title: Effects of noninvasive ventilation on dynamic hiperinflation of patients with COPD during activities of daily living with upper limbs.
abstract: BACKGROUND
  Patients with chronic obstructive pulmonary disease (COPD) complain of dyspnea on activities of daily living (ADLs) with the upper limbs. Dynamic hyperinflation (DH) is one of the ventilatory mechanisms that may contribute towards dyspnea. To minimize the DH it is indicated the use of noninvasive ventilation (NIV).
  
  
  OBJECTIVE
  To verify whether there is DH and dyspnea during the performance of ADL with the upper limbs with and without the use of NIV.
  
  
  METHODS
  32 patients with moderate-to-severe COPD, aged 54 to 87 years (mean 69.4, SD 7.4) were evaluated. The subjects lift up containers weighing between 0.5 and 5.0 kg over a five-minute period, starting from the waist level and putting them onto a shelf located above head height, with and without the use of NIV (BiPAP®; IPAP 10cmH₂O; EPAP 4 cmH₂O). The inspiratory capacity (IC) and dyspnea (Borg scale) were evaluated on all the patients. The IC was measured before and after simulation of the ADL. In order to analyze the data, Student's t test for dependent samples and the Wilcoxon test were used.
  
  
  RESULTS
  There were statistically significant reductions in IC after the ADL with and without NIV (p=0.01). The dyspnea increased after the ADL with and without the NIV, however between both interventional procedures protocols no between-group difference was observed.
  
  
  CONCLUSIONS
  The simulation of an ADL with the upper limbs resulted in an increase in DH and dyspnea. The NIV supplied with pre-established pressure was not enough to prevent the DH and dyspnea.
authors.affiliation: Physical Therapy Department, Universidade Católica de Minas Gerais, Belo Horizonte, MG, Brazil.
authors.forename: Isabela M B Sclauser
authors.initials: IM
authors.lastname: Pessoa
authors.forename: Dirceu
authors.initials: D
authors.lastname: Costa
authors.forename: Marcelo
authors.initials: M
authors.lastname: Velloso
authors.forename: Eliane
authors.initials: E
authors.lastname: Mancuzo
authors.forename: Marco A S
authors.initials: MA
authors.lastname: Reis
authors.forename: Verônica F
authors.initials: VF
authors.lastname: Parreira
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D004417:Dyspnea / Q000209:etiology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D012121:Respiration, Artificial; D034941:Upper Extremity