Annual Congress Copenhagen 2005

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Contemporary physiological approaches to reversing the disease spiral in advanced COPD

Symposium
Chairs: T. Troosters (Leuven, Belgium), M. Morgan (Leicester, United Kingdom)
Aims: In patients with COPD, ventilatory limitation results in reduced activity. This in turn leads to quadriceps myopathy, which in turn causes anaerobic metabolism during exercise, increasing ventilatory demands and, thus (because these cannot be met), further limits activity. This process has been termed a disease spiral. The aim of this session is to understand the evidence for this process and to evaluate three contemporary interventions (exogenous stimulation of the quadriceps muscle, ventilation-assisted pulmonary rehabilitation and lung volume reduction surgery) with the potential to break the spiral.

The disease spiral; what is it and does it exist? M. Polkey (London, United Kingdom)
Improving quadriceps function. Pulmonary rehabilitation and electrical stimulation A. Schols (Maastricht, The Netherlands)
How to augment rehabilitation in very severe COPD N. Ambrosino (Pisa, Italy)
Improving ventilatory mechanics T. Toma (Iasi, Romania)