Browsing by Author "Cebollero Rivas, Pilar"
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Publication Open Access Assessment of dyspnea and dynamic hyperinflation in male patients with chronic obstructive pulmonary disease during a six minute walk test and an incremental treadmill cardiorespiratory exercise test(Elsevier, 2017) Alfonso Imízcoz, María; Bustamante, V.; Cebollero Rivas, Pilar; Antón Olóriz, María Milagros; Herrero, S.; Ciencias de la Salud; Osasun ZientziakThe six minute walk test (6MWT) is a standardized test that provides information on exercise capacity in patients with COPD. It is considered a submaximal test in opposition to incremental cardiopulmonary exercise tests (CPET) that provide valuable information on all the systems involved in exercise. Objectives: 1. To compare the perceptive, physiological responses and degree of dynamic hyperinflation during two exercise tests: the 6MWT and the incremental CPET on a treadmill. 2. To evaluate how dyspnea is related to dynamic hyperinflation (DH) and other functional parameters in both tests. Methods: 29 stable COPD male patients, age 68 ± 5.8 years, mean post-bronchodilator FEV1 57 ± 11%, were recruited. To evaluate dynamic hyperinflation, inspiratory capacity (IC) was measured at rest and upon completing each one of the tests. At the same time, perceived dyspnea and leg discomfort were rated on specific modified Borg scales. Results: The mean walk distance in 6MWT was 494 ± 88 m. The Borg scale rating for shortness of breath upon completing the test was 4.7 ± 2, whilst 2.9 ± 2 for leg discomfort. IC changed from 2.53 ± 0.63 l before to 2.34 ± 0.60 l after completion of the test. In the treadmill CPET, maximal oxygen consumption (VO˙ 2 max) was 21.8 ± 5 mL/kg/min with 6.6 ± 2 dyspnea and 4.3 ± 2 leg discomfort on Borg scales. IC changed from 2.17 ± 0.53 l to 1.20 ± 0.43 l. Conclusions: Dynamic hyperinflation occurs in male COPD patients during submaximal exercise such as the 6MWT. This phenomenon is more pronounced after incremental CPET on a treadmill. Despite being dyspnea the dominant limiting symptom for both tests, we observed different physiological responses.Publication Open Access Efectos de realizar actividad física en la función muscular en EPOC(Universidad Autonoma de Madrid y Comunidad Virtual Ciencias del Deporte, 2021) Cebollero Rivas, Pilar; Zambom Ferraresi, Fabrício; Hueto, Javier; Cascante Rodrigo, José Antonio; Antón Olóriz, María Milagros; Ciencias de la Salud; Osasun ZientziakEl objetivo de este estudio fue examinar los efectos de un programa de actividad física (AF) de andar en la función muscular en pacientes con EPOC (Enfermedad Pulmonar Obstructiva Crónica), con un seguimiento de 12 meses. Se reclutaron 44 hombres (70,3 ± 6,7 años) diagnosticados de EPOC moderado-severo. El grupo intervención realizó un programa de actividad física (GAF) y el grupo control (GCO) siguió su tratamiento estándar. Se midió la fuerza máxima (1RM) del miembro inferior y superior, la potencia muscular del miembro inferior (50% y 70% 1RM) y la actividad física, antes y después de 12 meses. A los 12 meses, incremento un 8% (P<0,01) la 1RM del miembro inferior en GAF, sin cambios en GCO. La potencia muscular al 50%1RM incrementó un 12% en GAF, disminuyendo un 9% in GCO (P<0,05). Un programa de AF incrementa la fuerza y preserva la potencia muscular del miembro inferior.Publication Open Access Effects of simple long-term respiratory care strategies in older men with COPD(Sociedade Brasileira de Pneumologia e Tisiologia, 2017) Zambom Ferraresi, Fabrício; Cebollero Rivas, Pilar; Hueto, Javier; Antón Olóriz, María Milagros; Ciencias de la Salud; Osasun ZientziakObjective: To evaluate a 24-month supervised, community-based maintenance exercise program after 3 months of pulmonary rehabilitation (PR) in comparison with a 27-month physical activity counseling program, in terms of the effects on maximal muscle strength, muscle power output, and exercise capacity, in individuals with COPD. Methods: Sixty-three men with moderate-to-severe COPD were recruited from two previous studies. Of those 63 participants, 31 were offered 3 months of PR followed by a 24-month supervised maintenance exercise program (24MME group) and 32 were offered a 27-month physical activity counseling program (27MPAC group). Measurements at 3 months and at the end of the study period included maximal strength of the upper and lower limbs, power output of the lower limbs, six-minute walk distance (6MWD), and quality of life. Results: At 27 months, the improvements in maximal strength of the upper and lower limbs were greater in the 24MME group than in the 27MPAC group (37.6 ± 28.3% and 28.4 ± 13.3%, respectively, vs. 8.8 ± 16% and 13.6 ± 16.4%, respectively; p < 0.05), as was the improvement in power output of the lower limbs (24.6 ± 18.4% vs. −2.3 ± 28.5%; p < 0.01). The increase in the 6MWD after 3 months was also greater in the 24MME group than in the 27MPAC group (33.2 ± 36.6 m vs. 2.9 ± 34.7 m; p < 0.05), although there were no differences between the two groups in terms of the Δ6MWD at 27 months (vs. baseline). Conclusions: A supervised, community-based maintenance program is a successful long-term strategy to preserve the benefits of PR on peripheral muscle function and exercise capacity in individuals with COPD. However, physical activity counseling can maintain maximal muscle strength and exercise capacity in such individuals.Publication Open Access Inspiratory fraction as a marker of skeletal muscle dysfunction in patients with COPD(Elsevier, 2017) Cebollero Rivas, Pilar; Zambom Ferraresi, Fabrício; Hueto, Javier; Antón Olóriz, María Milagros; Ciencias de la Salud; Osasun Zientziak; Gobierno de Navarra / Nafarroako GobernuaBackground: An inspiratory capacity to total lung capacity (IC/TLC) ratio of ≤25% has emerged as a better marker of mortality in chronic obstructive pulmonary disease (COPD) patients. The relationship among the IC/TLC ratio to lower extremity skeletal muscle function remains unknown. Methods: Thirty-five men with moderate to severe COPD were divided into those with IC/TLC ≤ 25% (n = 16) and >25% (n = 19). The subjects were tested for thigh muscle mass volume (MMT), maximal strength, power output of the lower extremities, and physical activity. Results: Total MMT in the IC/TLC < 25% group was significantly lower (413.91 ± 89.42 cm3) (p < 0.001) than in the IC/TLC > 25% group (575.20 ± 11.76 cm3). In the IC/TLC ≤ 25% group, maximal strength of the lower extremities and muscle peak power output of the lower extremities were 36---56% lower (p < 0.01) than among the patients in the IC/TLC > 25% group. Conclusion: IC/TLC ≤ 25% is associated with reduced maximal strength and peak power output of the lower extremities. IC/TLC ≤ 25% may have an important clinical relevance as an index to determine peripheral muscle dysfunction.Publication Open Access Respuestas ventilatorias, metabólicas y perceptivas al ejercicio en pacientes con enfermedad pulmonar obstructiva crónica(2017) Alfonso Imízcoz, María; Gáldiz Iturri, Juan Bautista; Cebollero Rivas, Pilar; Ciencias de la Salud; Osasun ZientziakLos pacientes con EPOC presentan una limitación al ejercicio principalmente debido a una disfunción ventilatoria, anormalidades en el intercambio gaseoso y por una disfunción muscular (tanto de los músculos respiratorios como periféricos). Las Pruebas de Esfuerzo Cardiopulmonar (PECP) son herramientas imprescindibles para la valoración de los sistemas implicados en el ejercicio, y en el caso del EPOC permiten un análisis integrado de la respuesta al esfuerzo. Objetivo: evaluar si las respuestas encontradas durante la realización de las pruebas de esfuerzo mediante pedaleo o caminar en pacientes con EPOC son diferentes. Analizar el desarrollo de atrapamiento aéreo y el cambio en la fuerza y en la fatiga muscular tras realizar distintos tipos de ejercicio. Material y Métodos: se han incluido pacientes con EPOC en grado moderado-severo, a los que se les ha realizado, una PECP en cicloergómetro, en tapiz rodante y un test de marcha de seis minutos. Se ha analizado previamente y al finalizar cada prueba: el grado de atrapamiento aéreo, mediante el cálculo de la capacidad inspiratoria; la fuerza muscular, mediante dinamometría y la fatiga muscular por técnica de twitch. Además, se han valorado las respuestas perceptivas a lo largo de cada prueba. Resultados: tras la realización de la PECP en tapiz, se observa un mayor desarrollo de atrapamiento aéreo y menor fatiga muscular que en el cicloergómetro. A nivel perceptual, los pacientes presentan mayor grado de disnea al finalizar la prueba en tapiz, mientras en el cicloergómetro, la limitación es por dolor en miembros inferiores. En el test de marcha se observan una respuesta fisiológica y perceptual similar que las encontradas en el tapiz, pero con menor intensidad (menor grado de disnea al finalizar la prueba y menor desarrollo de atrapamiento aéreo). Conclusiones: las respuestas perceptivas y fisiológicas en las PECP son diferentes en función del método empleado. La limitación en las PECP en pacientes con EPOC es específica del método con el que se realiza. La disnea a lo largo del esfuerzo en pacientes con EPOC es multifactorial y no sólo se puede explicar por el atrapamiento aéreo que se desarrolla durante el ejercicio de caminar.Publication Open Access Updates in the new guidelines for idiopathic pulmonary fibrosis: role of cryobiopsy(Elsevier, 2023) Cascante Rodrigo, José Antonio; Cebollero Rivas, Pilar; Ciencias de la Salud; Osasun ZientziakThe first guide on the management of idiopathic pulmonary fibrosis (IPF), published in 2000, has been revised and updated on three occasions, and each time, the interval has been shorter; the guidelines are also being newly incorporated by scientific societies. Both facts highlight the growing interest in a high-impact disease and the important advances in its research. he new guide published in May of this year and promoted by the American Thoracic Society, the European Respiratory Society, the Japanese Respiratory Society and the Latin American Tho- racic Association (ATS/ERS/JRS/ALAT) continues to use the GRADE methodology, as in previous versions, in which pulmonologists have a prominent role. This version also includes the participation of patient.