Tristan Bonnevie1, Francis-Edouard Gravier2, Agathe Ducrocq3, David Debeaumont4, Catherine Viacroze5, Antoine Cuvelier6, Jean-François Muir7, Catherine Tardif8. 1. ADIR Association, Bois-Guillaume, France; Normandie University, UNIROUEN, EA UPRES 3830, Rouen University Hospital, Haute Normandie Research and Biomedical Innovation, Rouen, France. Electronic address: rehabilitation@adir-hautenormandie.com. 2. ADIR Association, Bois-Guillaume, France. 3. Rouen University Hospital, Physiology Department, Rouen, France; Rouen University Hospital, Pulmonary, Thoracic oncology and Respiratory Intensive care Department, Rouen, France. 4. ADIR Association, Bois-Guillaume, France; Rouen University Hospital, Physiology Department, Rouen, France. 5. Rouen University Hospital, Pulmonary, Thoracic oncology and Respiratory Intensive care Department, Rouen, France. 6. Normandie University, UNIROUEN, EA UPRES 3830, Rouen University Hospital, Haute Normandie Research and Biomedical Innovation, Rouen, France; Rouen University Hospital, Pulmonary, Thoracic oncology and Respiratory Intensive care Department, Rouen, France. 7. ADIR Association, Bois-Guillaume, France; Normandie University, UNIROUEN, EA UPRES 3830, Rouen University Hospital, Haute Normandie Research and Biomedical Innovation, Rouen, France. 8. ADIR Association, Bois-Guillaume, France; Normandie University, UNIROUEN, EA UPRES 3830, Rouen University Hospital, Haute Normandie Research and Biomedical Innovation, Rouen, France; Rouen University Hospital, Physiology Department, Rouen, France.
Abstract
PURPOSE: Diaphragm paresis (DP) is characterized by abnormalities of respiratory muscle function. However, the impact of DP on exercise capacity is not well known. This study was performed to assess exercise tolerance in patients with DP and to determine whether inspiratory muscle function was related to exercise capacity, ventilatory pattern and cardiovascular function during exercise. METHODS: This retrospective study included patients with DP who underwent both diaphragmatic force measurements, and cardiopulmonary exercise testing (CPET). RESULTS: Fourteen patients were included. Dyspnea was the main symptom limiting exertion (86%). Exercise capacity was slightly reduced (median VO2peak: 80% [74.5%-90.5%]), mostly due to ventilatory limitation. Diaphragm and overall inspiratory muscle function were correlated with exercise ventilation. Moreover, overall inspiratory muscle function was related with oxygen consumption (r=0.61) and maximal workload (r=0.68). CONCLUSIONS: DP decreases aerobic capacity due to ventilatory limitation. Diaphragm function is correlated with exercise ventilation whereas overall inspiratory muscle function is correlated with both exercise capacity and ventilation suggesting the importance of the accessory inspiratory muscles during exercise for patients with DP. Further larger prospective studies are needed to confirm these results.
PURPOSE: Diaphragm paresis (DP) is characterized by abnormalities of respiratory muscle function. However, the impact of DP on exercise capacity is not well known. This study was performed to assess exercise tolerance in patients with DP and to determine whether inspiratory muscle function was related to exercise capacity, ventilatory pattern and cardiovascular function during exercise. METHODS: This retrospective study included patients with DP who underwent both diaphragmatic force measurements, and cardiopulmonary exercise testing (CPET). RESULTS: Fourteen patients were included. Dyspnea was the main symptom limiting exertion (86%). Exercise capacity was slightly reduced (median VO2peak: 80% [74.5%-90.5%]), mostly due to ventilatory limitation. Diaphragm and overall inspiratory muscle function were correlated with exercise ventilation. Moreover, overall inspiratory muscle function was related with oxygen consumption (r=0.61) and maximal workload (r=0.68). CONCLUSIONS:DP decreases aerobic capacity due to ventilatory limitation. Diaphragm function is correlated with exercise ventilation whereas overall inspiratory muscle function is correlated with both exercise capacity and ventilation suggesting the importance of the accessory inspiratory muscles during exercise for patients with DP. Further larger prospective studies are needed to confirm these results.
Authors: Mayra Caleffi Pereira; Letícia Z Cardenas; Jeferson G Ferreira; Vinícius C Iamonti; Pauliane Vieira Santana; André Apanavicius; Pedro Caruso; Angelo Fernandez; Carlos R R de Carvalho; Daniel Langer; André L P de Albuquerque Journal: ERJ Open Res Date: 2021-02-01