Patients with Chronic Obstructive Pulmonary Disease (COPD) and chronic respiratory
insufficiency (CRI) have severe dyspnoea during exercise at low load. Physiological studies
performed in these patients during a unique session of training have shown a positive effect
on exercise tolerance if non-invasive mechanical ventilation (NIV) was added during
incremental effort test or endurance. Menadue and coworkers (2009) have shown in CRI patients
with hypercapnia, secondary to COPD or cifoscoliosis, that combination of NIV during arm
effort test improved ability to perform the exercise. Similar result was not reached using
NIV during walking. Further studies have underlined a positive effect of the ventilation
therapy during exercise within specific programs of pulmonary rehabilitation (Corner 2009).
Moreover, the addition of NIV to an exercise training (ET) program in COPD patients may
produce greater benefits in exercise tolerance and quality of life than exercise training
alone (Garrod 2000).
A great improvement in health-related quality of life, functional status and gas exchange in
COPD patients with chronic hypercapnic respiratory failure with nocturnal NIV compared with
patients in pulmonary rehabilitation alone has been also shown by Duieverman (2008). However,
in the same study Duieverman did not show any significant difference between groups in terms
of tolerance to effort test.
Aim of the study is to evaluate if application of daily NIV during physical training may
increase the benefits of rehabilitation in CRI patients with nocturnal NIV compared with
patients with nocturnal NIV performing training under spontaneous breathing.