title: Ventilatory demand and dynamic hyperinflation induced during ADL-based tests in Chronic Obstructive Pulmonary Disease patients.
abstract: BACKGROUND
  Airflow limitation frequently leads to the interruption of activities of daily living (ADL) in patients with Chronic Obstructive Pulmonary Disease (COPD). These patients commonly show absence of ventilatory reserve, reduced inspiratory reserve volume, and dynamic hyperinflation (DH).
  
  
  OBJECTIVE
  To investigate ventilatory response and DH induced by three ADL-based protocols in COPD patients and compare them to healthy subjects.
  
  
  METHODS
  Cross-sectional study. COPD group: 23 patients (65±6 years, FEV1 37.2±15.4%pred); control group: 14 healthy subjects (64±4 years) matched for age, sex, and body mass index. Both groups performed all three tests: Glittre-ADL test; an activity test that involved moving objects on a shelf (TSHELF); and a modified shelf protocol isolating activity with upper limbs (TSHELF-M). Ventilatory response and inspiratory capacity were evaluated.
  
  
  RESULTS
  Baseline ventilatory variables were similar between groups (p>0.05). The ventilatory demand increased and the inspiratory capacity decreased significantly at the end of the tests in the COPD group. Ventilatory demand and DH were higher (p<0.05) in the TSHELF than in the TSHELF-M in the COPD group (p<0.05). There were no differences in DH between the three tests in the control group (p>0.05) and ventilatory demand increased at the end of the tests (p<0.05) but to a lower extent than the COPD group.
  
  
  CONCLUSIONS
  The TSHELF induces similar ventilatory responses to the Glittre-ADL test in COPD patients with higher ventilatory demand and DH. In contrast, the ventilatory response was attenuated in the TSHELF-M, suggesting that squatting and bending down during the Glittre-ADL test could trigger significant ventilatory overload.
authors.affiliation: Núcleo de Assistência, Ensino e Pesquisa em Reabilitação Pulmonar, Universidade do Estado de Santa Catarina (UDESC), Florianópolis, SC, Brazil.|Programa de Pós-graduação em Fisioterapia, Centro de Ciências da Saúde e do Esporte (CEFID), UDESC, Florianópolis, SC, Brazil.
authors.forename: Karoliny Dos
authors.initials: KD
authors.lastname: Santos
authors.affiliation: Núcleo de Assistência, Ensino e Pesquisa em Reabilitação Pulmonar, Universidade do Estado de Santa Catarina (UDESC), Florianópolis, SC, Brazil.|Programa de Pós-graduação em Fisioterapia, Centro de Ciências da Saúde e do Esporte (CEFID), UDESC, Florianópolis, SC, Brazil.
authors.forename: Aline A
authors.initials: AA
authors.lastname: Gulart
authors.affiliation: Núcleo de Assistência, Ensino e Pesquisa em Reabilitação Pulmonar, Universidade do Estado de Santa Catarina (UDESC), Florianópolis, SC, Brazil.|Programa de Pós-graduação em Fisioterapia, Centro de Ciências da Saúde e do Esporte (CEFID), UDESC, Florianópolis, SC, Brazil.
authors.forename: Anelise B
authors.initials: AB
authors.lastname: Munari
authors.affiliation: Núcleo de Assistência, Ensino e Pesquisa em Reabilitação Pulmonar, Universidade do Estado de Santa Catarina (UDESC), Florianópolis, SC, Brazil.
authors.forename: Manuela
authors.initials: M
authors.lastname: Karloh
authors.affiliation: Núcleo de Assistência, Ensino e Pesquisa em Reabilitação Pulmonar, Universidade do Estado de Santa Catarina (UDESC), Florianópolis, SC, Brazil.|Programa de Pós-graduação em Fisioterapia, Centro de Ciências da Saúde e do Esporte (CEFID), UDESC, Florianópolis, SC, Brazil.
authors.forename: Anamaria F
authors.initials: AF
authors.lastname: Mayer
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D003430:Cross-Sectional Studies; D005080:Exercise Test / Q000592:standards*; D006801:Humans; D007320:Inspiratory Capacity / Q000502:physiology*; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology*; D012119:Respiration