Dyspnea affective response: comparing COPD patients with healthy volunteers and laboratory model with activities of daily living

A profound remodeling of the diaphragm and vastus lateralis (VL) occurs in patients with moderate-to-severe chronic obstructive pulmonary disease (COPD). In this mini-review, we discuss the following costal diaphragm remodeling features noted in patients with moderate-to-severe COPD: 1) deletion of serial sarcomeres, 2) increased proportion of slow-twitch fibers, 3) fast-to-slow isoform shift in sarco(endo)plasmic reticulum Ca2+-ATPase, 4) increased capacity of oxidative metabolism, 5) oxidative stress, and 6) myofiber atrophy. We then present the sole feature of diaphragm remodeling noted in mild-to-moderate COPD under the heading “ MyHC and contractile remodeling noted in mild-to-moderate COPD.” The importance of VL remodeling in COPD patients as a prognostic indicator as well as a major determinant of the ability to carry out activities of daily living is well accepted. We present the remodeling of the VL noted in COPD patients under the following headings: 1) Decrease in proportion of slow-twitch fibers, 2) Decreased activity of oxidative pathways, 3) Oxidative and nitrosative stress, and 4) Myofiber atrophy. For each of the remodeling features noted in both the VL and costal diaphragm of COPD patients, we present mechanisms that are currently thought to mediate these changes as well as the pathophysiology of each remodeling feature. We hope that our mechanistic presentation stimulates research in this area that focuses on improving the ability of COPD patients to carry out increased activities of daily living.

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Dynamic hyperinflation during activities of daily living in COPD patients

Chronic Respiratory Disease ◽

10.1177/1479972315576143 ◽

2015 ◽

Vol 12 (3) ◽

pp. 189-196 ◽

Cited By ~ 12

Author(s):

Cláudia S Silva ◽

Fabiana R Nogueira ◽

Elias F Porto ◽

Mariana R Gazzotti ◽

Oliver A Nascimento ◽

...

Keyword(s):

Activities Of Daily Living ◽

Daily Living ◽

Dynamic Hyperinflation ◽

Copd Patients

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Activities of daily living in patients with chronic obstructive pulmonary disease with depressive symptoms

Fisioterapia e Pesquisa ◽

10.1590/1809-2950/19018827022020 ◽

2020 ◽

Vol 27 (2) ◽

pp. 194-201

Author(s):

Rilda Carla Alves de Souza ◽

Fabíola Cássia de Oliveira Silva Vieira ◽

Graziella Monicky Oliveira Costa ◽

Kamila Roberta Perpétua de Souza ◽

Laura Maria Gomes de Siqueira ◽

...

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Depressive Symptoms ◽

Activities Of Daily Living ◽

Pulmonary Disease ◽

Daily Living ◽

Cross Sectional Study ◽

Chronic Obstructive ◽

Cross Sectional ◽

Obstructive Pulmonary Disease ◽

Copd Patients

ABSTRACT This cross-sectional study assessed the activities of daily living (ADL) and risk factors for developing depressive symptoms in patients with chronic obstructive pulmonary disease (COPD) and was carried out at the pulmonology outpatient clinic of the Hospital Universitário Oswaldo Cruz. Two hundred two (202) patients with COPD participated in the study. We evaluated the sociodemographic and anthropometric data, the ADL by means of Pulmonary Functional Status and Dyspnea Questionnaire - Modified version (PFSDQ-M), and the presence of depressive symptoms using the Beck Depression Inventory (BDI). All domains (dyspnea, fatigue and activity changes) of PFSDQ are compromised in patients with depressive symptoms. The prevalence of depressive symptoms was 38.6%. The chance of developing these symptoms was higher for those who used more than one bronchodilator (OR: 2.82, CI 95%: 1.47-5.38, p=0.002), presented dyslipidemias (OR: 2.74, CI95%: 1.24-6.07, p=0.012), had a heart disease (OR: 2.82, CI 95%: 1.18-6.74, p=0.020), presented expectoration (OR: 2.44, CI 95%: 1.2-4.95, p=0.014) or did not have a partner (OR: 2.58, CI 95%: 1.36-4.9, p=0.004). COPD patients with depressive symptoms had all domains of ADL compromised compared to patients without these symptoms.

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Cardiac, ventilatory, and metabolic adjustments in chronic obstructive pulmonary disease patients during the performance of Glittre activities of daily living test

Chronic Respiratory Disease ◽

10.1177/1479972314552805 ◽

2014 ◽

Vol 11 (4) ◽

pp. 247-255 ◽

Cited By ~ 15

Author(s):

Andréa Tufanin ◽

Gerson Fonseca Souza ◽

Guilherme Rocha Tisi ◽

Sergio Tufik ◽

Marco Túlio de Mello ◽

...

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Activities Of Daily Living ◽

Functional Status ◽

Pulmonary Disease ◽

Daily Living ◽

Lower Limbs ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Copd Patients ◽

The Impact

Functional status and quality of life are measures of the chronic obstructive pulmonary disease (COPD) patient’s health status and can demonstrate the impact of the disease on the patient’s ability to perform activities of daily living (ADLs). The Glittre-ADL test was developed to evaluate the functional status of COPD patients and their ability to perform activities of daily life. The objective of this study was to evaluate the cardiac, respiratory, and metabolic adjustments and reproducibility of the Glittre ADL test performed by COPD patients. Twenty-two mild to severe COPD patients (forced expiratory volume in 1 second (FEV1): 56.6 ± 19.9% predicted; mean age: 66.3 ± 9.18 years old) were enrolled in this study. Metabolic (oxygen uptake (VO2), carbon dioxide production (VCO2), pulmonary ventilation (VE)/VCO2, and VE/VO2), ventilatory (tidal volume, respiratory rate, and VE), and cardiovascular (pulse oxygen saturation, VO2/heart rate (HR), and HR) variables, lower limbs fatigue, and dyspnea (Borg score) after each lap of two Glittre ADL test were analyzed. All metabolic, ventilatory, and cardiac variables increased their values up to the third lap and remained stable (plateau) until the end of the test (five laps; multivariate analysis); there was no difference among the time spent to complete each of the five laps in each test and between tests (total time of second test: 4 minutes and 3 seconds); the second test was 17.8 seconds (6.6%) shorter than the first one (NS). All variables were highly reproducible in the two tests (NS). At the end of the test, patients reached 87.7% of the VO2 max, 81% of VE peak, and 88.5% of the HR peak obtained from an incremental maximal test on a treadmill. The Glittre ADL test is easy for COPD patients to perform and is a highly reproducible test in COPD patients with mild to severe stages of the disease. In addition, our results suggest that it is possible to demonstrate the patient’s functional capacity with a single test of only three laps, making it faster and easier to apply and less stressful for some patients.

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