Abstract
Near-infrared spectroscopy (NIRS) technology can evaluate muscle metabolism and oxygenation. NIRS-based oximeters can measure skeletal muscle oxygen delivery and utilization during static and dynamic work non-invasively. Our goal was to assess the value and usability of NIRS technology in chronic obstructive pulmonary disease (COPD) rehabilitation program. Forty patients with COPD participated in a 4-week inpatient rehabilitation program that included breathing exercises and personalized cycle/treadmill training adjusted to the functional capacity, physical activity and comorbidities of the patients. A NIRS muscle oxygen monitor was used to measure tissue oxygenation and hemoglobin levels. Total hemoglobin index, average muscle oxygenation, minimal and maximal muscle oxygenation were recorded before and after the rehabilitation program. Rehabilitation resulted improvement in 6 min walking distance (6MWD:335.3 ± 110. vs. 398.3 ± 126.2 m; P < 0.01), maximal inspiratory pressure (MIP: 57.7 ± 22.7 vs. 63.6 ± 18.0 cmH2O; P < 0.01), chest wall expansion (CWE: 2.84 ± 1.26 vs, 4.00 ± 1.76 cm; P < 0.01), breath hold time (BHT: 25.8 ± 10.6 vs. 29.2 ± 11.6 s; P < 0.01) and grip strength (GS: 24.9 ± 11.9 vs. 27.0 ± 11.4 kg; P < 0.01). Quality of life improvement was monitored by COPD Assessment Test (CAT: 17.00 ± 8.49 vs. 11.89 ± 7.3, P < 0.05). Total hemoglobin index (tHb: 12.8 ± 1.3% vs. 12.8 ± 1.4), average muscle oxygenation (SmO2: 67.5 ± 14.4% vs. 65.2 ± 20.4%) showed a tendency for improvement. Maximal muscle oxygenation decreased (SmO2 max: 98.0 ± 20.5% vs. 90.1 ± 14.3%; P < 0.01). Minimal muscle oxygenation increased (SmO2 min: 42.6 ± 12.6% vs. 54.8 ± 14.3%; P < 0.01). NIRS results showed that muscle oxygenation and microcirculation can be described as a high-risk factor in COPD patients. The 4-week rehabilitation improves functional parameters, quality of life and tissue oxygenation levels in COPD patients.
Highlights
Chronic obstructive pulmonary disease (COPD) is a complex and heterogeneous clinical syndrome found in 6–8% of the population [1]
Significant changes were detected in chest wall expansion (CWE), breath hold time (BHT), grip strength (GS), 6 min walking distance (6MWD), COPD Assessment Test (CAT), mMRC (Table 2)
We conducted clinical research for determining the peripheral oxygen consumption, capillarization of muscles in COPD patients and the effects of a 4-week rehabilitation program on the physiological phenomena measured by near-infrared spectroscopy (NIRS) technology during resting
Summary
Chronic obstructive pulmonary disease (COPD) is a complex and heterogeneous clinical syndrome found in 6–8% of the population [1]. COPD patients experience functional and structural changes of the respiratory system that deeply influence cardiovascular function [2]. The main part of COPD patient’s rehabilitation is physical therapy, the goal is to get the patients’ functional capacity back. Exercise training causes changes in muscle perfusion, peripheral muscle activity and function [4]. NIRS has been utilized to investigate local muscle oxidative metabolism at rest and during different exercise modalities since the end of the 1980s. NIRS technology has been used to evaluate blood flow and muscle oxygen availability in COPD patients during exercise [6]. During our study our goal was to measure the resting oxygenation levels, as this might contribute to a better understanding of individual differences in physical rehabilitation and exercise tolerance
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