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Abstract
Chronic obstructive pulmonary disease (COPD) is a growing health problem In spite of the relationship between neuropathy and increased morbidity in patients with (COPD), only few studies have assessed cranial neuropathies and brainstem dysfunction in COPD patients.
Pulmonary rehabilitation is now an integral part of COPD management, Biofeedback has been used to assist breathing retraining in patients with COPD.
The aim of our work was to study the effect of hypoxemia and hypercapnia in COPD patient on neural conduction of peripheral and central nerves. Also, our aim was to evaluate the effect of pulmonary rehabilitation program of those cases using biofeedback.
This study was done on 30 Egyptian patients with clinically stable COPD (28 male and 2 females) and ten controls. All subjects included in this study were subjected to ABGs, spirometric tests, electrophysiological studies as PN conduction studies, VEPs, and BAEP. According to results of ABG, the patients were classified into two groups GI (patients with hypoxemia and normocapnia) and GII (patients with hypoxemia and hypercapnia). Each group was classified to subgroups a & b according to the program of rehabilitation. All results were collected, tabulated & statically analyzed.
Our results showed a highly significant difference of ABGs in GIa & GIIa (before & after) exercise. The latter reflects the effect of exercise in improving ABGs. Also, there was a significant difference of all data of ABGs in GIb & GIIb after rehabilitation. This reflects the effect of exercise & biofeedback in improving ABGs.
As regards pulmonary function tests (PFT) our result showed significant difference in comparison between GIa & G1b before & after pulmonary rehabilitation regarding data of pulmonary function test. These results reflect the effectiveness of rehabilitation program in improving PFT in mild cases of COPD.
Also, there was significant difference in comparison between GIIa & GIIb before & after pulmonary rehabilitation regarding data of pulmonary function test. These also, reflect the effect of rehabilitation in improving PFT but in moderate to severe cases of COPD.
Also, there was significant difference in comparison between GIa & GIb regarding FVC, FEV1&FEV1/FVC after rehabilitation indicating the effectiveness of biofeedback in improving PFT.
Regarding central evoked potential (CEP), comparing GI & GII, there was significant difference of VEP, BAEPIII, BAEPV & IPLIII-V before rehabilitation, that reflect the effect of ABGs on CEP.
Comparing the data of CEP (BREV &VEP) before and after rehabilitation, the results showed significant difference of VEP and BAEPV BAEPI in comparison between (GIa & GIb) & of BAEPI between (GIIa & GIIb). It is thus clear that the rehabilitation namely biofeedback has a great role in improving blood chemistry and consequently the improvement of result of CEV.
There were significant differences, between group I and group II before rehabilitation as regarding different data of the median, ulnar, radial and phrenic nerves. These data reflect changes in peripheral nerve conduction study in patients with COPD due to change of ABGs.
In comparison of GIa, GIb, GIIa and GIIb before & after exercise program regarding to peripheral nerves there were significant difference in all data of conduction study in median, radial, ulnar & phrenic nerves. All this reflects effectiveness of both exercise program and biofeedback for all groups of the study.
In comparison between GIa & GIb after pulmonary rehabilitation there were significant difference of latency &