Dynamic hyperinflation induced by the 6-minute pegboard and ring test in hospitalized patients with exacerbated COPD

• Published in: PloS one Vol. 15; no. 11; p. e0241639
• Main Authors: Barros, Cassia Fabiane de, Felisberto, Rosimeire Marcos, Nucci, Kelly Cristina Albanezi, Albuquerque, Andre Luis Pereira de, Paulin, Elaine, Brito, Christina May Moran de, Yamaguti, Wellington Pereira
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 10.11.2020; Public Library of Science (PLoS)
• Subjects: Activities of daily living; Aged; Biology and Life Sciences; Chronic obstructive lung disease; Chronic obstructive pulmonary disease; Cross-Sectional Studies; Diagnosis; Dyspnea; Evaluation; Exercise; Fatigue; Fatigue tests; Female; Forced Expiratory Volume - physiology; Heart rate; Hemodynamics; Hemodynamics - physiology; Hospital patients; Hospitalization; Hospitals; Humans; Inspiratory Capacity - physiology; Limbs; Lung diseases; Male; Medicine and Health Sciences; Mortality; Obstructive lung disease; Patient outcomes; Patients; Physical fitness; Physical Sciences; Physiological responses; Physiology; Pulmonary Disease, Chronic Obstructive - physiopathology; Questionnaires; Recovery; Respiration; Respiratory function; Respiratory Function Tests; Respiratory rate; Respiratory Rate - physiology; Rest; Signs and symptoms; Ventilators; Brazil
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0241639

The six-minute pegboard and ring test (6-PBRT) has been used to evaluate functional capacity of the upper limbs in stable chronic obstructive pulmonary disease (COPD) patients. To the best of our knowledge, no studies have evaluated dynamic hyperinflation (DH) during exercise with upper limbs in the hospital setting. The aim of this study was to evaluate physiological responses and DH induced by 6-PBRT in hospitalized patients with acute exacerbation of COPD (AECOPD). A cross-sectional study was conducted in a tertiary hospital enrolling patients who were hospitalized due to AECOPD. All included participants underwent an evaluation of lung function and 6-PBRT when they reached minimum clinical criteria. Ventilatory and hemodynamics parameters were monitored during 6-PBRT and until 6 minutes of rest after the test. Symptoms of dyspnea and upper limb fatigue were also measured. Eighteen patients (71.3±5.1 years) with a mean FEV1 of 43.2±18.3% were included in the study (11 females). Prevalence of DH after 6-PBRT was 50% (considering the drop of 150 ml or 10% of inspiratory capacity, immediately after the end of the test). There was a significant increase in respiratory rate, minute volume, dyspnea, and upper limb fatigue after the end of 6-PBRT (p<0.05). Dyspnea recovered more precociously than the perception of fatigue, being reestablished within four minutes of rest. An increase in heart rate, systolic and diastolic blood pressures was also induced by 6-PBRT (p<0.05), requiring 6 minutes of recovery to return to baseline. No adverse events were observed during 6-PBRT. We concluded that 6-PBRT induces physiological changes during its execution, at safe levels, requiring a maximum of 6 minutes for recovery. Finally, the test proved to be safe and applicable for patients hospitalized due to AECOPD.