Effects of Exhalation Valve on the Lack of Air and Exercise Tolerance in Patients With COPD

NCT ID: NCT02566915

Last Updated: 2016-02-23

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

19 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-08-31

Study Completion Date

2016-12-31

Brief Summary

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The purpose of this study is to evaluate the effects of the application of Expiratory Positive Airway Pressure (EPAP) on Dynamic Hyperinflation, dyspnea and exercise tolerance in patients with Chronic Obstructive Pulmonary Disease (COPD).

Detailed Description

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Initially will be collected clinical and anthropometric data of the participants, and they are packaged in self-evaluation form. The evaluation of pulmonary function at rest (spirometry, body plethysmography and lung diffusion capacity for carbon monoxide) will be rescued from patient charts. When carried out for over six months, will be repeated by the researchers. Patients will conduct incremental CPET of 5-10W / min limited by symptoms (FEV1 \<1L - 5W or FEV1\> 1L - 10W) (Visit 1). After a period of 2-7 days the CPET will be performed submaximal with 75% of the peak load reached in the incremental CPET (visits 2 and 3). The application of EPAP (10cmH2O) via face mask (Vital RHDSON Signs®, New Jersey, USA) will be randomized with the help of opaque envelopes to be given in one visit. During the visit without EPAP will be maintained using the facial mask applied without resistance. IC serial measurements will be carried out before, during and immediately after the exercise. Participants will be instructed to maintain the use of long-acting bronchodilator as prescribed by the medical assistant usually before the methodological stages of the study.

Conditions

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COPD

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

TRIPLE

Participants Caregivers Outcome Assessors

Study Groups

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CPET submaximal without EPAP

Will be collected clinical and anthropometric data of the participants and they are packaged in self-evaluation form. Evaluation of pulmonary function at rest will be rescued from patient charts. When carried out for over six months, will be repeated by the researchers. Patients will conduct incremental CPET of 5-10W/min limited by symptoms (FEV1 \<1L-5W or FEV1\> 1L-10W) (Visit 1). After a period of 2-7 days the CPET will be performed submaximal with 75% of the peak load reached in the incremental CPET (visits 2-3). During the visit without EPAP will be maintained using the facial mask applied without resistance.

Group Type NO_INTERVENTION

No interventions assigned to this group

CPET submaximal with EPAP

Will be collected clinical and anthropometric data of the participants and they are packaged in self-evaluation form. Evaluation of pulmonary function at rest will be rescued from patient charts. When carried out for over six months, will be repeated by the researchers. Patients will conduct incremental CPET of 5-10W/min limited by symptoms (FEV1 \<1L-5W or FEV1\> 1L-10W) (Visit 1). After a period of 2-7 days the CPET will be performed submaximal with 75% of the peak load reached in the incremental CPET (visits 2-3). The application of EPAP (10cmH2O) via face mask (Vital RHDSON Signs®, New Jersey, USA) will be randomized with the help of opaque envelopes to be given in one visit. IC serial measurements will be carried out before, during and immediately after the exercise.

Group Type EXPERIMENTAL

CPET submaximal with EPAP

Intervention Type DEVICE

The expiratory positive pressure is applied through silicone mask (RHDSON Vital Signs®, New Jersey, USA) containing one-way valve and a resistance mechanism expiratory positive expiratory pressure generator adjustable 5-20 cm H2O (Spring Loaded) (Vital Signs® , New Jersey, USA). The mask one headgear will be comfortably adjusted to face being used to prevent air leakage, and the pressure level gradually adjusted to the level of 10 cm H2O.

Interventions

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CPET submaximal with EPAP

The expiratory positive pressure is applied through silicone mask (RHDSON Vital Signs®, New Jersey, USA) containing one-way valve and a resistance mechanism expiratory positive expiratory pressure generator adjustable 5-20 cm H2O (Spring Loaded) (Vital Signs® , New Jersey, USA). The mask one headgear will be comfortably adjusted to face being used to prevent air leakage, and the pressure level gradually adjusted to the level of 10 cm H2O.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* clinically stable patients without exacerbation of signs in the eight weeks preceding the study
* making use of drug therapy (long-acting bronchodilators)
* able to perform the exercise on the bike
* without other comorbidities that compromise the results exercise
* sign the Informed Consent

Exclusion Criteria

* associated heart diseases
* diagnosis of asthma
* Oxygen therapy use
* SpO2 \<85% at rest
* use of oral corticosteroids or antihistamines
* use of artificial airway
* musculoskeletal dysfunction
Minimum Eligible Age

50 Years

Maximum Eligible Age

90 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Hospital de Clinicas de Porto Alegre

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Danilo C Berton

Role: PRINCIPAL_INVESTIGATOR

HCPA/UFRGS

Marli M Knorst

Role: STUDY_CHAIR

HCPA/UFRGS

Mariane B Monteiro

Role: STUDY_CHAIR

IPA

Paulo José Z Teixeira

Role: STUDY_CHAIR

Federal University of Health Science of Porto Alegre

Dulciane N Paiva

Role: STUDY_CHAIR

University of Santa Cruz do Sul

Dannuey M Cardoso

Role: STUDY_CHAIR

University of Santa Cruz do Sul

Locations

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Hospital de Clínicas de Porto Alegre

Porto Alegre, Rio Grande do Sul, Brazil

Site Status

Countries

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Brazil

References

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PMID: 22878278 (View on PubMed)

O'Donnell DE, Gebke KB. Activity restriction in mild COPD: a challenging clinical problem. Int J Chron Obstruct Pulmon Dis. 2014 Jun 4;9:577-88. doi: 10.2147/COPD.S62766. eCollection 2014.

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Gagnon P, Guenette JA, Langer D, Laviolette L, Mainguy V, Maltais F, Ribeiro F, Saey D. Pathogenesis of hyperinflation in chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis. 2014 Feb 15;9:187-201. doi: 10.2147/COPD.S38934. eCollection 2014.

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Silveira L, Teixeira PJ, da Costa CC, de Souza RM, Merola PK, Colombo C, Marques RD, Berton DC. The relationship between fat-free mass index and pulmonary hyperinflation in COPD patients. Respirology. 2014 Nov;19(8):1204-8. doi: 10.1111/resp.12406.

Reference Type BACKGROUND
PMID: 25302758 (View on PubMed)

Pessoa IM, Costa D, Velloso M, Mancuzo E, Reis MA, Parreira VF. Effects of noninvasive ventilation on dynamic hiperinflation of patients with COPD during activities of daily living with upper limbs. Rev Bras Fisioter. 2012 Jan-Feb;16(1):61-7. English, Portuguese.

Reference Type BACKGROUND
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Reference Type BACKGROUND
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Borg GA. Psychophysical bases of perceived exertion. Med Sci Sports Exerc. 1982;14(5):377-81.

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Belman MJ, Botnick WC, Shin JW. Inhaled bronchodilators reduce dynamic hyperinflation during exercise in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 1996 Mar;153(3):967-75. doi: 10.1164/ajrccm.153.3.8630581.

Reference Type BACKGROUND
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Yan S, Kaminski D, Sliwinski P. Reliability of inspiratory capacity for estimating end-expiratory lung volume changes during exercise in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 1997 Jul;156(1):55-9. doi: 10.1164/ajrccm.156.1.9608113.

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Reference Type BACKGROUND
PMID: 9817708 (View on PubMed)

Mahler DA, Weinberg DH, Wells CK, Feinstein AR. The measurement of dyspnea. Contents, interobserver agreement, and physiologic correlates of two new clinical indexes. Chest. 1984 Jun;85(6):751-8. doi: 10.1378/chest.85.6.751.

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Monteiro MB, Berton DC, Moreira MA, Menna-Barreto SS, Teixeira PJ. Effects of expiratory positive airway pressure on dynamic hyperinflation during exercise in patients with COPD. Respir Care. 2012 Sep;57(9):1405-12. doi: 10.4187/respcare.01481. Epub 2012 Feb 17.

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Related Links

Access external resources that provide additional context or updates about the study.

http://www.scielo.br/pdf/bjmbr/v32n6/3179c.pdf

Reference values for lung function testes. I.Static volumes.

http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0103-51502012000300018

Analysis of chest radiography of individuals with COPD and its correlation with functional testing

http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1806-37132012000100004

Dynamic hyperinflation during treadmill exercise testing in patients with moderate to severe COPD

http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0103-51502012000400004

Determining anaerobic threshold through heart rate variability in patients with COPD during cycloergometer exercise

http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1517-86922012000500002&lng=en&nrm=iso&tlng=en

Comparison of the physiological variables in the six-minute walk test and stair-climbing test in patients with chronic obstructive pulmonary disease

http://www.scielo.br/pdf/jbpneu/v34n12/v34n12a05.pdf

Validation of the Modified Pulmonary Functional Status and Dyspnea Questionnaire and the Medical Research Council scale for use in Brazilian patients with chronic obstructive pulmonary disease

Other Identifiers

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15-0067

Identifier Type: -

Identifier Source: org_study_id

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