Slow chest compression acutely reduces dynamic hyperinflation in people with chronic obstructive pulmonary disease: a randomized cross-over trial

Abstract

ABSTRACT Background Strategies to minimize dynamic hyperinflation (DH) and dyspnea, such as slow chest compression (SCC), are relevant in people with chronic obstructive pulmonary disease (COPD). Objectives To analyze the acute effects of SCC after exercise on DH and dyspnea in people with COPD and to identify responders to the technique. Methods This is a cross-over study with 40 patients. Two six-minute step tests (6MSTs) were performed followed by a one-minute application of SCC (6MSTSCC) or rest (6MSTCONTROL), at random. End-expiratory lung volume (EELV) and dyspnea were assessed. A difference ≥76 ml in ΔEELV between SCC and control characterized the responders. Results The performance in 6MSTSCC and 6MSTCONTROL were similar. There was a greater reduction in EELV after 6MSTSCC compared to 6MSTCONTROL (124 ± 193 ml vs. 174 ± 183 ml; p = .049), while there was no difference in change in dyspnea between the SCC and control groups. Twenty-one participants were SCC responders and had higher functional residual capacity [FRC: 5.36 ± 1.09 vs. 4.58 ± 0.94; p = .02; cutoff point: 4.56; sensitivity = 76%; specificity = 53%; AUC = 0.71 (95%CI: 0.54 to 0.87); p = .02]. Conclusion SCC applied immediately after exercise reduced DH, but did not reduce dyspnea in people with COPD. The technique is beneficial only for some patients and FRC can help to identify them.