title: Effects of noninvasive ventilation on treadmill 6-min walk distance and regional chest wall volumes in cystic fibrosis: randomized controlled trial.
abstract: BACKGROUND
  Dyspnea and exercise intolerance are the symptoms that most affect the quality of life of children and adolescents with respiratory disorders resulting from cystic fibrosis (CF).
  
  
  OBJECTIVE
  To evaluate the effect of noninvasive ventilation (NIV) on treadmill 6-min walk distance and regional chest wall volumes in cystic fibrosis patients.
  
  
  METHODS
  Crossover clinical trial, randomized, controlled and open with 13 children and adolescents with CF, aged 7-16 years, with pulmonary impairment (NTC01987271). The patients performed a treadmill walking test (TWT) during 6 min, with and without NIV on a BiLEVEL mode, an interval of 24-48 h between tests. Before and after each test, patients were assessed by spirometry and optoelectronic plethysmography.
  
  
  RESULTS
  Walking distance in TWT with NIV was significantly higher that without ventilatory support (mean ± sd: 0.41 ± 0.08 vs. 0.39 ± 0.85 km, p = 0.039). TWT with NIV increase forced expiratory volume on 1 s (FEV1; p = 0.036), tidal volume (Vt; p = 0.005), minute ventilation (MV; p = 0.013), pulmonary rib cage volume (Vrcp; p = 0.011), and decrease the abdominal volume (Vab; p = 0.013) after test. There was a significant reduction in oxygen saturation (p = 0.018) and permanent increase in respiratory rate after 5 min (p = 0.021) after the end test without NIV.
  
  
  CONCLUSIONS
  During the walking test on the treadmill, the NIV change thoracoabdominal kinematics and lung function in order to optimized ventilation and tissue oxygenation, with improvement of walk distance. Consequently, NIV is an effective tool to increase functional capacity in children and adolescents with cystic fibrosis.
authors.affiliation: Universidade Federal de Pernambuco - UFPE, Rua Pessoa de Melo, 333, 702, Madalena, Recife, PE 50721610, Brazil. Electronic address: cibellea@yahoo.com.
authors.forename: Cibelle Andrade
authors.initials: CA
authors.lastname: Lima
authors.affiliation: Universidade Federal de Pernambuco - UFPE, Departamento de Fisioterapia, Av. Jornalista Anibal Fernandes, Cidade Universitária, Recife, PE 50740-560-901, Brazil. Electronic address: armeledornelas@yahoo.com.
authors.forename: Armèle de Fátima Dornelas de
authors.initials: Ade F
authors.lastname: Andrade
authors.affiliation: Universidade Federal de Pernambuco - UFPE, Departamento de Fisioterapia, Av. Jornalista Anibal Fernandes, Cidade Universitária, Recife, PE 50740-560-901, Brazil. Electronic address: shirleylcampos@uol.com.br.
authors.forename: Shirley Lima
authors.initials: SL
authors.lastname: Campos
authors.affiliation: Universidade Federal de Pernambuco - UFPE, Departamento de Fisioterapia, Av. Jornalista Anibal Fernandes, Cidade Universitária, Recife, PE 50740-560-901, Brazil. Electronic address: daniellacunha@hotmail.com.
authors.forename: Daniella Cunha
authors.initials: DC
authors.lastname: Brandão
authors.affiliation: Departamento de Fisioterapia, Universidade Federal do Rio Grande do Norte, Campus Universitário Lagoa Nova, Caixa Postal 1524, CEP:59072-970 Natal-RN, Brazil. Electronic address: gfregonezi@msn.com.
authors.forename: Guilherme
authors.initials: G
authors.lastname: Fregonezi
authors.affiliation: Universidade Federal de Pernambuco - UFPE, Departamento de Fisioterapia, Av. Jornalista Anibal Fernandes, Cidade Universitária, Recife, PE 50740-560-901, Brazil. Electronic address: iannymourato@hotmail.com.
authors.forename: Ianny Pereira
authors.initials: IP
authors.lastname: Mourato
authors.affiliation: Dipartimento di Elettronica, Informazione e Bioingegneria Politecnico di Milano, Piazza Leonardo da Vinci, 32, I-20133 Milan, Italy. Electronic address: andrea.aliverti@biomed.polimi.it.
authors.forename: Andrea
authors.initials: A
authors.lastname: Aliverti
authors.affiliation: Instituto Materno Infantil de Pernambuco, Rua dos Coelhos 300, Pós Graduação, Boa Vista, Mailbox: 1393, Recife, PE 50070-550, Brazil. Electronic address: murilobritto@ig.com.br.
authors.forename: Murilo Carlos Amorim de
authors.initials: MC
authors.lastname: Britto
mesh_terms: D000293:Adolescent; D002648:Child; D018592:Cross-Over Studies; D003550:Cystic Fibrosis / Q000503:physiopathology*; D004417:Dyspnea / Q000503:physiopathology*; D015444:Exercise / Q000502:physiology*; D005080:Exercise Test; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology; D006801:Humans; D008297:Male; D063087:Noninvasive Ventilation; D010991:Plethysmography / Q000379:methods; D013147:Spirometry; D013990:Tidal Volume / Q000502:physiology; D014797:Vital Capacity / Q000502:physiology
keywords: Cystic fibrosis; Exercise test; Exercise tolerance; Noninvasive ventilation