Acute effects of NIV on peripheral muscle function and aerobic performance in patients with chronic obstructive pulmonary disease: a pilot study.

BACKGROUND: Non-invasive ventilation (NIV) reduces respiratory load and demands on peripheral muscles. METHODS: This study aims to evaluate the acute effects of bi-level NIV on peripheral muscle function during isokinetic exercise and aerobic performance in chronic obstructive pulmonary disease (COPD) patients. This is a pilot crossover study performed with a non-probabilistic sample of 14 moderate to very severe COPD patients. Procedures carried out in two days. Dyspnea, quality of life, lung function, respiratory muscle strength, functional capacity (6-min walk test-6MWT), and isokinetic assessment of the quadriceps were assessed. Blood samples (lactate, lactate dehydrogenase, and creatine kinase concentration) were also collected. Right after, NIV was performed for 30 min (bi-level or placebo, according to randomization) followed by new blood sample collection, 6MWT, and isokinetic dynamometer tests. Before and after evaluations, the subjective perception of dyspnea and fatigue in the lower limbs was quantified. After a wash-out period of seven days, participants returned, and all assessments were performed again. RESULTS: NIV showed improvements in perceived exertion and dyspnea after isokinetic exercise (p < 0.02 and p < 0.05, respectively). CONCLUSIONS: NIV improves the perception of dyspnea and fatigue during the isokinetic exercise.

Effectiveness of low-intensity aquatic exercise on COPD: a randomized clinical trial.

BACKGROUND: Despite the growing number of studies reporting therapeutic success in water environments, research involving aquatic exercise among patients with Chronic Obstructive Pulmonary Disease (COPD) is scarce. This study evaluates the impact of low-intensity water and floor exercises on COPD. METHODS: Forty two individuals with moderate to very severe COPD, divided into 3 groups: Control Group (CG), Floor Group (FG) and the Aquatic Group (AG). All participants were assessed using spirometry, respiratory muscle strength (MIP and MEP), the 6-Minute Walk Test (6MWT), Medical Research Council (MRC), BODE index and the St George's Respiratory Questionnaire (SGRQ). RESULTS: A difference was recorded after intervention for the 6MWT in the AG (p = 0.02); for VEF(1) in the FG (p = 0.00) and AG (p = 0.01); for MIP in the FG (p = 0.01) and AG (p = 0.02); for MEP in the FG (p = 0.02) and AG (p = 0.01); the MRC fell in the AG (p = 0.00). The FG showed improved quality of life evidenced by the total score on the SGRQ (p = 0.00). The BODE index decreased in the FG (p = 0.00) and AG (p = 0.01). CONCLUSION: Results show that both forms of low-intensity physical exercise benefit patients with moderate and very severe COPD. The AG exhibited additional benefits in physical ability, indicating a new therapeutic modality targeting patients with COPD.