The association of breathing pattern with exercise tolerance and perceived fatigue in women with systemic lupus erythematosus: an exploratory case-control study

Authors

Monira I. Aldhahi, Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, Kingdom of Saudi Arabia. Mialdhahi@pnu.edu.sa.
Liana C. Wooten, George Washington University, Washington, D.C., USA.
Sarfaraz Hasni, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, MD, USA.
Jamal Mikdashi, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.
Randall E. Keyser, Department of Rehabilitation Science, George Mason University, 4400 University Drive, Fairfax, VA, 22030, USA.

Document Type

Journal Article

Publication Date

11-1-2022

Journal

Rheumatology international

Volume

42

Issue

11

DOI

10.1007/s00296-021-05005-z

Keywords

Breathing pattern; Cardiorespiratory fitness; Inspiratory muscle; Systemic lupus; Ventilation

Abstract

The aims of the study were to (1) to characterize the breathing pattern and work of breathing during peak exercise in patients with SLE; (2) to examine the extent to which the breathing pattern and work of breathing impact the exercise capacity and fatigue. Forty-one women participated in the study (SLE: n = 23, median = 35, range = 21-57 years, control: n = 18, median = 38, range = 22-45 years). Each subject performed a treadmill cardiopulmonary exercise test (a modified Bruce treadmill protocol) ending with volitional exhaustion. Breathing mechanic was characterized by measures of expired minute volume (V), tidal volume (Vt), respiratory rate (f), work of breathing, and cardiorespiratory fitness was quantified by measures of peak oxygen consumption (VO) and time to exhaustion. Data presented as median and interquartile range (IQR). Women with SLE had lower Vt {1221 [488.8] mL/min vs. 1716 [453.1] mL; p = .006}, V {58.9 [18.9] L/min vs 70 [28.1] L/min, p = 0.04} and increased breathing frequency {51.5 [10.8] vs 43.6 [37.8] bpm, p = 0.01} compared to the control group. The time to exhaustion and peak VO during the CPET were significantly reduced in those with SLE compared to controls {13.3 [10.2] vs 16.1 [2.2] min; p = 0.004}, {20 [6.1] mL/kg/min vs 26.6 [7] mL/kg/min p < 0.001}, respectively. Differences remained when the analyses were controlled for the observed differences in peak VO. When the regression model adjusted for the peak VO, it had been shown that Vt, WOB and f were explained variances in the fatigue severity by 64% [p < 0.001]. The decline in V and Vt coupled with a decreased peak VO and work of breathing may have contributed to low cardiorespiratory fitness and fatigue in patients with systemic lupus erythematosus.

APA Citation

Aldhahi, Monira I.; Wooten, Liana C.; Hasni, Sarfaraz; Mikdashi, Jamal; and Keyser, Randall E., "The association of breathing pattern with exercise tolerance and perceived fatigue in women with systemic lupus erythematosus: an exploratory case-control study" (2022). GW Authored Works. Paper 2031.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/2031

Department

Health, Human Function, and Rehabilitation Sciences