Pinto Paulo Victor Leandro da Silva, Fonseca Iasmin Maria Pereira Pinto, Silva Marcela Pinto Venâncio Lourenço da, Silva Matheus Mello da, Rodrigues Thais Souza, Bártholo Thiago Prudente, Lopes Agnaldo José
Rehabilitation Sciences Postgraduate Programme, Centro Universitário Augusto Motta (UNISUAM), Rio de Janeiro, Brazil.
Postgraduate Programme in Medical Sciences, School of Medical Sciences, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, Brazil.
Physiother Res Int. 2025 Oct;30(4):e70094. doi: 10.1002/pri.70094.
Dynamic hyperinflation (DH) is a treatable trait that impairs activities of daily living in adults living with asthma (alwA) and should therefore be detected early. We aimed to identify DH in alwA using the Glittre-ADL test (TGlittre) and, secondarily, to assess the association of DH with small airway dysfunction (SAD) and quality of life (QoL).
Cross-sectional study in which 41 alwA underwent the TGlittre coupled with dynamic ventilation measurement, with detection of DH using inspiratory capacity (∆IC). They also underwent spirometry, impulse oscillometry (IOS), and the Mini-Asthma Quality of Life Questionnaire (Mini-AQLQ).
In TGlittre, 19 participants presented DH at the end of the test (DH group), while 22 did not (NDH group). Although participants in the DH group took longer to complete the TGlittre tasks, there were no statistical differences between the 2 groups (269.9 ± 77.1% vs. 260.1 ± 73.8% predicted, p = 0.68). While the DH and NDH groups did not show significant differences in any of the spirometric parameters, these two groups differed in various IOS parameters, with higher values for frequency response (Fres, p = 0.037) and heterogeneity of resistance between 5 and 20 Hz (R5-R20, p = 0.003) in the DH group. Although ∆IC did not show significant correlations with either spirometric or Mini-AQLQ parameters, there were several significant correlations with IOS parameters. In the multiple linear regression, Fres and R5-R20 explained 51% of IC variability.
In alwA, the TGlittre is able to detect DH in about half of the cases. Having HD does not have a negative impact on performance during TGlittre. However, there is an association between DH and SAD. Since DH can be detected even in individuals with normal spirometry and/or good performance during the TGlittre, it may be interesting to incorporate the assessment of ventilatory dynamics during the TGlittre in alwA.
动态肺过度充气（DH）是一种可治疗的特征，会损害哮喘成年患者（alwA）的日常生活活动能力，因此应尽早检测。我们旨在使用Glittre-ADL测试（TGlittre）在alwA中识别DH，其次评估DH与小气道功能障碍（SAD）和生活质量（QoL）之间的关联。
进行横断面研究，41例alwA患者接受TGlittre测试并同时进行动态通气测量，使用吸气容量（∆IC）检测DH。他们还接受了肺功能测定、脉冲振荡法（IOS）和小型哮喘生活质量问卷（Mini-AQLQ）。
在TGlittre测试中，19名参与者在测试结束时出现DH（DH组），而22名未出现（非DH组）。尽管DH组的参与者完成TGlittre任务的时间更长，但两组之间无统计学差异（预测值分别为269.9±77.1%和260.1±73.8%，p = 0.68）。虽然DH组和非DH组在任何肺功能参数上均无显著差异，但这两组在各种IOS参数上存在差异，DH组的频率响应（Fres，p = 0.0 .037）和5至20 Hz之间的阻力异质性（R5-R20，p = 0.003）值更高。尽管∆IC与肺功能或Mini-AQLQ参数均无显著相关性，但与IOS参数存在若干显著相关性。在多元线性回归中，Fres和R5-R20解释了IC变异性的51%。
在alwA中，TGlittre能够在约一半的病例中检测到DH。患有DH对TGlittre测试期间的表现没有负面影响。然而，DH与SAD之间存在关联。由于即使在肺功能正常和/或TGlittre测试期间表现良好的个体中也能检测到DH，因此将TGlittre测试期间的通气动力学评估纳入alwA可能会很有意义。
