Influence of static hyperinflation on exercise capacity in patients with chronic obstructive pulmonary disease: a literature review

Abstract

Introduction: Patients with Chronic Obstructive Pulmonary Disease (COPD) develop static hyperinflation that is a determining factor in the development of dyspnea, morbidity, and reduced ability to perform exercises. The literature demonstrates that reduced exercise capacity reduces quality of life and is a predictor of mortality in patients with COPD. The decline in the ability to perform exercise can be reduced with therapeutic strategies including the physical reconditioning of patients with pneumopathies, so knowing and identifying the limitations offered by static hyperinflation in patients with COPD is necessary for an optimization of therapeutic behaviors. Methods: We searched the Lilacs, Medline, PEDRO and Scielo databases, limited to the period from 2000 to 2015, using descriptors: chronic obstructive pulmonary disease, hyperinflation, static hyperinflation, exercise capacity, without restriction to study design . Animal studies as well as those published in languages other than English or Portuguese were excluded. Results: 170 titles were found in the databases, 110 of which were eliminated due to duplicity. A detailed reading of 60 abstracts was carried out, of which 35 were excluded because they did not include the integration of the descriptors. After reading the full text of 25 articles, six (06) were withdrawn, as they did not address static hyperinflation, as a central theme. Thus, 17 articles remained, being 9 clinical trials and 8 review articles. Conclusion: Although static pulmonary hyperinflation was a predictor of exercise performance, few studies of the clinical trial type were conducted in the 10-year period, which indicates a scientific gap in the pathophysiological understanding of the decline in the ability to perform exercises in patients with COPD. A better understanding of static hyperinflation may serve as a parameter in clinical practice on the most appropriate time to initiate the physical reconditioning of patients with COPD