Acute Effects of a Stretching Program of the Rib Cage Muscles on Patients With COPD During Exercise

Study Overview
=================
Brief Summary
-----------------
Investigate the effects of stretching the muscles of the rib cage in individuals with COPD during exercise.

Detailed Description
-----------------
To investigate the effects of a stretching program for the muscles of the rib cage or control in patients with COPD during exercise and / or the immediate post-exercise, using the following parameters: Tidal volume (VT), respiratory rate (RR), minute volume (MV), inspiratory time (Tins) and expiratory (T exp). Change in volumes of total and regional chest magazines (pulmonary rib cage, abdominal rib cage and abdomen). Diaphragmatic mobility. electrical muscle activity endurance time. Dyspnea sensation.

Official Title
-----------------
Acute Effects of a Stretching Program of the Rib Cage Muscles on the Regional Distribution of Ventilation and the Diaphragmatic Mobility of Patients With COPD During Exercise: a Randomized Crossover Clinical Trial

Conditions
-----------------
Pulmonary Disease, Chronic Obstructive

Intervention / Treatment
-----------------
* Other: Stretching
* Other: Control
* Other: Exercise


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Smoking history, occupational or environmental exposure to pollutants and / or symptoms of cough, dyspnea or hypersecretion; FEV1 <80% predicted and post-bronchodilator FEV1 / FVC <70% to confirm the diagnosis of airway obstruction not fully reversible bronchodilator therapy; Absence of co-morbidities that does not allow the realization of stress (hypertension, severe pulmonary hypertension, myocardial infarction, congestive heart failure, severe dyspnoea); Preserved cognitive functioning; Sedentary Clinically stable during the study period. Exclusion Criteria: Patients with cognitive, hearing or visual deficit; Changes in the neuro-musculo-skeletal system which endangers or impairs the assessment; Obese Not be able to achieve at least three stages of the incremental test.

Ages Eligible for Study
-----------------
Minimum Age: 50 Years
Maximum Age: 80 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Stretching and Exercise<br>This group undergo a session of stretching aiming flexibility of the rib cage and later at an exercise test with constant load up to the limit of tolerance for exercise bike | Other: Stretching<br>* Stretching of the rib cage muscles<br>Other: Exercise<br>* Constant load exercise on a bike<br>|
| Sham Comparator: Control and Exercise<br>This group will carry out the exercise test with constant load up to the limit of tolerance for exercise bike after a period of rest under the same environmental conditions and the experimental group time. During this time the therapist will place their hands but not performing the stretch. | Other: Control<br>* Rest without stretching (sham)<br>Other: Exercise<br>* Constant load exercise on a bike<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Endurance tolerance as measured by the duration of the exercise |  | Participants will be followed for the duration of the exercise, an expected average of 10 minutes | 
| Dyspnea as measured by Borg Escale |  | Participants will be followed for the duration of the exercise, an expected average of 10 minutes | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Diaphragm mobility measured by ultrasound |  | Participants will be followed for the duration of the stretching and the exercise, an expected average of 60 minutes | 
| Volumes of the chest wall measured by pletismography optoelectronic |  | Participants will be followed for the duration of the stretching and the exercise, an expected average of 60 minutes | 
| Muscle electrical activity measured by surface electromyography |  | Participants will be followed for the duration of the stretching and the exercise, an expected average of 60 minutes |