Department of Physical Therapy, Medical School, University of São Paulo, São Paulo, Brazil.
Biomedical Engineering Laboratory, Escola Politécnica, University of São Paulo, São Paulo, Brazil.
J Appl Physiol (1985). 2020 Sep 1;129(3):492-499. doi: 10.1152/japplphysiol.00690.2019. Epub 2020 Jul 23.
Subjects with severe and very severe chronic obstructive pulmonary disease (COPD) present thoracoabdominal asynchrony (TAA) that reduces ventilatory efficiency and exercise capacity. However, no therapeutic intervention has focused on reducing TAA. The purpose of this study was to evaluate the effects of elastic tape (ET) on thoracoabdominal mechanics, dyspnea symptoms, exercise capacity, and physical activity level in nonobese male subjects with severe-to-very severe COPD. This crossover, randomized trial included nonobese males with severe to very severe COPD. ET was placed on the chest wall and abdomen to reduce TAA. Subjects were evaluated at three hospital visits, each 7 days apart. At , thoracoabdominal kinematic and pulmonary ventilation were evaluated by optoelectronic plethysmography and electrical impedance tomography, respectively, both at rest and during isoload exercise testing. At , a cardiopulmonary exercise test (CPET; 10 W/min) was performed until exhaustion. Between the visits, subjects used a physical activity monitor (PAM) (at least 5 days of measurement; 10 h/day). At , all the tests were repeated in the opposite order of the previous randomization. During the isoload exercise, subjects with ET presented lower tidal and minute volumes ( = 0.01) and reduced TAA ( = 0.02) and dyspnea ( = 0.04). During the CPET, subjects with ET presented an increase in peak oxygen consumption (V̇o; L/min and mL·kg·min; = 0.01), test duration ( = 0.009), and maximal load ( = 0.03). Moderate and vigorous physical activity (MVPA), which was evaluated by the PAM, was also increased in subjects with ET ( = 0.01). ET reduced TAA and dyspnea and increased exercise capacity and the duration of MVPA in nonobese male subjects with severe-to-very severe COPD Elastic tape can be used as a new and low-cost intervention to reduce thoracoabdominal asynchrony and sedentary behavior as well as improve exercise capacity and physical activity level in nonobese male subjects with severe-to-very severe chronic obstructive pulmonary disease.
患有严重和极严重慢性阻塞性肺疾病（COPD）的患者存在胸腹不同步（TAA），这会降低通气效率和运动能力。然而，目前尚无针对减少 TAA 的治疗干预措施。本研究的目的是评估弹性带（ET）对非肥胖男性严重至极严重 COPD 患者的胸腹力学、呼吸困难症状、运动能力和身体活动水平的影响。这是一项交叉随机试验，纳入了严重至极严重 COPD 的非肥胖男性患者。在胸部和腹部放置 ET 以减少 TAA。患者在三个医院就诊，每次间隔 7 天。在第 1 天，通过光电体积描记法和电阻抗断层扫描分别评估胸腹运动和肺通气，均在休息和等负荷运动测试时进行。在第 3 天，进行心肺运动试验（CPET；10 W/min），直至衰竭。在就诊之间，患者使用身体活动监测器（PAM）（至少测量 5 天，每天 10 小时）。在第 5 天，按照前一次随机分组的相反顺序重复所有测试。在等负荷运动期间，使用 ET 的患者潮气量和分钟通气量较低（ = 0.01），TAA 减少（ = 0.02），呼吸困难减轻（ = 0.04）。在 CPET 期间，使用 ET 的患者峰值摄氧量（V̇o；L/min 和 mL·kg·min； = 0.01）、测试持续时间（ = 0.009）和最大负荷（ = 0.03）增加。通过 PAM 评估的中度和剧烈体力活动（MVPA）也在使用 ET 的患者中增加（ = 0.01）。ET 减少了 TAA 和呼吸困难，增加了运动能力和 MVPA 的持续时间，非肥胖男性严重至极严重 COPD 患者。弹性带可作为一种新的、低成本的干预措施，减少胸腹不同步和久坐行为，提高非肥胖男性严重至极严重慢性阻塞性肺疾病患者的运动能力和身体活动水平。
