Slow chest compression acutely reduces dynamic hyperinflation in people with chronic obstructive pulmonary disease: a randomized cross-over trial

ABSTRACT

Background

Strategies to minimize dynamic hyperinflation (DH) and dyspnea, such as slow chest compression (SCC), are relevant in people with chronic obstructive pulmonary disease (COPD).

Objectives

To analyze the acute effects of SCC after exercise on DH and dyspnea in people with COPD and to identify responders to the technique.

Methods

This is a cross-over study with 40 patients. Two six-minute step tests (6MSTs) were performed followed by a one-minute application of SCC (6MST_SCC) or rest (6MST_CONTROL), at random. End-expiratory lung volume (EELV) and dyspnea were assessed. A difference ≥76 ml in ΔEELV between SCC and control characterized the responders.

Results

The performance in 6MST_SCC and 6MST_CONTROL were similar. There was a greater reduction in EELV after 6MST_SCC compared to 6MST_CONTROL (124 ± 193 ml vs. 174 ± 183 ml; p = .049), while there was no difference in change in dyspnea between the SCC and control groups. Twenty-one participants were SCC responders and had higher functional residual capacity [FRC: 5.36 ± 1.09 vs. 4.58 ± 0.94; p = .02; cutoff point: 4.56; sensitivity = 76%; specificity = 53%; AUC = 0.71 (95%CI: 0.54 to 0.87); p = .02].

Conclusion

SCC applied immediately after exercise reduced DH, but did not reduce dyspnea in people with COPD. The technique is beneficial only for some patients and FRC can help to identify them.

KEYWORDS:

• Chronic obstructive pulmonary disease
• activities of daily living
• inspiratory capacity
• dyspnea

Acknowledgments

This study was partly financed by Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES) - Finance Code 001 and supported by the Fundação de Amparo à Pesquisa e Inovação do Estado de Santa Catarina – FAPESC/Brazil (PAP-UDESC Chamada Pública Nº 01/2016 - Termo de Outorga 2017TR645).

Declarations of Interest

None declared.

Additional information

Funding

This work was supported by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior [CAPES; Finance Code 001]; Fundação de Amparo à Pesquisa e Inovação do Estado de Santa Catarina [FAPESC/Brazil; PAP-UDESC Chamada Pública Nº 01/2016 - Termo de Outorga 2017TR645].