scholarly journals Comprehensive exercise training improves ventilatory muscle function and reduces dyspnea perception in patients with COPD

2016 ◽  
Vol 71 (3) ◽  
Author(s):  
F. Cortopassi ◽  
A.A.M. Castro ◽  
E.F. Porto ◽  
M. Colucci ◽  
G. Fonseca ◽  
...  
Keyword(s):  
Exercise Training ◽  
Respiratory Muscles ◽  
Exercise Programme ◽  
Lower Limbs ◽  
Test Time ◽  
Chronic Obstructive ◽  
Endurance Test ◽  
Incremental Test ◽  
Copd Patients ◽  
Before And After

Background. Comprehensive exercise training (CET) is an efficient strategy to decrease dyspnea perception in chronic obstructive pulmonary disease (COPD) and may result in significant improvement in ventilatory muscles function. Our aim was to evaluate the effects of general exercise training on dyspnea perception and on respiratory muscles strength in COPD patients. Methods. Consecutive COPD patients were enrolled to complete a CET programme. The patients underwent a routine that included a global warm up, upper and lower limbs endurance exercise as well as stretching and relaxation. Before and after the CET programme, patients completed maximal inspiratory (PImax) and expiratory (PEmax) pressures measurements, maximal incremental test, endurance test, and 6-min walk distance (6MWD). Results. 71 patients (52 male). Mean age 67.6±8.6 years, FEV1 (%) 44.2±16.2 and Mahler dyspnea scale 6.4±1.8. The results before and after the exercise programme were: PImax 64.7±22.9 vs. 75.5±23.7 cmH2O (p=0.001), PEmax 110.8±28.1 vs. 120.4±28.1 cmH2O (p=0.004), 6MWD 510.6±90.3 vs. 528.2±99.7 metres (p=0.88), time of incremental test 672±135 vs. 856±226 sec (p<0.0001). Compared with the pre exercise programme, we observed a significant reduction on Borg dyspnea scale (6.1±2.8 to 3.6±2.3, p<0.0001) as well as a longer test time (504±218 to 1.038±841, p<0.0001) at the end of the endurance test after CET programme. Improvement of PImax correlated negatively with dyspnea perception at iso-time during the endurance test (r= -0.33, p=0.03). Conclusions. Our results confirm that CET is associated with significant improvement in PImax, PEmax and provide evidence demonstrating that CET reduces dyspnea perception in patients with COPD.

scholarly journals Effects of exercise training on quadriceps muscle gene expression in chronic obstructive pulmonary disease

2007 ◽  
Vol 102 (5) ◽  
pp. 1976-1984 ◽  
Author(s):  
Shlomit Radom-Aizik ◽  
Naftali Kaminski ◽  
Shlomo Hayek ◽  
Hillel Halkin ◽  
Dan M. Cooper ◽  
...  
Keyword(s):  
Gene Expression ◽  
Chronic Obstructive Pulmonary Disease ◽  
Exercise Training ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Muscle Gene Expression ◽  
Copd Patients ◽  
Before And After ◽  
Ubiquitin Proteasome ◽  
Muscle Gene

Exercise capacity and training response are limited in chronic obstructive pulmonary disease (COPD), but the extent to which this is related to altered skeletal muscle function is not fully understood. To test the hypothesis that muscle gene expression is altered in COPD, we performed needle biopsies from the vastus lateralis of six COPD patients and five sedentary age-matched healthy men, before and after 3 mo of exercise training. RNA was hybridized to Affymetrix U133A Genechip arrays. In addition, peak O2 uptake and other functional parameters (e.g., 6-min walk) were measured before and after training. The 6-min walk test increased significantly following training in both groups (53.6 ± 18.6 m in controls, P = 0.045; 37.1 ± 6.7 m in COPD, P = 0.002), but peak O2 uptake increased only in controls (19.4 ± 4.5%, P = 0.011). Training significantly altered muscle gene expression in both groups, but the number of affected genes was lower in the COPD patients (231) compared with controls (573). Genes related to energy pathways had higher expression in trained controls. In contrast, oxidative stress, ubiquitin proteasome, and COX gene pathways had higher expression in trained COPD patients, and some genes (e.g., COX11, COX15, and MAPK-9) were upregulated by training only in COPD patients. We conclude that both COPD and control subjects demonstrated functional responses to training but with somewhat different patterns in muscle gene expression. The pathways that are uniquely induced by exercise in COPD (e.g., ubiquitin proteasome and COX) might indicate a greater degree of tissue stress (perhaps by altered O2 and CO2 dynamics) than in controls.

Metabolic derangements in COPD muscle dysfunction

2013 ◽  
Vol 114 (9) ◽  
pp. 1282-1290 ◽  
Author(s):  
Luis Puente-Maestu ◽  
Alberto Lázaro ◽  
Blanca Humanes
Keyword(s):  
Lactate Production ◽  
Respiratory Muscles ◽  
Oxidative Capacity ◽  
Chronic Obstructive ◽  
Diabetic Patients ◽  
Peroxisome Proliferator ◽  
Type I ◽  
Oxidase Gene ◽  
Altered Expression ◽  
Copd Patients

Mitochondrial muscle alterations are common in patients with chronic obstructive pulmonary disease (COPD) and manifest mainly as decreased oxidative capacity and excessive production of reactive oxygen species (ROS). The significant loss of oxidative capacity observed in the quadriceps of COPD patients is mainly due to reduced mitochondrial content in the fibers, a finding consistent with the characteristic loss of type I fibers observed in that muscle. Decreased oxidative capacity does not directly limit maximum performance; however, it is associated with increased lactate production at lower exercise intensity and reduced endurance. Since type I fiber atrophy does not occur in respiratory muscles, the loss of such fibers in the quadriceps could be to the result of disuse. In contrast, excessive production of ROS and oxidative stress are observed in both the respiratory muscles and the quadriceps of COPD patients. The causes of increased ROS production are not clear, and a number of different mechanisms can play a role. Several mitochondrial alterations in the quadriceps of COPD patients are similar to those observed in diabetic patients, thus suggesting a role for muscle alterations in this comorbidity. Amino acid metabolism is also altered. Expression of peroxisome proliferator-activated receptor-γ coactivator-1α mRNA is low in the quadriceps of COPD patients, which could also be a consequence of type I fiber loss; nevertheless, its response to exercise is not altered. Patterns of muscle cytochrome oxidase gene activation after training differ between COPD patients and healthy subjects, and the profile is consistent with hypoxic stress, even in nonhypoxic patients.

scholarly journals Immediate effect of Chest Proprioceptive Neuromuscular Facilitation on Respiratory Rate, Chest Expansion and Peak Expiratory Flow Rate in patients with Chronic Obstructive Pulmonary Disease

2021 ◽  
Vol 9 (1) ◽  
pp. 3724-3729
Author(s):  
Hetal M Mistry ◽  
◽  
Rutuja V Kamble ◽  
Keyword(s):  
Respiratory Rate ◽  
Peak Expiratory Flow ◽  
Flow Rate ◽  
Peak Expiratory Flow Rate ◽  
Respiratory Muscles ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Chest Expansion ◽  
Copd Patients ◽  
Expiratory Flow

Background: In Chronic Obstructive Pulmonary Disease (COPD), as result of dynamic hyperinflation, primary respiratory muscles go into weakness and length tension relationship of muscles is altered. This leads to decreased ability of primary respiratory muscles to generate muscle tension. COPD patients mostly use accessory muscle for breathing and there is lack of facilitation of intercostal muscle and weakness of diaphragm. Few studies are conducted to assess the immediate effect of Chest Proprioceptive Neuromuscular Facilitation (PNF) i.e. intercostal stretch among COPD patients. Therefore, there is need to find out immediate effect of chest PNF- intercostal stretch on respiratory rate (RR), chest expansion, peak expiratory flow rate (PEFR) among patient with COPD. Objective: To find out immediate effect chest PNF on respiratory rate, chest expansion and peak expiratory flow rate. Methodology: Ethical clearance and participant consent was taken. Study design was Qausi experimental study. The 65 subjects were taken by convenient sampling. Intercostal stretch was applied over 2nd and 3rd rib bilaterally for 10 breaths with 1 minute rest with a 10 repetitions and Outcome measures were assessed before and immediately after giving chest PNF. SPSS 16 software was used to analyse the data. The normality of the data was assessed using parametric paired t test. Significance level was set at 0.05 and 95% Confidence Interval. Outcome Measures: Respiratory rate, Chest expansion, Peak expiratory flow rate. Result: Immediate effect of chest PNF showed that there was statistically significant increase in PEFR and chest expansion at three level (P=0.000) and there was statistically significant decrease in RR (P=0.000). Conclusion: There is immediate effect of Chest PNF- intercostal stretch on, Respiratory rate, Chest expansion at three level that is axillary, nipple and xiphisternal and Peak expiratory flow rate. It is an easy to use, less time consuming, easy to understand and cost effective technique. KEY WORDS: Chest PNF, intercostal stretch, COPD.

scholarly journals The Effect of Opiocephalus striatus Extract on Leptin, Adiponectin and COPD Assessment Test Scores on Stable COPD Patients Experiencing Muscle Wasting

2018 ◽  
Vol 38 (3) ◽  
pp. 158-163
Author(s):  
Komang Sri Rahayu Widiasari ◽  
Susanthy Djajalaksana ◽  
Harun Al Rasyid
Keyword(s):  
Quality Of Life ◽  
Muscle Wasting ◽  
Nutrition Therapy ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Before And After ◽  
Quasi Experimental ◽  
Physiology Laboratory

Background: Muscle wasting is one of extrapulmonary manifestations that occur in 20-40% of patients with COPD as a result of an imbalance of protein synthesis and degradation, where it is thought to be a consequence of chronic inflammation. One of the factor that affect muscle wasting is nutritional factor. The purpose of this study is to prove that nutrition therapy can improve inflammation (measured by levels of leptin, adiponectin) further improve muscle wasting and improve the quality of life of patients COPD with muscle wasting. Method: The clinical study design is pre and post auto control quasi experimental in stable COPD patients with comorbid muscle wasting. The experiment was conducted in Pulmonary Outpatient Clinic Dr. Saiful Anwar Hospital and Physiology Laboratory of Medical Faculty Brawijaya University. Chronic obstructive pulmonary disease was diagnosed based on 2014 GOLD criteria. Muscle wasting was diagnosed through examination of the BIA. Levels of leptin and adiponectin was measured using ELISA method, and quality of life was assessed using CAT score. We measured BIA, Leptin, Adiponectin and CAT in 32 COPD patients with muscle wasting, before and after 12 weeks supplementation of Opiocephalus striatus extract 3x1000mg/day. Results: There were significant increased of BMI (p = 0.046), no significant increase of FFMI (p = 0506), a significant decrease in leptin levels (p = 0.000) and a significant increase in adiponectin levels (p = 0.048) and improvement of quality of life (score CAT) (p = 0.000) ) after administration of opiocephalus striatus extract for 12 weeks. Conclusion: Suplementation of Opiocephalus striatus extract for 12 weeks can improve BMI, decrease levels of leptin and increase level of adiponectin resulting in improvement of quality of life in stable COPD patients with muscle wasting.

scholarly journals Krónikus légzőszervi betegek tápláltsági állapotának vizsgálata – klinikai megfigyelések

2019 ◽  
Vol 160 (23) ◽  
pp. 908-913
Author(s):  
Mónika Fekete ◽  
Vince Pongor ◽  
Ágnes Fehér ◽  
Márta Veresné Bálint ◽  
János Tamás Varga ◽  
...  
Keyword(s):  
Nutritional Status ◽  
Pulmonary Function ◽  
Respiratory Muscles ◽  
Prognostic Indicator ◽  
Chronic Obstructive ◽  
Forced Expiration ◽  
Record System ◽  
Severity Of Disease ◽  
Copd Patients ◽  
System Inclusion

Abstract: Introduction: The increased metabolism of nutrients and the low energy intake may lead to malnutrition among chronic obstructive pulmonary disease (COPD) patients. Aim: The goal of our study was to examine the nutritional status of our population aged over 40, and its relationship with the severity of the disease. Method: We conducted a retrospective study at the National Korányi Institute of Pulmonology in 2017. Pulmonary function and anthropometric data were obtained from the electronic health record system. Inclusion criteria were age over 40 and the diagnosis of COPD. Severity of disease was assessed by forced expiration volume and categorized according to GOLD stages. We used SPSS Statistics V22.0 for data analysis. Results: The mean age of participants was 66; 49.3% were men, 50.7% were women. Average BMI was 27.14 kg/m², with values comprising cachexia and severe obesity. According to the FEV1%pred results of the 3236 patients, 30% fell in the GOLD I, 40% in the GOLD II, 23% in the GOLD III, and 7% in the GOLD IV categories. Pearson coefficient found positive correlation between FEV1 and nutritional status (H = 0.2297, r = 0.1401), specifically between severity of cachexia and severity of disease. The analysis of variance showed significant correlation between severity of disease and nutritional status; patients with higher BMI had better pulmonary function. Conclusion: Malnutrition had an adverse effect on pulmonary functions and performance of respiratory muscles, whereas higher BMI had a positive effect on FEV1. Our results suggest that BMI could be used as a lung function prognostic indicator for COPD patients. Orv Hetil. 2019; 160(23): 908–913.

scholarly journals EFEKTIVITAS TEKNIK PURSED LIPSBREATHING PADA PASIEN PENYAKIT PARU OBSTRUKSI KRONIK (PPOK): STUDY SYSTEMATIC REVIEW

2019 ◽  
Vol 12 (2) ◽  
pp. 137
Author(s):  
Barakatul Qamila ◽  
Maria Ulfah Azhar ◽  
Risnah Risnah ◽  
Muhammad Irwan
Keyword(s):  
Systematic Review ◽  
Respiratory Muscles ◽  
Chronic Obstructive ◽  
Inclusion Criteria ◽  
Breathing Patterns ◽  
Obstructive Pulmonary Disease ◽  
Main Complaint ◽  
Copd Patients ◽  
Research Questions ◽  
Quantitative Descriptive

Chronic obstructive pulmonary disease (COPD) is one of the chronic diseases characterized by limited air flow contained in the respiratory tract. Breathing shortness becomes the main complaint feeling by COPD patients. Pursed lips breathing (PLB) technique can increase pulmonary compliance to retrain the respiratory muscles to function properly and prevent respiratory distress. This study aims to determine the effectiveness of pursed lips breathing technique in COPD patients. The research used a quantitative descriptive design with a systematic review approach. There were 315 articles published from 2015-2019. From 315 articles, 7 articles that met the inclusion criteria and research questions. Based on the result of the Systematic Review that has been conducted on pursed lips breathing technique in COPD patients, it was concluded that the PLB technique is effective to reduce breathing frequency and improve oxygen saturation. PLB technique given 3 times per day in every morning, afternoon, and evening with a time of 6-30 minutes for 3 consecutive days. The PLB technique is effective in reduce frequency respiratory and increase oxygenation in COPD patients with ineffective breathing patterns. Furthermore, it is suggested that PLB techniques can be applied as one of the nurses' independent interventions in nursing care for COPD patients to reduce patients complaints of breathing shortness.ABSTRAKPenyakit paru obstruksi kronik (PPOK) merupakan salah satu penyakit kronik yang ditandai dengan terbatasnya aliran udara yang terdapat di dalam saluran pernapasan. Sesak napas menjadi keluhan utama yang dirasakan oleh pasien PPOK. Teknik pernapasan pursed lips breathing (PLB) merupakan teknik pernapasan yang membantu meningkatkan compliance paru untuk melatih kembali otot pernapasan berfungsi dengan baik serta mecegah distress pernapasan. Penelitian ini bertujuan untuk mengetahui efektivitas teknik pursed lips breathing pada pasien PPOK. Penelitian menggunakan desain deskriptif kuantitatif dengan pendekatan systematic review. Terdapat 315 artikel yang dipublikasi dari tahun 2015-2019. Dari 315 artikel 7 artikel yang sesuai dengan kriteria inklusidan pertanyaan penelitian, dimana kriteria inklusi tersebut ialah artikel tahun 2015-2019 full text yang sesuai dengan topik penelitia yaitu teknik PLB pada pasien PPOK, terdapat ISSN dan atau DOI, artikel yang berfokus pada intervensi terapi Pursed Lips Breathing, artikel yang berfokus pada pemenuhan oksigenisasi dan frekuensi pernapasan sebagai alat ukur. Berdasarkan hasil Systematic Review yang telah dilakukan tentang teknik pursed lips breathing pada pasien PPOK disimpulkan bahwa teknik PLB efektif menurunkan frekuensi pernapasan dan meningkatkan pemenuhan oksigenisasi dalam tubuh. Dengan demikian pemberian latihan yaitu 3x sehari setiap pagi, siang, dan sore dengan waktu 6-30 menit selama 3 hari berturut-turut. Teknik PLB efektif dalam menurunkan frekuensi pernapasan dan meningkatkan pemenuhan oksigenisasi pada pasien PPOK dengan pola napas tidak efektif. Selanjutnya, disarankan teknik PLB dapat dijadikan sebagai salah satu intervensi mandiri perawat dalam melakukan asuhan keperawatan pada pasien PPOK untuk mengurangi keluhan sesak.

scholarly journals Impaired training-induced angiogenesis process with loss of pericyte-endothelium interactions is associated with an abnormal capillary remodelling in the skeletal muscle of COPD patients

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Léo Blervaque ◽  
Emilie Passerieux ◽  
Pascal Pomiès ◽  
Matthias Catteau ◽  
Nelly Héraud ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Skeletal Muscle ◽  
Exercise Training ◽  
Exercise Intolerance ◽  
Moderate Intensity ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Link Type ◽  
Copd Patients ◽  
Response To Exercise

Abstract Chronic obstructive pulmonary disease (COPD) is associated with exercise intolerance and limits the functional gains in response to exercise training in patients compared to sedentary healthy subjects (SHS). The blunted skeletal muscle angiogenesis previously observed in COPD patients has been linked to these limited functional improvements, but its underlying mechanisms, as well as the potential role of oxidative stress, remain poorly understood. Therefore, we compared ultrastructural indexes of angiogenic process and capillary remodelling by transmission electron microscopy in 9 COPD patients and 7 SHS after 6 weeks of individualized moderate-intensity endurance training. We also assessed oxidative stress by plasma-free and esterified isoprostane (F2-IsoP) levels in both groups. We observed a capillary basement membrane thickening in COPD patients only (p = 0.008) and abnormal variations of endothelial nucleus density in response to exercise training in these patients when compared to SHS (p = 0.042). COPD patients had significantly fewer occurrences of pericyte/endothelium interdigitations, a morphologic marker of capillary maturation, than SHS (p = 0.014), and significantly higher levels of F2-IsoP (p = 0.048). Last, the changes in pericyte/endothelium interdigitations and F2-IsoP levels in response to exercise training were negatively correlated (r = − 0.62, p = 0.025). This study is the first to show abnormal capillary remodelling and to reveal impairments during the whole process of angiogenesis (capillary creation and maturation) in COPD patients. Trial registration NCT01183039 & NCT01183052, both registered 7 August 2010 (retrospectively registered).

scholarly journals A CLINICAL STUDY ON SAFETY AND EFFICACY OF FORMOTEROL AND TIOTROPIUM COMBINATION COMPARED TO FORMOTEROL AND TIOTROPIUM WITH ROFLUMILAST COMBINATION IN TREATMENT OF MODERATE TO SEVERE CHRONIC OBSTRUCTIVE PULMONARY DISEASE PATIENTS

2018 ◽  
Vol 11 (3) ◽  
pp. 184 ◽  
Author(s):  
Kavitha Devi M ◽  
Sarumathy S ◽  
Sarath Lal Sasidharan ◽  
Sarumathy S ◽  
Mehanaz Shaik ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Chronic Obstructive ◽  
Comorbid Condition ◽  
Obstructive Pulmonary Disease ◽  
Safety And Efficacy ◽  
Copd Patients ◽  
Before And After ◽  
Study Population ◽  
Group B

 Objectives: The objective of this study is to assess the safety and efficacy of formoterol and tiotropium combination compared to formoterol and tiotropium with roflumilast combination in treatment of moderate-to-severe chronic obstructive pulmonary disease (COPD) patients on inhaled combination therapy. Methods: A comparative prospective interventional study was carried out in 61 COPD patients who were visiting the pulmonary medicine ward during 6 months (October 2016 to March 2017). The patients were randomized into two groups. Group A patients received a combination of formoterol and tiotropium, whereas Group B patients received roflumilast along with formoterol and tiotropium combination. Spirometry tests were done to both the study population. Forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) were noted at the initial visit and after the treatment. All the statistical analyses such as mean and p values were calculated using SPSS 14.0 version software. Results: The average age group of the study population was 57.63±8.3 years. Comorbid condition such as diabetes mellitus was higher in the study groups. Comparison of spirometry reports before and after drug administration in both groups was done. FEV1 and FVC were found to be statistically significant between the study group (0.001, p<0.05).The average mean change of FEV1 before and after treatment in Group B was found to be improved as compared to Group B (0.66). Conclusion: Tiotropium and formoterol with roflumilast combination were found to be safe and effective in moderate-to-severe COPD patients.

The effect of posture on asynchronous chest wall movement in COPD

2013 ◽  
Vol 114 (8) ◽  
pp. 1066-1075 ◽  
Author(s):  
Rita Priori ◽  
Andrea Aliverti ◽  
André L. Albuquerque ◽  
Marco Quaranta ◽  
Paul Albert ◽  
...  
Keyword(s):  
Chest Wall ◽  
Body Position ◽  
Respiratory Muscles ◽  
Forced Expiratory Volume ◽  
Chronic Obstructive ◽  
Quiet Breathing ◽  
Obstructive Pulmonary Disease ◽  
Rib Cage ◽  
Copd Patients ◽  
Supine Posture

Chronic obstructive pulmonary disease (COPD) patients often show asynchronous movement of the lower rib cage during spontaneous quiet breathing and exercise. We speculated that varying body position from seated to supine would influence rib cage asynchrony by changing the configuration of the respiratory muscles. Twenty-three severe COPD patients (forced expiratory volume in 1 s = 32.5 ± 7.0% predicted) and 12 healthy age-matched controls were studied. Measurements of the phase shift between upper and lower rib cage and between upper rib cage and abdomen were performed with opto-electronic plethysmography during quiet breathing in the seated and supine position. Changes in diaphragm zone of apposition were measured by ultrasounds. Control subjects showed no compartmental asynchronous movement, whether seated or supine. In 13 COPD patients, rib cage asynchrony was noticed in the seated posture. This asynchrony disappeared in the supine posture. In COPD, upper rib cage and abdomen were synchronous when seated, but a strong asynchrony was found in supine. The relationships between changes in diaphragm zone of apposition and volume variations of chest wall compartments supported these findings. Rib cage paradox was noticed in approximately one-half of the COPD patients while seated, but was not related to impaired diaphragm motion. In the supine posture, the rib cage paradox disappeared, suggesting that, in this posture, diaphragm mechanics improves. In conclusion, changing body position induces important differences in the chest wall behavior in COPD patients.

Reproducibility and responsiveness of a noninvasive EMG technique of the respiratory muscles in COPD patients and in healthy subjects

2004 ◽  
Vol 96 (5) ◽  
pp. 1723-1729 ◽  
Author(s):  
Marieke L. Duiverman ◽  
Leo A. van Eykern ◽  
Peter W. Vennik ◽  
Gerard H. Koëter ◽  
Eric J. W. Maarsingh ◽  
...  
Keyword(s):  
Muscle Activity ◽  
Healthy Subjects ◽  
Respiratory Muscles ◽  
Emg Activity ◽  
Chronic Obstructive ◽  
Abdominal Muscles ◽  
Breathing Patterns ◽  
Obstructive Pulmonary Disease ◽  
Intercostal Muscles ◽  
Copd Patients

In the present study, we assessed the reproducibility and responsiveness of transcutaneous electromyography (EMG) of the respiratory muscles in patients with chronic obstructive pulmonary disease (COPD) and healthy subjects during breathing against an inspiratory load. In seven healthy subjects and seven COPD patients, EMG signals of the frontal and dorsal diaphragm, intercostal muscles, abdominal muscles, and scalene muscles were derived on 2 different days, both during breathing at rest and during breathing through an inspiratory threshold device of 7, 14, and 21 cmH2O. For analysis, we used the logarithm of the ratio of the inspiratory activity during the subsequent loads and the activity at baseline [log EMG activity ratio (EMGAR)]. Reproducibility of the EMG was assessed by comparing the log EMGAR values measured at test days 1 and 2 in both groups. Responsiveness (sensitivity to change) of the EMG was assessed by comparing the log EMGAR values of the COPD patients to those of the healthy subjects at each load. During days 1 and 2, log EMGAR values of the diaphragm and the intercostal muscles correlated significantly. For the scalene muscles, significant correlations were found for the COPD patients. Although inspiratory muscle activity increased significantly during the subsequent loads in all participants, the COPD patients displayed a significantly greater increase in intercostal and left scalene muscle activity compared with the healthy subjects. In conclusion, the present study showed that the EMG technique is a reproducible and sensitive technique to assess breathing patterns in COPD patients and healthy subjects.

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