Effects of aerobic training combined with respiratory muscle stretching on the functional exercise capacity and thoracoabdominal kinematics in patients with COPD: a randomized and controlled trial.
BACKGROUND
Patients with COPD present a major recruitment of the inspiratory muscles, predisposing to chest incoordination, increasing the degree of dyspnea and impairing their exercise capacity. Stretching techniques could decrease the respiratory muscle activity and improve their contractile capacity; however, the systemic effects of stretching remain unknown.


OBJECTIVE
The aim of this study was to evaluate the effects of aerobic training combined with respiratory muscle stretching on functional exercise capacity and thoracoabdominal kinematics in patients with COPD.


METHODS
This study was a randomized and controlled trial.


METHODS
A total of 30 patients were allocated to a treatment group (TG) or a control group (CG; n=15, each group).


METHODS
The TG was engaged in respiratory muscle stretching and the CG in upper and lower limb muscle stretching. Both groups performed 24 sessions (twice a week, 12 weeks) of aerobic training.


METHODS
Functional exercise capacity (6-minute walk test), thoracoabdominal kinematics (optoelectronic plethysmography), and respiratory muscle activity (surface electromyography) were evaluated during exercise. Analysis of covariance was used to compare the groups at a significance level of 5%.


RESULTS
After the intervention, the TG showed improved abdominal (ABD) contribution, compartmental volume, mobility, and functional exercise capacity with decreased dyspnea when compared with the CG (P<0.01). The TG also showed a decreased respiratory muscle effort required to obtain the same pulmonary volume compared to the CG (P<0.001).


CONCLUSIONS
Our results suggest that aerobic training combined with respiratory muscle stretching increases the functional exercise capacity with decreased dyspnea in patients with COPD. These effects are associated with an increased efficacy of the respiratory muscles and participation of the ABD compartment.
Department of Physical Therapy.
Juliano T
JT
Wada
Department of Physical Therapy.
Erickson
E
Borges-Santos
Department of Physical Therapy.
Desiderio Cano
DC
Porras
Department of Physical Therapy.
Denise M
DM
Paisani
Department of Cardiopneumology, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil.
Alberto
A
Cukier
Department of Physical Therapy.
Adriana C
AC
Lunardi
Department of Physical Therapy.
Celso Rf
CR
Carvalho
D000368:Aged; D001696:Biomechanical Phenomena; D001938:Brazil; D001945:Breathing Exercises; D004417:Dyspnea / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D005081:Exercise Therapy / Q000379:methods*; D017079:Exercise Tolerance; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008168:Lung / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009119:Muscle Contraction; D052580:Muscle Stretching Exercises; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D020127:Recovery of Function; D012132:Respiratory Muscles / Q000503:physiopathology*; D013997:Time Factors; D016896:Treatment Outcome; D014797:Vital Capacity
COPD; dyspnea; muscular stretching; respiratory mechanics; respiratory muscles