ArticleCanadian journal of respiratory therapy : CJRT = Revue canadienne de la therapie respiratoire : RCTR2025
Influence of conical-PEP breathing on exercise performance in patients with chronic obstructive pulmonary disease: A single-blind randomized crossover trial.
Article in Canadian journal of respiratory therapy : CJRT = Revue canadienne de la therapie respiratoire : RCTR, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Effects of Conical Positive Expiratory Pressure Mask Application During Exercise Training on Pulmonary Rehabilitation Outcomes in Moderate to Severe COPD Cases: A Randomized Controlled Trial.Pulmonary medicine · 2025Trial
- Personalized respiratory guidance strategy via millimeter-wave radar-based breathing consistency score.Medical & biological engineering & computing · 2026Article
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Authors and funding
6 authors.
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Abstract
Background: Conical-positive expiratory pressure (conical-PEP) has been applied during exercise to improve exercise capacity, dynamic hyperinflation (DH), and dyspnea in COPD. However, evidence remains limited regarding the individualized selection of its resistor (orifice size) and its effects on exercise duration, DH development, and dyspnea. Method: A randomized crossover trial was conducted to evaluate the effects of conical-PEP. Participants performed spot marching exercise while breathing through a conical-PEP device with a mask, compared to a sham-PEP condition in which a similar mask was worn without the conical-PEP component. The conical-PEP resistor was selected to achieve the minimum required PEP level, calculated by the proposed formula, while ensuring that pressure did not exceed 35 cmH₂O. Exercise endurance time, end-exercise inspiratory capacity (IC) to assess DH, and dyspnea using the modified Borg scale were recorded. Results: Twenty moderate to severe COPD subjects (19 male, 1 female, age 67.40 ± 8.22 years, FEV1% predicted 56.05 ± 16.90) participated. Conical-PEP resulted in longer exercise time (4.98 ± 2.97 minutes) than sham-PEP (3.99 ± 2.19 minutes, p = 0.004). End-exercise IC was significantly better in conical-PEP (1.51 [1.24, 1.85] L) than sham-PEP (1.42 [1.16, 1.84] L, Conclusion: Conical-PEP with minimum required PEP level improves exercise capacity, delays DH development, and delays dyspnea onset in COPD patients.
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