Effect of Threshold Positive Expiratory Pressure on Dynamic Hyperinflation & Dyspnea in COPD: A Randomized Cross Over Trial

*, Sridhar S. A and *, Vaishali.K and Alaparthi, Gopal Krishna and *, Shyam Krishnan and *, Zulfeequer and *, Anand R (2012) Effect of Threshold Positive Expiratory Pressure on Dynamic Hyperinflation & Dyspnea in COPD: A Randomized Cross Over Trial. International Journal of Health Sciences and Research, 2 (5). pp. 7-16. ISSN 2249-9571

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Background: Hyperinflation seen in COPD patients puts excess loads on ventilatory muscles exercise intolerance and limits physical activity. Physiotherapeutic management mainly emphasizes on increasing providing positive end expiratory pressure devices (PEEP). Threshold PEP is a device generating this pressure. Aim of the study is to evaluate efficacy of Threshold PEP in reducing dynamic hyperinflation & dyspnea during exercise. Material and Methods: Thirty two patients were screened out of which twenty seven were included who were clinically stable with mean age of (64.63 ± 4.83) of either gender Male (n=20), Female (n=12). Patients included were into moderate to severely affected category (GOLD). Crossing over of patients in either group was done & sequence of therapy was allocated by block randomization. After recruitment initial assessment including PFT, RPE, 1RM & vitals was done. Patients performed same exercise with the device in experimental group & without device in control group. Patients performed knee extension exercise with weights (30% of 1RM) firmly strapped to ankles in high sitting position. Both legs were exercised alternately, with approximately 15 repetitions per leg per minute. A washout period of 60 minutes was given between interventions. Number of repetitions, time duration of exercise, PFT (Inspiratory capacity, slow vital capacity) breathlessness by RPE & vitals were measured in both the group pre – post intervention. Results: A statistically significant difference was found in the inspiratory capacity in experimental group (0.52 ± 0.10) compared to (-0.11 ± 0.10) in control group. The RPE scores were lesser on experimental group post intervention (-0.61 ± 0.19) as compared to controls (0.9 ± 0.2). The duration of exercise in experimental group (94.85 ± 43.03) was more than controls (78.22 ± 35.39) .The number of repetitions in experimental group (93.55 ± 35.43) was higher than controls (71.55 ± 25.28). Conclusion: Threshold positive expiratory pressure (PEP) improves inspiratory capacity & slow vital capacity by reducing dynamic hyperinflation during exercise. This helps in alleviating dyspnea during training & improves exercise performance in COPD patients.

Item Type: Article
Uncontrolled Keywords: Dynamic hyperinflation, COPD, threshold positive expiratory pressure (PEP), Physiotherapy, dyspnea , exercise training
Subjects: Allied Health > Mangalore Campus > Physiotherapy
Depositing User: KMCMLR User
Date Deposited: 10 Sep 2012 11:25
Last Modified: 10 Sep 2012 11:25
URI: http://eprints.manipal.edu/id/eprint/77179

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