Stair climbing is associated with dynamic pulmonary hyperinflation and the development of severe
dyspnea in patients with
chronic obstructive pulmonary disease (
COPD). This study aimed to assess whether (i)
continuous positive airway pressure (CPAP) applied during stair climbing prevents dynamic hyperinflation and thereby reduces exercise-induced
dyspnea in
oxygen-dependent
COPD-patients, and (ii) the CPAP-device and
oxygen tank can be carried in a hip belt. In a randomised cross-over design,
oxygen-dependent
COPD patients performed two stair-climbing tests (44 steps): with supplemental
oxygen only, then with the addition of CPAP (7 mbar). The
oxygen tank and CPAP-device were carried in a hip belt during both trials. Eighteen
COPD patients were included in the study. Although all patients could tolerate stair climbing with
oxygen alone, 4 patients were unable to perform stair climbing while using CPAP. Fourteen
COPD patients (mean FEV1 36 ± 14%
pred.) completed the trial and were analyzed. The mean flow rate of supplemental
oxygen was 3 ± 2 l/min during stair climbing. Lung hyperinflation, deoxygenation,
hypoventilation, blood
lactate production,
dyspnea and the time needed to manage stair climbing were not improved by the application of CPAP (all p > 0.05). However, in comparison to climbing with
oxygen alone, limb discomfort was reduced when
oxygen was supplemented with CPAP (p = 0.008). In conclusion, very severe
COPD patients are able to carry supporting devices such as
oxygen tanks or CPAP-devices in a hip belt during stair climbing. However, the application of CPAP in addition to supplemental
oxygen during stair climbing prevents neither exercise-induced dynamic hyperinflation, nor
dyspnea.