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Is static hyperinflation a limiting factor during exercise in adolescents with cystic fibrosis?
Pediatr Pulmonol 2011; 46(2):119-24PP

Abstract

Increased work of breathing is considered to be a limiting factor in patients with cystic fibrosis (CF) performing aerobic exercise. We hypothesized that adolescents with CF and with static hyperinflation are more prone to a ventilatorily limited exercise capacity than non-static hyperinflated adolescents with CF. Exercise data of 119 adolescents with CF [range 12-18 years], stratified for static hyperinflation, defined as ratio of residual volume to total lung capacity (RV/TLC) > 30%, were obtained during a progressive bicycle ergometer test with gas analysis and analyzed for ventilatory limitation. Static hyperinflation showed a significant, though weak association (Φ 0.38; P < 0.001) with a ventilatorily limited exercise capacity (breathing reserve index at maximal effort >0.70; FEV(1) < 80% predicted and reduced exercise capacity, defined as VO(2peak) < 85% predicted). Analysis of association for increasing degrees of hyperinflation showed an increase to Φ 0.49 (P < 0.001) for RV/TLC > 50%. In adolescents with static hyperinflation, peak work rate (W(peak) ; 3.1 ± 0.7 W/kg (75.1 ± 17.3% of predicted), peak oxygen uptake (VO(2peak) /kg (ml/min/kg); 39.2 ± 9.2 ml/min/kg (91.0 ± 20.3% of predicted), peak heart rate (HR(peak) ; 176 ± 19 beats/min) were significantly (P < 0.05) decreased when compared with non-static hyperinflated adolescents (W(peak) 3.5 ± 0.5 W/kg (81.4 ± 10.0% of predicted)); VO(2peak) /kg (ml/min/kg); 43.1 ± 7.5 ml/min/kg (98.0 ± 15.1% of predicted); and HR(peak) 185 ± 14 beats/min). Additionally, no difference was found in the degree of association of FEV(1) (%) and RV/TLC (%) with VO(2peak) /kg(pred) and W(peak) /kg(Pred) , but we found the RV/TLC (%) to be a slightly stronger predictor of VO(2peak) /kg(pred) and W(peak) /kg(Pred) than FEV(1) (%). These results indicate that the presence of static hyperinflation in adolescents with CF by itself does not strongly influence ventilatory constraints during exercise and that static hyperinflation is only a slightly stronger predictor of W(peak) /kg(Pred) and VO(2peak) /kg(Pred) than airflow obstruction (FEV(1) (%)).

Authors+Show Affiliations

Child Development & Exercise Center, Cystic Fibrosis Center, University Medical Center Utrecht, Utrecht, the Netherlands.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20812244

Citation

Werkman, M S., et al. "Is Static Hyperinflation a Limiting Factor During Exercise in Adolescents With Cystic Fibrosis?" Pediatric Pulmonology, vol. 46, no. 2, 2011, pp. 119-24.
Werkman MS, Hulzebos HJ, Arets HG, et al. Is static hyperinflation a limiting factor during exercise in adolescents with cystic fibrosis? Pediatr Pulmonol. 2011;46(2):119-24.
Werkman, M. S., Hulzebos, H. J., Arets, H. G., van der Net, J., Helders, P. J., & Takken, T. (2011). Is static hyperinflation a limiting factor during exercise in adolescents with cystic fibrosis? Pediatric Pulmonology, 46(2), pp. 119-24. doi:10.1002/ppul.21329.
Werkman MS, et al. Is Static Hyperinflation a Limiting Factor During Exercise in Adolescents With Cystic Fibrosis. Pediatr Pulmonol. 2011;46(2):119-24. PubMed PMID: 20812244.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Is static hyperinflation a limiting factor during exercise in adolescents with cystic fibrosis? AU - Werkman,M S, AU - Hulzebos,H J, AU - Arets,H G M, AU - van der Net,J, AU - Helders,P J M, AU - Takken,T, Y1 - 2010/09/01/ PY - 2009/12/18/received PY - 2010/06/09/revised PY - 2010/06/26/accepted PY - 2010/9/3/entrez PY - 2010/9/3/pubmed PY - 2011/5/20/medline SP - 119 EP - 24 JF - Pediatric pulmonology JO - Pediatr. Pulmonol. VL - 46 IS - 2 N2 - Increased work of breathing is considered to be a limiting factor in patients with cystic fibrosis (CF) performing aerobic exercise. We hypothesized that adolescents with CF and with static hyperinflation are more prone to a ventilatorily limited exercise capacity than non-static hyperinflated adolescents with CF. Exercise data of 119 adolescents with CF [range 12-18 years], stratified for static hyperinflation, defined as ratio of residual volume to total lung capacity (RV/TLC) > 30%, were obtained during a progressive bicycle ergometer test with gas analysis and analyzed for ventilatory limitation. Static hyperinflation showed a significant, though weak association (Φ 0.38; P < 0.001) with a ventilatorily limited exercise capacity (breathing reserve index at maximal effort >0.70; FEV(1) < 80% predicted and reduced exercise capacity, defined as VO(2peak) < 85% predicted). Analysis of association for increasing degrees of hyperinflation showed an increase to Φ 0.49 (P < 0.001) for RV/TLC > 50%. In adolescents with static hyperinflation, peak work rate (W(peak) ; 3.1 ± 0.7 W/kg (75.1 ± 17.3% of predicted), peak oxygen uptake (VO(2peak) /kg (ml/min/kg); 39.2 ± 9.2 ml/min/kg (91.0 ± 20.3% of predicted), peak heart rate (HR(peak) ; 176 ± 19 beats/min) were significantly (P < 0.05) decreased when compared with non-static hyperinflated adolescents (W(peak) 3.5 ± 0.5 W/kg (81.4 ± 10.0% of predicted)); VO(2peak) /kg (ml/min/kg); 43.1 ± 7.5 ml/min/kg (98.0 ± 15.1% of predicted); and HR(peak) 185 ± 14 beats/min). Additionally, no difference was found in the degree of association of FEV(1) (%) and RV/TLC (%) with VO(2peak) /kg(pred) and W(peak) /kg(Pred) , but we found the RV/TLC (%) to be a slightly stronger predictor of VO(2peak) /kg(pred) and W(peak) /kg(Pred) than FEV(1) (%). These results indicate that the presence of static hyperinflation in adolescents with CF by itself does not strongly influence ventilatory constraints during exercise and that static hyperinflation is only a slightly stronger predictor of W(peak) /kg(Pred) and VO(2peak) /kg(Pred) than airflow obstruction (FEV(1) (%)). SN - 1099-0496 UR - https://www.unboundmedicine.com/medline/citation/20812244/Is_static_hyperinflation_a_limiting_factor_during_exercise_in_adolescents_with_cystic_fibrosis L2 - https://doi.org/10.1002/ppul.21329 DB - PRIME DP - Unbound Medicine ER -