Dyspnea and Activity Limitation in COPD: Mechanical Factors
Abstract
Dyspnea and activity limitation are the primary symptoms of chronic obstructive pulmonary disease and progress relentlessly as the disease advances. In COPD, dyspnea is multifactorial but abnormal dynamic ventilatory mechanics are believed to be important. Dynamic lung hyperinflation occurs during exercise in the majority of flow-limited patients with chronic obstructive pulmonary disease and may have serious sensory and mechanical consequences. This proposition is supported by several studies, which have shown a close correlation between indices of dynamic lung hyperinflation and measures of both exertional dyspnea and exercise performance. The strength of this association has been further confirmed by studies that have therapeutically manipulated this dependent variable. Relief of exertional dyspnea and improved exercise endurance following bronchodilator therapy correlate well with reduced lung hyperinflation. The mechanisms by which dynamic lung hyperinflation give rise to exertional dyspnea and exercise intolerance are complex. However, recent mechanistic studies suggest that dynamic lung hyperinflation-induced volume restriction and consequent neuromechanical uncoupling of the respiratory system are key mechanisms. This review examines, in some detail, the derangements of ventilatory mechanics that are peculiar to chronic obstructive pulmonary disease and attempts to provide a mechanistic rationale for the attendant respiratory discomfort and activity limitation.
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Hyperinflation contributes to dyspnea in patients with COPD.
“Hyperinflation is clinically relevant for patients with COPD mainly because it contributes to dyspnea, exercise intolerance, skeletal muscle limitations, morbidity, and reduced physical activity levels associated with the disease.”
From Pathogenesis of hyperinflation in chronic obstructive pulmonary disease (2014) · cites this paper as [8]
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- Authors
- O'Donnell, D. E., & Laveneziana, P.
- Affiliations
- Queen's University (CA)
- Venue
- COPD: Journal of Chronic Obstructive Pulmonary Disease
- Publisher
- Informa UK Limited
- Published
- 2007-01
- Volume
- 4
- Issue
- 3
- Pages
- 225-236
- ISSN
- 1541-2555 (ISSN-L)
- 1541-2563
- OpenAlex
- W2158320806
- Cited by
- 220
- References
- 91
- Citations by year
- 2026: 12 · 2025: 9 · 2024: 8 · 2023: 5 · 2022: 8 · 2021: 15 · 2020: 22 · 2019: 17 · 2018: 16 · 2017: 14 · 2016: 11 · 2015: 19 · 2014: 12 · 2013: 10 · 2012: 12
- FWCI
- 4.34
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- COPD Journal of Chronic Obstructive Pulmonary Disease (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory Support and Mechanisms
- Keywords
- chronic obstructive pulmonary disease, dyspnea, exertional dyspnea, activity limitation, respiratory mechanics, exercise intolerance, bronchodilator therapy
- MeSH terms
- Dyspnea, Humans, Pulmonary Ventilation, Total Lung Capacity, Respiratory Mechanics, Exercise Tolerance, Pulmonary Disease, Chronic Obstructive
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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