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Differences in respiratory muscle activity during cycling and walking do not influence dyspnea perception in obese patients with COPD
Abstract
In patients with combined obesity and chronic obstructive pulmonary disease (COPD), dyspnea intensity at matched work rates during weight-supported cycling and weight-bearing walking is similar, despite consistent metabolic differences between test modalities. The present study examined the influence of differences in activity of the diaphragm and abdominal muscles during cycling and walking on intensity and quality of dyspnea at matched ventilation in obese patients with COPD. We compared respiratory muscle activity patterns and dyspnea ratings during incremental cycle and treadmill exercise tests, where work rate was matched, in 12 obese (body mass index 36.6 ± 5.4 kg/m 2; mean ± SD) patients with moderate COPD. We used a multipair electrode-balloon catheter to compare electromyography of the diaphragm and esophageal, gastric, and transdiaphragmatic pressures during the two exercise tests. Ventilation, breathing pattern, operating lung volumes, global respiratory effort, and electrical activation of the diaphragm were similar across exercise modalities for a given work rate. The cycling position was associated with greater neuromuscular efficiency of the diaphragm ( P < 0.01), greater diaphragm use ( P < 0.01) measured by the ventilatory muscle recruitment index, and less expiratory muscle activity compared ( P < 0.01) with treadmill walking. However, intensity and quality of dyspnea were similar between exercise modalities. In obese patients with COPD, altered respiratory muscle activity due to body position differences between cycling and walking did not modulate perceived dyspnea when indirect measures of respiratory neural drive were unchanged.
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“The rise in dyspnea intensity ratings during exercise correlates strongly with indirect indices of increased respiratory neural drive (central motor command output) such as tidal electromyographic activation of the diaphragm relative to maximum, tidal esophageal pressure swings relative to maximum, and ventilation relative to peak ventilatory capacity [66,76].”
From Lung hyperinflation in COPD: applying physiology to clinical practice (2015) · cites this paper as [76]
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Parshall, M. B., Schwartzstein, R. M., Adams, L., Banzett, R. B., Manning, H. L., Bourbeau, J., Calverley, P. M., Gift, A. G., Harver, A., Lareau, S. C., et al. (2012) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.201111-2042st · Cited by 1,844
Self-citationDynamic Hyperinflation and Exercise Intolerance in Chronic Obstructive Pulmonary Disease
O'DONNELL, D. E., REVILL, S. M., & WEBB, K. A. (2001) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.164.5.2012122 · Cited by 1,076
Self-citationHodges, P. W., & Gandevia, S. C. (2000) · Journal of Applied Physiology · doi:10.1152/jappl.2000.89.3.967 · Cited by 493
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Cited by
Mechanisms of exertional dyspnoea in symptomatic smokers without COPD
Elbehairy, A. F., Guenette, J. A., Faisal, A., Ciavaglia, C. E., Webb, K. A., Jensen, D., Ramsook, A. H., Neder, J. A., & O'Donnell, D. E. (2016) · European Respiratory Journal · doi:10.1183/13993003.00077-2016 · Cited by 99
Self-citationLung hyperinflation in COPD: applying physiology to clinical practice
O’Donnell, D. E., Webb, K. A., & Neder, J. A. (2015) · COPD Research and Practice · doi:10.1186/s40749-015-0008-8 · Cited by 93
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Metadata
- Authors
- Ciavaglia, C. E., Guenette, J. A., Langer, D., Webb, K. A., Alberto Neder, J., & O'Donnell, D. E.
- Venue
- Journal of Applied Physiology
- Publisher
- American Physiological Society
- Published
- 2014-12-01
- Volume
- 117
- Issue
- 11
- Pages
- 1292-1301
- ISSN
- 8750-7587
- 1522-1601
- Cited by
- 29
- References
- 4
- Language
- en
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- Ciavaglia, C. E., Guenette, J. A., Langer, D., Webb, K. A., Alberto Neder, J., & O'Donnell, D. E. (2014). Differences in respiratory muscle activity during cycling and walking do not influence dyspnea perception in obese patients with COPD. Journal of Applied Physiology. https://doi.org/10.1152/japplphysiol.00502.2014
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