title: The impact of noninvasive ventilation during the physical training in patients with moderate-to-severe chronic obstructive pulmonary disease (COPD).
abstract: OBJECTIVE
  To evaluate the influence of physical training with or without noninvasive ventilation at 2 levels of pressure in the airways (BiPAP) in patients with chronic obstructive pulmonary disease.
  
  
  METHODS
  Eighteen patients with FEV(1) = 34 +/- 8% of predicted values, mean age of 68 +/- 9 years were randomly distributed into 2 groups, one group performing physical training on a treadmill and the other group performing physical training associated with BiPAP (physical training+B), for 30 minutes, 3 times a week for 12 weeks. The training velocity was based on a test of cardiopulmonary force performed pre- and postintervention, which registered the values for heart rate, systolic blood pressure, diastolic blood pressure, peripheral oxygen saturation, blood lactate, sensation of dyspnea, respiratory muscle strength, and analysis of gases expired such as oxygen consumption and the production of carbon dioxide.
  
  
  RESULTS
  For both groups, there was a significant improvement in dyspnea and peripheral oxygen saturation at identical levels of physical exercise, in distance walked during the physical training, and in respiratory muscle strength (P < 0.05). Only the physical training+B group had a significant improvement in heart rate, systolic blood pressure, and oxygen consumption after training (P < 0.05). Significant reductions of blood lactate were observed at identical levels of exercise in physical training+B when compared to isolated physical training (from 1.3 +/- 0.7 mMol/L versus 2.5 +/- 0.9 mMol/L, (P < 0.05), respectively).
  
  
  CONCLUSIONS
  Physical training associated with BiPAP enhanced the oxidative muscular capacity and could be an adjunctive recourse for physical rehabilitation in patients with chronic obstructive pulmonary disease.
authors.affiliation: Federal University of São Carlos, São Carlos, SP, Brazil. andrezatoledo@aol.com
authors.forename: Andreza
authors.initials: A
authors.lastname: Toledo
authors.forename: Audrey
authors.initials: A
authors.lastname: Borghi-Silva
authors.forename: Luciana Maria Malosá
authors.initials: LM
authors.lastname: Sampaio
authors.forename: Karla Paiva
authors.initials: KP
authors.lastname: Ribeiro
authors.forename: Vilmar
authors.initials: V
authors.lastname: Baldissera
authors.forename: Dirceu
authors.initials: D
authors.lastname: Costa
mesh_terms: D000368:Aged; D005080:Exercise Test; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008297:Male; D010101:Oxygen Consumption / Q000502:physiology; D029424:Pulmonary Disease, Chronic Obstructive / Q000534:rehabilitation*; D011659:Pulmonary Gas Exchange / Q000502:physiology; D012121:Respiration, Artificial; D012143:Respiratory Physiological Phenomena; D012720:Severity of Illness Index; D016896:Treatment Outcome