV1 but not to FRC. The increase in Te with PLB resulted in a decrease in Vcwee, mostly at the abdominal level (Vabee). The decrease in Borg score significantly related to the decrease in Vcwee.
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