Burapha University, Thailand
Title: Effects of Conical-PEP on Dynamic Hyperinflation and Exercise Recovery in Patient with mild to moderate COPD
Miss Tadsawiya Padkao is a lecturer in physical therapy program at Burapha university. She has been experienced in clinical rehabilitation of COPD patients and elderly, and also, she interests investigate on impact of air pollution in northern and eastern of Thailand to pulmonary functions
Statement of the Problem: Expiratory airflow limitation is the pathophysiological significant of COPD that leads to air trapping and increases in dynamic hyperinflation (DH), consequently causes dyspnea during exercise and prolongs recovery time. Positive expiratory pressure (PEP) has been widely used in the management of lung where airway collapse is a problem. Therefore, the purpose of this study was to examine the effects of Conical-PEP, a new PEP device, on DH and recovery time in COPD. Methodology: A crossover study, which had been approved by the local ethics committee, was carried out in 8 patients with mild to moderate COPD (Age 55.75±9.82 yrs, FEV1 58.00±8.77 %predicted, FEV1% 66.38±12.91). Patients undertook five-minute knee extension exercise at 30% of 1RM while breathing out through the mouth with (Conical-PEP) or without (Control) the device. DH was evaluated by change in the inspiratory capacity (IC) measured immediately at the end of exercise compared pre-exercise values. Recovery time was record when their heart rate was returned to HR resting. Respiratory rate (RR), expiratory time (Te) and mouth pressure were also measured during exercise. Conclusion & Significance: During exercise with Conical-PEP, positive expiratory mouth pressure was 12.85±4.03 cmH2O. IC was larger 0.18±0.10 liters in Conical-PEP than Control (2.8±0.1 vs 2.6±0.1liters, respectively, p<0.05). Te was prolonged compared to the Control condition (2.2±0.3 vs 1.5 ±0.2 s, respectively, p<0.05). RR in the Conical-PEP condition was slower compared to Control (19.0±1.7 vs 25.1±1.7 bpm, respectively, p<0.05). Recovery time of Conical-PEP was reduced 88.0±43.6 s compared to Control (290±51.4 vs 378±79 s, respectively, p<0.05). This study provides data indicating that Conical-PEP generates sufficiently high positive expiratory pressures to allow effective lung emptying and prevent DH during exercise and contribute to decrease recovery period in COPD. Further studies are indicated to determine how useful Conical-PEP can be for a wider population.