Next Article in Journal
Non-Invasive Ventilation Therapy Implementation in Medical Wards—A Scoping Review to Understand Hospitals’ Protocols and Procedures
Previous Article in Journal
Psoriatic Arthritis: From Diagnosis to Treatment
Previous Article in Special Issue
Sex-Based Disparities in Clinical Burden and Diagnostic Delay in COPD: Insights from Primary Care
 
 
Search for Articles:
Title / Keyword
Author / Affiliation / Email
Journal
Article Type
 
 
Advanced Search
 
Section
Special Issue
Volume
Issue
Number
Page
 
Journals
JCM
Volume 14
Issue 22
10.3390/jcm14228150
jcm-logo
Submit to this Journal Review for this Journal Propose a Special Issue
► Article Menu

Article Menu

share Share announcement Help format_quote Cite
first_page
settings
Order Article Reprints
Font Type:
Arial Georgia Verdana
Font Size:
Aa Aa Aa
Line Spacing:
Column Width:
Background:
This is an early access version, the complete PDF, HTML, and XML versions will be available soon.
Article

Muscle Unloading During Exercise: Comparative Effects of Conventional Oxygen, NIV, and High-Flow Therapy on Neural Drive in Severe COPD

by
Javier Sayas-Catalán
1,2,
Victoria Villena Garrido
1,2,*,
Cristina Lalmolda
3,4,
Ana Hernández-Voth
1,
Marta Corral-Blanco
1,
Miguel Jiménez-Gómez
1,
Laura González-Ramos
1 and
Manel Luján
3,4,*
1
Hospital Universitario 12 de Octubre, 28041 Madrid, Spain
2
Facultad de Medicina, Universidad Complutense de Madrid, 28040 Madrid, Spain
3
Corporació Sanitària Parc Taulí, 08208 Sabadell, Spain
4
Facultad de Medicina, Universitat Autonoma de Barcelona, 08193 Barcelona, Spain
*
Authors to whom correspondence should be addressed.
J. Clin. Med. 2025, 14(22), 8150; https://doi.org/10.3390/jcm14228150 (registering DOI)
Submission received: 5 September 2025 / Revised: 30 October 2025 / Accepted: 13 November 2025 / Published: 17 November 2025
(This article belongs to the Special Issue Diagnosis, Treatment and Comorbidities in Chronic Obstructive Pulmonary Disease (COPD): 2nd Edition)
Versions Notes

Abstract

Objectives: This study aimed to evaluate how non-invasive ventilation (NIV) and high-flow nasal cannula therapy (HFT) versus conventional oxygen therapy (COT) affect neural ventilatory drive during exercise in patients with severe chronic obstructive pulmonary disease (COPD). Methods: We conducted an experimental, controlled study with one arm and three different conditions for the same cohort. After initial testing on conventional oxygen therapy (COT), patients exercised under NIV and HFT in sequential days and a random order. Participants: Twenty patients (mean age 60 years old (SD 3.9), 6 female) with severe COPD (30% women) on home NIV as a bridge to lung transplantation were enrolled in this study, with a mean FEV1 of 19.78% predicted and marked hyperinflation. Protocol: Participants performed constant-load cycling exercises at 75% maximum tolerated workload under three conditions: COT, NIV, and HFT. Neuro-respiratory drive (NRD) was measured using surface parasternal and sternocleidomastoid electromyography, and mixed ANOVA was performed to analyze repeated measures across conditions. Results: In total, 20 patients were included in this study. NIV demonstrated superior performance, with 60% lower NRD compared to COT (488.81 µV vs. 1180.63 µV, p < 0.05). HFT showed intermediate effects (807.8 µV). NIV also achieved greater reduction in respiratory rate (4.2 breaths/min), lower perceived exertion (Borg score decrease: 1.8 points), and more pronounced CO2 reduction (5.3 mmHg) compared to both COT and HFT. Conclusions: NIV significantly reduces NRD during exercise in severe COPD patients compared to HFT and COT. This supports its use as a valuable adjunct to pulmonary rehabilitation in severe COPD.
Keywords: chronic obstructive pulmonary disease; exercise therapy; high-flow therapy; neural drive; non-invasive ventilation chronic obstructive pulmonary disease; exercise therapy; high-flow therapy; neural drive; non-invasive ventilation

Share and Cite

MDPI and ACS Style

Sayas-Catalán, J.; Villena Garrido, V.; Lalmolda, C.; Hernández-Voth, A.; Corral-Blanco, M.; Jiménez-Gómez, M.; González-Ramos, L.; Luján, M. Muscle Unloading During Exercise: Comparative Effects of Conventional Oxygen, NIV, and High-Flow Therapy on Neural Drive in Severe COPD. J. Clin. Med. 2025, 14, 8150. https://doi.org/10.3390/jcm14228150

AMA Style

Sayas-Catalán J, Villena Garrido V, Lalmolda C, Hernández-Voth A, Corral-Blanco M, Jiménez-Gómez M, González-Ramos L, Luján M. Muscle Unloading During Exercise: Comparative Effects of Conventional Oxygen, NIV, and High-Flow Therapy on Neural Drive in Severe COPD. Journal of Clinical Medicine. 2025; 14(22):8150. https://doi.org/10.3390/jcm14228150

Chicago/Turabian Style

Sayas-Catalán, Javier, Victoria Villena Garrido, Cristina Lalmolda, Ana Hernández-Voth, Marta Corral-Blanco, Miguel Jiménez-Gómez, Laura González-Ramos, and Manel Luján. 2025. "Muscle Unloading During Exercise: Comparative Effects of Conventional Oxygen, NIV, and High-Flow Therapy on Neural Drive in Severe COPD" Journal of Clinical Medicine 14, no. 22: 8150. https://doi.org/10.3390/jcm14228150

APA Style

Sayas-Catalán, J., Villena Garrido, V., Lalmolda, C., Hernández-Voth, A., Corral-Blanco, M., Jiménez-Gómez, M., González-Ramos, L., & Luján, M. (2025). Muscle Unloading During Exercise: Comparative Effects of Conventional Oxygen, NIV, and High-Flow Therapy on Neural Drive in Severe COPD. Journal of Clinical Medicine, 14(22), 8150. https://doi.org/10.3390/jcm14228150

Note that from the first issue of 2016, this journal uses article numbers instead of page numbers. See further details here.

Article Metrics

Back to TopTop