Chronic Obstructive Pulmonary Disease Clinical Trial
Official title:
Influence of Diaphragmatic Mobility on the Exercise Capacity and Dyspnoea in Patients With Chronic Obstructive Pulmonary Disease
The purpose of this study is to evaluate the influence of diaphragm mobility on exercise capacity and dyspnoea in patients with chronic obstructive pulmonary disease (COPD).
Chronic Obstructive Pulmonary Disease (COPD) is characterized by progressive obstruction of
the airways which is partially irreversible. COPD patients commonly present increased
resistance to airflow, air trapping, and pulmonary hyperinflation that alters the chest wall
placing the respiratory muscles in mechanical disadvantage, thereby increasing both
respiratory drive and the sensation of dyspnoea. Furthermore, to prevent dyspnoea, COPD
patients reduce their daily living activities leading to loss of physical condition, social
isolation, depression and anxiety,whilst compromising their quality of life.
Forced expiratory volume in one second (FEV1) is the main parameter used to establish the
severity of pulmonary impairment and disease progression.
Nevertheless, some studies have suggested that FEV1 does not adequately reflect the clinical
manifestations of the disease and is only weakly associated with the severity of dyspnoea,
health related quality of life (HRQOL) features, and the ability to perform activities of
daily living.
Moreover, FEV1 appears not to be a predictor of mortality in COPD patients. Pulmonary
hyperinflation has been related with adaptation in diaphragm muscle maintaining the muscle's
capacity to generate power whilst reducing its displacement. The importance of the diaphragm
in lung mechanics associated with hyperinflation has been the subject of frequent discussion
owing to widespread use of lung volume reducing surgery which results in increased movement
range of the diaphragm muscle. However, to date, the relationship between diaphragm mobility
and functional capacity in COPD patients remains unknown.
The objective of the present study was to evaluate the influence of diaphragm mobility in
the exercise capacity and dyspnoea of patients with COPD.
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