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Elayne Moura Teixeira,1 Caroline Oliveira Ribeiro,1 Agnaldo José Lopes,2,3 Pedro Lopes de Melo1,4 1Biomedical Instrumentation Laboratory, Institute of Biology and Faculty of Engineering, State University of Rio de Janeiro, Rio de Janeiro, Brazil; 2Pulmonary Function Laboratory, Pedro Ernesto University Hospital, Faculty of Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro, Brazil; 3Pulmonary Rehabilitation Laboratory, Augusto Motta University Center, Rio de Janeiro, Brazil; 4Laboratory of Clinical and Experimental Research in Vascular Biology - Biomedical Center, State University of Rio de Janeiro, Rio de Janeiro, BrazilCorrespondence: Pedro Lopes de Melo, Rua São Francisco Xavier 524, Pavilhão Haroldo Lisboa da Cunha, Sala 104, Maracanã, Rio de Janeiro, RJ, 20550-013, Brazil, Tel +55-21-2334-0705, Email plopes@uerj.brPurpose: Chronic obstructive pulmonary disease (COPD) phenotypes may introduce different characteristics that need to be known to improve treatment. Respiratory oscillometry provides a detailed analysis and may offer insight into the pathophysiology of COPD. In this paper, we used this method to evaluate the differences in respiratory mechanics of COPD phenotypes.Patients and Methods: This study investigated a sample of 83 volunteers, being divided into control group (CG = 20), emphysema (n = 23), CB (n = 20) and asthma-COPD overlap syndrome (ACOS, n = 20). These analyses were performed before and after bronchodilator (BD) use. Functional capacity was evaluated using the Glittre‑ADL test, handgrip strength and respiratory pressures.Results: Initially it was observed that oscillometry provided a detailed description of the COPD phenotypes, which was consistent with the involved pathophysiology. A correlation between oscillometry and functional capacity was observed (r=− 0.541; p = 0.0001), particularly in the emphysema phenotype (r = − 0.496, p = 0.031). BD response was different among the studied phenotypes. This resulted in an accurate discrimination of ACOS from CB [area under the receiver operating curve (AUC) = 0.84] and emphysema (AUC = 0.82).Conclusion: These results offer evidence that oscillatory indices may enhance the comprehension and identification of COPD phenotypes, thereby potentially improving the support provided to these patients.Keywords: asthma-COPD overlap, emphysema, chronic bronchitis, respiratory impedance, handgrip analysis, Glittre-ADL test, forced oscillation technique, bronchodilator response

Caroline Oliveira Ribeiro,1 Agnaldo José Lopes,2,3 Pedro Lopes de Melo1 1Biomedical Instrumentation Laboratory, Institute of Biology and Faculty of Engineering, State University of Rio de Janeiro, Rio de Janeiro, Brazil; 2Pulmonary Function Laboratory, State University of Rio de Janeiro, Rio de Janeiro, Brazil; 3Pulmonary Rehabilitation Laboratory, Augusto Motta University Center, Rio de Janeiro, BrazilCorrespondence: Pedro Lopes de Melo, Rua São Francisco Xavier 524, Pavilhão Haroldo Lisboa da Cunha, Sala 104, Maracanã, Rio de Janeiro, 20550-013, Brazil, Tel +55-21-2334-0705, Email plopes@uerj.brPurpose: Respiratory oscillometry has emerged as a powerful method for detecting respiratory abnormalities in COPD. However, this method has not been widely introduced into clinical practice. This limitation arises, at least in part, because the clinical meaning of the oscillometric parameters is not clear. In this paper, we evaluated the association of oscillometry with functional capacity and its ability to predict abnormal functional capacity in COPD.Patients and Methods: This cross-sectional study investigated a control group formed by 30 healthy subjects and 30 outpatients with COPD. The subjects were classified by the Glittre‑ADL test and handgrip strength according to the functional capacity.Results: This study has shown initially that subjects with abnormal functional capacity had a higher value for resistance (p < 0.05), reactance area (Ax, p < 0.01), impedance modulus (Z4, p < 0.05), and reduced dynamic compliance (Cdyn, p < 0.05) when compared with subjects with normal functional capacity. This resulted in significant and consistent correlations among resistive oscillometric parameters (R=− 0.43), Cdyn (R=− 0.40), Ax (R = 0.42), and Z4 (R = 0.41) with exercise performance. Additionally, the effects of exercise limitation in COPD were adequately predicted, as evaluated by the area under the curve (AUC) obtained by receiver operating characteristic analysis. The best parameters for this task were R4-R20 (AUC = 0.779) and Ax (AUC = 0.752).Conclusion: Respiratory oscillometry provides information related to functional capacity in COPD. This method is also able to predict low exercise tolerance in these patients. These findings elucidate the physiological and clinical meaning of the oscillometric parameters, improving the interpretation of these parameters in COPD patients.Keywords: chronic obstructive pulmonary disease, COPD physiopathology, forced oscillation technique, respiratory impedance, Glittre-ADL test, handgrip strength, exercise limitation

Abstract Objective The Glittre-ADL test (GA-T) is a functional capacity test that stands out for encompassing multiple tasks similar to activities of daily living. As ventilatory efficiency is one of the variables valued in the prognosis of chronic heart failure (CHF), this study aimed to evaluate associations between functional capacity and ventilatory variables in patients with CHF during the GA-T. Results Eight patients with CHF and New York Heart Association (NYHA) functional classification II–III underwent the GA-T coupled with metabolic gas analysis to obtain data by means of telemetry. The median total GA-T time was 00:04:39 (00:03:29–00:05:53). Borg dyspnoea scale scores before and after the GA-T were 2 (0–9) and 3 (1–10), respectively (P = 0.011). The relationship between the regression slope relating minute ventilation to carbon dioxide output (VE/VCO2 slope) was correlated with the total GA-T time (rs = 0.714, P = 0.047) and Borg dyspnoea score (rs = 0.761, P = 0.028). The other ventilatory variables showed no significant correlations. Our results suggest that the total GA-T time can be applied to estimate the ventilatory efficiency of patients with CHF. Future studies may use the GA-T in conjunction with other functional capacity tests to guide the treatment plan and evaluate the prognosis.

Objective: The Glittre-ADL test (GA-T) is a functional capacity test that stands out for encompassing multiple tasks similar to activities of daily living. As ventilatory efficiency is one of the variables valued in the prognosis of chronic heart failure (CHF), this study aimed to evaluate associations between functional capacity and ventilatory variables in patients with CHF during the GA-T. Results: Eight patients with CHF and New York Heart Association (NYHA) functional classification II–III underwent the GA-T coupled with metabolic gas analysis to obtain data by means of telemetry. The median total GA-T time was 00:04:39 (00:03:29–00:05:53). Borg dyspnoea scale scores before and after the GA-T were 2 (0–9) and 3 (1–10), respectively (P = 0.011). The relationship between the regression slope relating minute ventilation to carbon dioxide output (VE/VCO2 slope) was correlated with the total GA-T time (rs = 0.714, P = 0.047) and Borg dyspnoea score (rs = 0.761, P = 0.028). The other ventilatory variables showed no significant correlations. Our results suggest that the total GA-T time can be applied to estimate the ventilatory efficiency of patients with CHF. Future studies may use the GA-T in conjunction with other functional capacity tests to guide the treatment plan and evaluate the prognosis. [ABSTRACT FROM AUTHOR]

Background: For people with chronic obstructive pulmonary disease (COPD) the ability to perform functional activities for a prolonged duration is important for completion of daily tasks. While the Glittre-ADL test measures time taken to complete a series of functional activities, there is no test of endurance capacity for common daily activities., Research Question: Is the Glittre Endurance test a valid and responsive test to measure endurance capacity for functional daily tasks in people with COPD?, Methods: This was a cross-sectional study. Fifty-seven participants with COPD (mean ± SD age:69 ± 7 years; FEV 1 :48 ± 18%predicted) were recruited. All participants performed the Glittre-ADL test without a backpack (Glittre-ADL-noBP). Nine participants (Group A) performed a Glittre Endurance test at 90% of the speed to complete one lap of the Glittre-ADL-noBP. 48 participants (Group B) performed two Glittre Endurance tests at 100% of Glittre-ADL-noBP speed. The time to voluntary cessation or not keeping up with target pace was the test outcome., Results: Mean ± SD of the Glittre Endurance test was 12.11 ± 6.43 min and 6.90 ± 4.40 min for the test at 90% and 100% speeds, respectively. When the 100% Glittre Endurance test 2 was compared to test 1, there was a 14% increase in test time, indicating a learning effect (p = 0.005). Following pulmonary rehabilitation (n = 20) the Glittre Endurance test increased by 3.12 min (29%), and the Glittre-ADL-noBP reduced by 0.33 min (10%)., Conclusion: The Glittre Endurance test performed at 100% of the Glittre-ADL-noBP speed provided an appropriate endurance test time, and was more sensitive to change following pulmonary rehabilitation than the Glittre-ADL-noBP., Competing Interests: Declaration of competing interest None., (Copyright © 2022. Published by Elsevier Ltd.)