Clinical Effects Of Acupuncture On The Pathophysiological Mechanism Of Chronic Obstructive Pulmonary Disease During Exercise
Tomonori Maekura,1,2 Keisuke Miki,1 Mari Miki,1 Seigo Kitada,1 Ryoji Maekura1,2 1Department of Respiratory Medicine, National Hospital Organization Osaka Toneyama Medical Center, Toyonaka, Japan; 2Course of Safety Management in Health Care Sciences, Graduate School of Health Care Sciences, Jikei Ins...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2019-12-01
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| Series: | International Journal of COPD |
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| Online Access: | https://www.dovepress.com/clinical-effects-of-acupuncture-on-the-pathophysiological-mechanism-of-peer-reviewed-article-COPD |
| _version_ | 1818898137864994816 |
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| author | Maekura T Miki K Miki M Kitada S Maekura R |
| author_facet | Maekura T Miki K Miki M Kitada S Maekura R |
| author_sort | Maekura T |
| collection | DOAJ |
| description | Tomonori Maekura,1,2 Keisuke Miki,1 Mari Miki,1 Seigo Kitada,1 Ryoji Maekura1,2 1Department of Respiratory Medicine, National Hospital Organization Osaka Toneyama Medical Center, Toyonaka, Japan; 2Course of Safety Management in Health Care Sciences, Graduate School of Health Care Sciences, Jikei Institute, Osaka, JapanCorrespondence: Ryoji MaekuraCourse of Safety Management in Health Care Sciences, Graduate School of Health Care Sciences, Jikei Institute, 1-2-8 Miyahara, Yodogawa-Ku, Osaka 532-0003, JapanTel +81 6 6150 1336Fax +81 6 6150 1337Email r-maekura@ghsj.ac.jpPurpose: Pharmacological therapy and pulmonary rehabilitation are useful for exertional dyspnoea in patients with chronic obstructive pulmonary disease (COPD); however, several patients have no meaningful improvements. Although acupuncture significantly improves exercise intolerance and dyspnoea, the pathophysiological mechanism of these effects is unknown; therefore, we evaluated this mechanism using cardiopulmonary exercise testing in a single-arm, open experimental study.Patients and methods: Sixteen patients with COPD underwent acupuncture once a week for 12 weeks. Primary outcomes were exercise performance parameters, including peak oxygen uptake in the incremental exercise tests (IETs) and the time to the limit of tolerance measured in constant work rate exercise tests (CWRETs) at 70% peak work-rate of the IET. IETs and CWRETs were performed at baseline and at weeks 12, 16, and 24.Results: During the time course, there were significant increases in peak oxygen uptake (p = 0.018) and minute ventilation (V̇E, p = 0.04) in the IETs. At 12 weeks, the endurance time significantly increased (810 ± 470 vs 1125 ± 657 s, p < 0.001) and oxygen uptakes at terminated exercise were significantly lower (771 ± 149 mL/min, p < 0.05) than those at baseline (822 ± 176 mL/min) in CWRETs. The significant decreases in oxygen uptake and minute ventilation and improvements in Borg scale scores were also observed during CWRETs after acupuncture. The decreases at isotime in the Borg scale (r = −0.789, p = 0.0007) and V̇E (r = −0.6736, p = 0.0042) were significantly correlated with the improvement of endurance time.Conclusion: The positive effects of acupuncture on exertional dyspnoea were associated with increased endurance time influenced by improved oxygen utilisation and reduced ventilation during exercise. Acupuncture may be a new intervention for COPD in addition to conventional maintenance therapies.Keywords: chronic obstructive pulmonary disease, COPD, acupuncture, exercise intolerance and dyspnoea, cardiopulmonary exercise test, CPET |
| first_indexed | 2024-12-19T19:27:18Z |
| format | Article |
| id | doaj.art-3a6500029340473b81662295c00a4683 |
| institution | Directory Open Access Journal |
| issn | 1178-2005 |
| language | English |
| last_indexed | 2024-12-19T19:27:18Z |
| publishDate | 2019-12-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | International Journal of COPD |
| spelling | doaj.art-3a6500029340473b81662295c00a46832022-12-21T20:08:44ZengDove Medical PressInternational Journal of COPD1178-20052019-12-01Volume 142787279850236Clinical Effects Of Acupuncture On The Pathophysiological Mechanism Of Chronic Obstructive Pulmonary Disease During ExerciseMaekura TMiki KMiki MKitada SMaekura RTomonori Maekura,1,2 Keisuke Miki,1 Mari Miki,1 Seigo Kitada,1 Ryoji Maekura1,2 1Department of Respiratory Medicine, National Hospital Organization Osaka Toneyama Medical Center, Toyonaka, Japan; 2Course of Safety Management in Health Care Sciences, Graduate School of Health Care Sciences, Jikei Institute, Osaka, JapanCorrespondence: Ryoji MaekuraCourse of Safety Management in Health Care Sciences, Graduate School of Health Care Sciences, Jikei Institute, 1-2-8 Miyahara, Yodogawa-Ku, Osaka 532-0003, JapanTel +81 6 6150 1336Fax +81 6 6150 1337Email r-maekura@ghsj.ac.jpPurpose: Pharmacological therapy and pulmonary rehabilitation are useful for exertional dyspnoea in patients with chronic obstructive pulmonary disease (COPD); however, several patients have no meaningful improvements. Although acupuncture significantly improves exercise intolerance and dyspnoea, the pathophysiological mechanism of these effects is unknown; therefore, we evaluated this mechanism using cardiopulmonary exercise testing in a single-arm, open experimental study.Patients and methods: Sixteen patients with COPD underwent acupuncture once a week for 12 weeks. Primary outcomes were exercise performance parameters, including peak oxygen uptake in the incremental exercise tests (IETs) and the time to the limit of tolerance measured in constant work rate exercise tests (CWRETs) at 70% peak work-rate of the IET. IETs and CWRETs were performed at baseline and at weeks 12, 16, and 24.Results: During the time course, there were significant increases in peak oxygen uptake (p = 0.018) and minute ventilation (V̇E, p = 0.04) in the IETs. At 12 weeks, the endurance time significantly increased (810 ± 470 vs 1125 ± 657 s, p < 0.001) and oxygen uptakes at terminated exercise were significantly lower (771 ± 149 mL/min, p < 0.05) than those at baseline (822 ± 176 mL/min) in CWRETs. The significant decreases in oxygen uptake and minute ventilation and improvements in Borg scale scores were also observed during CWRETs after acupuncture. The decreases at isotime in the Borg scale (r = −0.789, p = 0.0007) and V̇E (r = −0.6736, p = 0.0042) were significantly correlated with the improvement of endurance time.Conclusion: The positive effects of acupuncture on exertional dyspnoea were associated with increased endurance time influenced by improved oxygen utilisation and reduced ventilation during exercise. Acupuncture may be a new intervention for COPD in addition to conventional maintenance therapies.Keywords: chronic obstructive pulmonary disease, COPD, acupuncture, exercise intolerance and dyspnoea, cardiopulmonary exercise test, CPEThttps://www.dovepress.com/clinical-effects-of-acupuncture-on-the-pathophysiological-mechanism-of-peer-reviewed-article-COPDchronic obstructive pulmonary disease (copd)acupunctureexercise intolerance and dyspnoeacardiopulmonary exercise test (cpet) |
| spellingShingle | Maekura T Miki K Miki M Kitada S Maekura R Clinical Effects Of Acupuncture On The Pathophysiological Mechanism Of Chronic Obstructive Pulmonary Disease During Exercise International Journal of COPD chronic obstructive pulmonary disease (copd) acupuncture exercise intolerance and dyspnoea cardiopulmonary exercise test (cpet) |
| title | Clinical Effects Of Acupuncture On The Pathophysiological Mechanism Of Chronic Obstructive Pulmonary Disease During Exercise |
| title_full | Clinical Effects Of Acupuncture On The Pathophysiological Mechanism Of Chronic Obstructive Pulmonary Disease During Exercise |
| title_fullStr | Clinical Effects Of Acupuncture On The Pathophysiological Mechanism Of Chronic Obstructive Pulmonary Disease During Exercise |
| title_full_unstemmed | Clinical Effects Of Acupuncture On The Pathophysiological Mechanism Of Chronic Obstructive Pulmonary Disease During Exercise |
| title_short | Clinical Effects Of Acupuncture On The Pathophysiological Mechanism Of Chronic Obstructive Pulmonary Disease During Exercise |
| title_sort | clinical effects of acupuncture on the pathophysiological mechanism of chronic obstructive pulmonary disease during exercise |
| topic | chronic obstructive pulmonary disease (copd) acupuncture exercise intolerance and dyspnoea cardiopulmonary exercise test (cpet) |
| url | https://www.dovepress.com/clinical-effects-of-acupuncture-on-the-pathophysiological-mechanism-of-peer-reviewed-article-COPD |
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