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Relationship between psychosocial factors, dyspnea and thoracoabdominal mechanics in COPD patients

Erickson Borges-Santos, Juliano Wada, Desiderio Cano, Denise Paisani, Cibele Marques da Silva, Alberto Cukier, Rafael Stelmach, Celso Carvalho, Adriana Lunardi
European Respiratory Journal 2013 42: P1379; DOI:
Erickson Borges-Santos
1Department of Physical Therapy, University of Sao Paulo, Sao Paulo, Brazil
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Juliano Wada
1Department of Physical Therapy, University of Sao Paulo, Sao Paulo, Brazil
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Desiderio Cano
1Department of Physical Therapy, University of Sao Paulo, Sao Paulo, Brazil
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Denise Paisani
1Department of Physical Therapy, University of Sao Paulo, Sao Paulo, Brazil
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Cibele Marques da Silva
1Department of Physical Therapy, University of Sao Paulo, Sao Paulo, Brazil
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Alberto Cukier
2Departament of Cardiopulmonary, University of Sao Paulo, Sao Paulo, Brazil
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Rafael Stelmach
2Departament of Cardiopulmonary, University of Sao Paulo, Sao Paulo, Brazil
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Celso Carvalho
1Department of Physical Therapy, University of Sao Paulo, Sao Paulo, Brazil
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Adriana Lunardi
1Department of Physical Therapy, University of Sao Paulo, Sao Paulo, Brazil
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Abstract

Chronic obstructive pulmonary disease (COPD) patients commonly present higher anxiety and depression levels. These symptoms are related with dyspnea and alterations in the respiratory pattern but remains unclear this association with the thoracoabdominal mechanics. Objective: To evaluate the relationship between anxiety and depression symptoms with self-related dyspnea, thoracoabdominal distribution of pulmonary volume and inspiratory muscular activity in COPD patients. Methods: Twenty nine moderate to severe COPD patients (18 males, 63±6yrs, 23±8kg/m2, FEV1=47±13% of predicted) were enrolled and classified according the Hospital Anxiety and Depression Scale (Anxiety HAD>8; Depression HAD>9). Dyspnea was evaluated by MRC scale. Patients at rest were submitted to evaluation of total and compartimental volumes, thoracoabdominal synchrony by optoelectronic plethysmography and of inspiratory muscular activity by electromyography. T test was used to compare COPD with or without psychological symptoms. The significance level was set at 5%. Results: 13 patients had anxiety and 9 had depression symptoms. Lung function values were similar between groups. Anxious patients presents a higher MRC score than non-anxious patients (3.5±0.9 vs. 2.5±0.8 points; p<0.01) and depressed patients also had higher MRC score and non-depressed ones (3.7±0.7 vs. 2.6±0.9 points; p<0.01). No difference was observed in the distribution of pulmonary volumes and inspiratory muscular activity between groups. Conclusion: The anxiety and depression levels are associated with higher perception of dyspnea; however, without changes on thoracoabdominal mechanics in COPD patients.

  • COPD - mechanism
  • Extrapulmonary impact
  • Respiratory muscle
  • © 2013 ERS
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Relationship between psychosocial factors, dyspnea and thoracoabdominal mechanics in COPD patients
Erickson Borges-Santos, Juliano Wada, Desiderio Cano, Denise Paisani, Cibele Marques da Silva, Alberto Cukier, Rafael Stelmach, Celso Carvalho, Adriana Lunardi
European Respiratory Journal Sep 2013, 42 (Suppl 57) P1379;

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Relationship between psychosocial factors, dyspnea and thoracoabdominal mechanics in COPD patients
Erickson Borges-Santos, Juliano Wada, Desiderio Cano, Denise Paisani, Cibele Marques da Silva, Alberto Cukier, Rafael Stelmach, Celso Carvalho, Adriana Lunardi
European Respiratory Journal Sep 2013, 42 (Suppl 57) P1379;
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