Acute Effect of Inspiratory Muscle Training on Peripheral Tissue Oxygenation Behavior in Individuals With COPD: A Randomized Crossover Study.

IF 1.7 Q3 REHABILITATION
Natália Mota da Silva Borges, Dyego Tavares de Lima, Arthur Bruno de Abreu Morais, Laura Natália Freitas Cavalcante Tenório, Sandyelle Teixeira Vieira, Hellen Maria Lacerda de Oliveira Carneiro, Annicia Lins Freitas, Daniele Ferreira de Santana Silva, Elysson da Silva, Maria Anita Oliveira Souza Paiva, José Vinicius Bulhões da Silva, Kauane Paulino Guedes, Tatiana Onofre Gama, Ana Tereza do Nascimento Sales Figueiredo Fernandes, Ingrid Guerra Azevedo, Pollyana Soares de Abreu Morais, Danielle Aparecida Gomes Pereira, Rafaela Pedrosa, José Heriston de Morais Lima, Eduardo Eriko Tenório de França
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Abstract

Background and purpose: Chronic Obstructive Pulmonary Disease (COPD) is a pulmonary condition characterized by airflow obstruction, which progresses with systemic alterations such as changes in muscle composition and metabolism, anticipating the activation of the inspiratory metaboreflex. This study aimed to analyze the acute effects of Inspiratory Muscle Training (IMT) on peripheral muscle metabolism in individuals with COPD, using near-infrared spectroscopy (NIRS).

Methods: This randomized, blinded, crossover study included 29 individuals with COPD who underwent three distinct sessions: high-load IMT (IMT-Strength, 60% of maximal inspiratory pressure-MIP), low-load IMT (IMT-Endurance, 30% of MIP), and a sham protocol. Tissue oxygenation of the gastrocnemius muscle was assessed using NIRS before and after each protocol.

Results: Differences in mean final tissue oxygen saturation were observed only during the IMT-Endurance protocol. The oxygen desaturation time was shorter during the IMT-Strength protocol compared with the other groups. Although not statistically significant, patients with more severe COPD (GOLD 3-4) exhibited an oxygen desaturation rate higher during the strength IMT compared with the endurance and sham protocols.

Conclusions: Acute high-intensity IMT may accentuate the reduction in peripheral perfusion, especially in patients with advanced COPD, suggesting possible metaboreflex activation. Conversely, endurance IMT may improve peripheral perfusion. These findings reinforce the need for careful and individualized prescription of IMT in the COPD population.

Trial registration: Clinical Trials number: NCT06827379 https://clinicaltrials.gov/study/NCT06827379.

吸气肌训练对慢性阻塞性肺病患者外周组织氧合行为的急性影响:一项随机交叉研究
背景和目的:慢性阻塞性肺疾病(COPD)是一种以气流阻塞为特征的肺部疾病,其进展伴随着全身改变,如肌肉成分和代谢的改变,预期吸气代谢反射的激活。本研究旨在利用近红外光谱(NIRS)分析吸气肌训练(IMT)对COPD患者外周肌肉代谢的急性影响。方法:这项随机、盲法、交叉研究纳入了29名COPD患者,他们经历了三个不同的阶段:高负荷IMT (IMT-强度,最大吸气压力的60%)、低负荷IMT (IMT-耐力,最大吸气压力的30%)和假方案。在每个方案之前和之后使用近红外光谱评估腓肠肌的组织氧合。结果:仅在imt -耐力方案中观察到平均最终组织氧饱和度的差异。与其他组相比,IMT-Strength方案的氧去饱和时间更短。虽然没有统计学意义,但与耐力组和假手术组相比,强度IMT期间更严重的COPD患者(GOLD 3-4)表现出更高的氧去饱和率。结论:急性高强度IMT可能会加重外周灌注的减少,特别是在晚期COPD患者中,提示可能的代谢反射激活。相反,耐力IMT可以改善周围灌注。这些发现加强了在COPD人群中谨慎和个性化IMT处方的必要性。临床试验注册号:NCT06827379 https://clinicaltrials.gov/study/NCT06827379。
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来源期刊
CiteScore
3.30
自引率
5.90%
发文量
53
期刊介绍: Physiotherapy Research International is an international peer reviewed journal dedicated to the exchange of knowledge that is directly relevant to specialist areas of physiotherapy theory, practice, and research. Our aim is to promote a high level of scholarship and build on the current evidence base to inform the advancement of the physiotherapy profession. We publish original research on a wide range of topics e.g. Primary research testing new physiotherapy treatments; methodological research; measurement and outcome research and qualitative research of interest to researchers, clinicians and educators. Further, we aim to publish high quality papers that represent the range of cultures and settings where physiotherapy services are delivered. We attract a wide readership from physiotherapists and others working in diverse clinical and academic settings. We aim to promote an international debate amongst the profession about current best evidence based practice. Papers are directed primarily towards the physiotherapy profession, but can be relevant to a wide range of professional groups. The growth of interdisciplinary research is also key to our aims and scope, and we encourage relevant submissions from other professional groups. The journal actively encourages submissions which utilise a breadth of different methodologies and research designs to facilitate addressing key questions related to the physiotherapy practice. PRI seeks to encourage good quality topical debates on a range of relevant issues and promote critical reflection on decision making and implementation of physiotherapy interventions.
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