Correlation of functional capacity to effort with functionpulmonary and quality of life in people with asthma

Abstract

Introduction: Asthma is a chronic disease that causes inflammation in the large airways, which can be exacerbated by various factors. These inflammatory characteristics can result in dynamic hyperinflation (DH), a “treatable treat” that impairs daily activities and, therefore, should be detected early. Objective: Our goal was to identify DH in adults with asthma (alwA) using the Glittre-ADL test (TGlittre) and assess the association of DH with small airway dysfunction (SAD) and quality of life (QoL). Methods: This is a cross-sectional study in which 41 alwA underwent the TGlittre coupled with dynamic ventilation measurement, with detection of DH using inspiratory capacity (∆IC). They also underwent spirometry, impulse oscillometry (IOS), and the Mini-Asthma Quality of Life Questionnaire (Mini-AQLQ). Results: In TGlittre, 19 participants presented DH at the end of the test, while 22 did not. Although participants in the DH group took longer to complete the TGlittre tasks, there were no statistical differences between the 2 groups (269.9 ± 77.1 vs. 260.1 ± 73.8% predicted, p = 0.68). While the DH and NDH groups did not show significant differences in any of the spirometric parameters, these two groups differed in IOS parameters, with higher values for frequency response (Fres, p = 0.037) and heterogeneity of resistance between 5-20 Hz (R5-R20, p=.003] in the DH group. Although ∆IC did not show significant correlations with either spirometric or Mini-AQLQ parameters, there were several significant correlations with IOS parameters. In the multiple linear regression, Fres and R5-R20 explained 51% of IC variability. Conclusion: In alwA, TGlittre is able to detect DH in around half of the cases. Having DH does not have a negative impact on performance during TGlittre. However, the more severe the DH, the more severe the SAD. Therefore, it is essential to incorporate the assessment of ventilation dynamics during TGlittre in alwA, since it can be detected even in those with normal spirometry and/or good performance during TGlittre.