A randomised crossover trial investigating the effect of a portable positive pressure ventilation device on exercise tolerance in patients with COPD

Background: Dyspnoea is a common symptom in COPD and can lead to progressive decline in exercise capacity. Non-Invasive Ventilation has been shown to improve symptoms and exercise capacity but is clinically impractical due to logistical constraints. A portable ventilation device (Vitabreath) may overcome these barriers and be a useful adjunct therapy. Aim: To investigate the effect of Vitabreath on exercise capacity in patients with COPD. Methods: Randomised crossover design; 12 participants with COPD (FEV1% 45±15) performed 3 Six-Minute Walk Tests using i) Vitabreath, ii) Threshold Positive Expiratory Pressure (PEP), or iii) no device. Primary outcome: six-minute walk distance (6MWD). Secondary outcomes: changes in heart rate, oxygen saturations (SpO2), dyspnoea, and lower limb (LL) fatigue, and recovery time of each variable. Results: Mean 6MWD was less using Vitabreath compared to no device (p=0.01). Use of Vitabreath resulted in a smaller change in dyspnoea (p=0.008) and LL fatigue scores (p=0.02), and a faster LL recovery time (p=0.01) compared to Threshold PEP. SpO2 recovery time was faster using Vitabreath compared to both Threshold PEP (p=0.008) and no device (p=0.03). Conclusion: The data suggest no benefit in using the Vitabreath in improving exercise capacity.