Cardiopulmonary stress during exercise training in patients with COPD

Abstract

Exercise training is an essential component of pulmonary rehabilitation. However, the cardiopulmonary stress imposed during different modalities of exercise training is not yet known.In the present study, the cardiopulmonary stress of a 12-week exercise training programme in 11 chronic obstructive pulmonary disease (COPD) patients (forced expiratory volume in one second 42¡12%pred, age 69¡6 yrs) was measured. Pulmonary gas exchange and cardiac frequency (fC) of three training sessions were measured with a portable metabolic system at the beginning, mid-term and end of the programme. Symptoms were assessed with Borg scores.The exercise intensity was compared with the recommendations for exercise training by the American College of Sports Medicine (ACSM). Training effects were significant (maximum change in work: 14¡11 Watts, 6-min walk test: 44¡36 m). Whole body exercises (cycling, walking and stair climbing) consistently resulted in higher cardiopulmonary stress (oxygen uptake (V9O 2 ), minute ventilation and fC) than arm cranking and resistance training. Dyspnoea was higher during cycling than resistance training. Patients exercised for .70% (.20 min) of the total exercise time at .40% of the V9O 2 reserve and fC reserve (''moderate'' intensity according to the ACSM) throughout the programme.The cardiopulmonary stress resistance training is lower than during whole-body exercise and results in fewer symptoms. In addition, exercise testing based on guidelines using a fixed percentage of baseline peak performance and symptom scores achieves and sustains training intensities recommended according to the American College of Sports Medicine.

Effects of 2 Exercise Training Programs on Physical Activity in Daily Life in Patients With COPD

“…12 Exercise capacity was evaluated with 3 tests: the 6-min walk test, 13 with the reference values from Troosters et al 14 ; incremental symptom-limited cycle ergometry, 15 following a program previously described 16 ; and constant-workcycle ergometry (endurance time). Body composition was assessed with bioelectrical impedance 17 and we used the specific values described by Kyle et al 18 Respiratory muscle force was measured with the maximum inspiratory and expiratory pressures, 19 with the reference values from Neder et al 20 Peripheral muscle force was assessed with the onerepetition maximum test.…”

Impact of Resistance Training in Subjects With COPD: A Systematic Review and Meta-Analysis

“…In addition, resistance training evokes less dyspnea during exercise, 9 thereby making this strategy easier to tolerate than endurance training. 10,11 A combination of resistance and endurance training in COPD has demonstrated a greater improvement in peripheral muscle function compared with endurance training alone. 12 In the past few years, there have been several systematic reviews on the efficacy of resistance training.…”

Correlation of cardiopulmonary exercise testing parameters with quality of life in stable COPD patients

“…Considering these unquestionable aspects of COPD, the patient reported daily symptoms and function status in assessment of the disease has been included in the new Global Initiative on Obstructive Lung Disease (GOLD) classification (5 Although more difficult to use than other tools such as COPD Assessment Test (CAT) or COPD Clinical Questionnaire (CCQ) during routine daily practice (6), the St. George's Respiratory Questionnaire (SGRQ) is one of the most widely used self-complete measures in research for assessing patients' symptoms, activities and quality of life (7,8). Along with this subjective measurement, functional capacity in COPD could be measured by objective tools such as cardio-pulmonary exercise testing (CPET) or 6-min walk distance (6MWD) (9)(10)(11). Considering the fact that at rest physiologic variable such as pulmonary diffusing capacity for carbon monoxide (DLCO), body mass index (BMI) or even forced expiratory volume in one second (FEV1) could not solely predict exercise intolerance, CPET has been proposed as the gold standard for evaluating the exercise intolerance in patients with pulmonary diseases, including COPD (12).…”