Effects of a Rehabilitation Programme Using a Nasal Inspiratory Restriction Device in COPD

Jose L Gonzalez-Montesinos; Jorge R Fernandez-Santos; Carmen Vaz-Pardal; Jesus G Ponce-Gonzalez; Alberto Marin-Galindo; Aurelio Arnedillo

doi:10.3390/ijerph18084207

Effects of a Rehabilitation Programme Using a Nasal Inspiratory Restriction Device in COPD

Int J Environ Res Public Health. 2021 Apr 15;18(8):4207. doi: 10.3390/ijerph18084207.

Authors

Jose L Gonzalez-Montesinos¹, Jorge R Fernandez-Santos^{2

3}, Carmen Vaz-Pardal⁴, Jesus G Ponce-Gonzalez^{3

5}, Alberto Marin-Galindo⁵, Aurelio Arnedillo^{3

6}

Affiliations

¹ Department of Physical Education, Faculty of Education Sciences, University of Cádiz, 11519 Puerto Real, Spain.
² Galeno Research Group, Department of Physical Education, Faculty of Education Science, University of Cádiz, 11519 Puerto Real, Spain.
³ Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, Puerta del Mar University Hospital, University of Cádiz, 11009 Cádiz, Spain.
⁴ Bahía Sur Andalusian Center for Sports Medicine, 11100 Cádiz, Spain.
⁵ MOVE-IT Research Group Department of Physical Education, Faculty of Education Science, University of Cádiz, 11519 Puerto Real, Spain.
⁶ Pneumology, Allergy and Thoracic Surgery Department, Puerta del Mar University Hospital, 11009 Cádiz, Spain.

Abstract

Chronic obstructive pulmonary disease (COPD) patients are characterised for presenting dyspnea, which reduces their physical capacity and tolerance to physical exercise. The aim of this study was to analyse the effects of adding a Feel-Breathe (FB) device for inspiratory muscle training (IMT) to an 8-week pulmonary rehabilitation programme. Twenty patients were randomised into three groups: breathing with FB (FBG), oronasal breathing without FB (ONBG) and control group (CG). FBG and ONBG carried out the same training programme with resistance, strength and respiratory exercises for 8 weeks. CG did not perform any pulmonary rehabilitation programme. Regarding intra group differences in the value obtained in the post-training test at the time when the maximum value in the pre-training test was obtained (Post_PRE), FBG obtained lower values in oxygen consumption (VO₂, mean = -435.6 mL/min, Bayes Factor (BF₁₀) > 100), minute ventilation (VE, -8.5 L/min, BF₁₀ = 25), respiratory rate (RR, -3.3 breaths/min, BF₁₀ = 2), heart rate (HR, -13.7 beats/min, BF₁₀ > 100) and carbon dioxide production (VCO₂, -183.0 L/min, BF₁₀ = 50), and a greater value in expiratory time (Tex, 0.22 s, BF₁₀ = 12.5). At the maximum value recorded in the post-training test (Post_FINAL), FBG showed higher values in the total time of the test (T_t, 4.3 min, BF₁₀ = 50) and respiratory exchange rate (RER, 0.05, BF₁₀ = 1.3). Regarding inter group differences at Pre_POST, FBG obtained a greater negative increment than ONBG in the ventilatory equivalent of CO₂ (EqCO₂, -3.8 L/min, BF₁₀ = 1.1) and compared to CG in VE (-8.3 L/min, BF₁₀ = 3.6), VCO₂ (-215.9 L/min, BF₁₀ = 3.0), EqCO2 (-3.7 L/min, BF₁₀ = 1.1) and HR (-12.9 beats/min, BF₁₀ = 3.4). FBG also showed a greater Pre_POST positive increment in Tex (0.21 s, BF₁₀ = 1.4) with respect to CG. At Pre_FINAL, FBG presented a greater positive increment compared to CG in T_t (4.4 min, BF₁₀ = 3.2) and negative in VE/VCO₂ intercept (-4.7, BF₁₀ = 1.1). The use of FB added to a pulmonary rehabilitation programme in COPD patients could improve tolerance in the incremental exercise test and energy efficiency. However, there is only a statically significant difference between FBG and ONBG in EqCO₂. Therefore, more studies are necessary to reach a definitive conclusion about including FB in a pulmonary rehabilitation programme.

Keywords: cardiopulmonary exercise test; chronic pulmonary obstructive pulmonary disease; inspiratory muscle training; physical exercise.

Publication types

Randomized Controlled Trial

MeSH terms

Bayes Theorem
Breathing Exercises
Exercise Test
Exercise Tolerance*
Humans
Pulmonary Disease, Chronic Obstructive*