Global initiative for chronic obstructive lung disease 2023 report: gold executive summary

Agustí, Àlvar; Celli, Bartolomé R.; Criner, Gerard J.; Halpin, David; Anzueto, Antonio; Barnes, Peter J.; Bourbeau, Jean; Han, MeiLan K.; Martínez, Fernando J.; de, María Montes; Mortimer, Kevin; Papi, Alberto; Pavord, Ian; Roche, Nicolás; Salvi, Sundeep; Sin, Don D.; Singh, Dave; Stockley, Robert A.; Varela, María Victorina López; Wedzicha, Jadwiga A.; Vogelmeier, Claus

doi:10.25259/jpats_ges_2023

Cited by 1 publication

(4 citation statements)

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“…12 The COPD GOLD guidelines 2023-recommend promoting physical activity for every individual with COPD. 1 However, the recruitment of a standard PR program is based on symptom/risk assessment. According to this guideline, the symptom/risk assessment used two questionnaires: modified medical research council dyspnea scale (mMRC) and COPD assessment test (CAT) as well as previous 1-year history of exacerbation or hospitalization into three groups: GOLD A (low symptoms and 0-1 moderate exacerbation), GOLD B (moderatesevere symptoms and 0-1 moderate exacerbation), and GOLD E (whichever severity of symptoms and ≥2 moderate exacerbation or hospitalization.…”

Section: Incremental Spot Marching Exercise Testing (Ismt)mentioning

confidence: 99%

“…This recommendation is not based on the actual exercise capacity but only symptom/risk assessment. 1,13 Therefore, there is an ambiguity, as to whether missing out on the mild COPD GOLD A from the standard PR program is good practice for this group. It is difficult to include every patient with COPD into standard PR because referring COPD patients to PR is limited by Thai COPD clinical practice guideline that follow GOLD guideline.…”

Section: Incremental Spot Marching Exercise Testing (Ismt)mentioning

confidence: 99%

“…It is difficult to include every patient with COPD into standard PR because referring COPD patients to PR is limited by Thai COPD clinical practice guideline that follow GOLD guideline. 1 However, it is also important that patients who have low exercise capacity should not lose the benefit of attending standard PR programs. 14 Therefore, this study aimed to evaluate exercise capacity and cardiopulmonary responses in patients with mild COPD GOLD A.…”

Section: Incremental Spot Marching Exercise Testing (Ismt)mentioning

confidence: 99%

“…Patients with COPD exhibit chronic respiratory symptoms, including dyspnea, cough, sputum, and exacerbations. 1 The prevalence of COPD is increasing globally due to factors like increased exposure to inhaled particles and a rising ageing population. 2 The airflow limitation is one of the factors that relate to exercise capacity although it is weakly correlated.…”

Section: Introductionmentioning

confidence: 99%

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Does mild chronic obstructive pulmonary disease need a standard pulmonary rehabilitation program? A case report

Kosura,

Aung Nwe,

Chumpangern

et al. 2024

JAMS

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Background: Patients with mild chronic obstructive pulmonary disease (COPD) are usually not recommended for a standard pulmonary rehabilitation (PR)program based on the GOLD guideline in mild COPD GOLD A classification. Especially, the scientific evidence on exercise capacity that can be identified for recruitment in PR programs has been less reported. Thus, a preliminary case study to identify the exercise capacity under cardiopulmonary responses by aerobic exercise testing among patients in mild COPD GOLD A classification was the aim of this study. Objective: To evaluate the cardiopulmonary responses from exercise capacity testing in individual COPD patients with mild COPD GOLD A Classification. Materials and methods: Four participants with mild COPD GOLD A performed an exercise endurance capacity test at home using Spot Marching Exercise Test (SMT), marching on the spot with high hip and arm raising. The load of SMT was indicated by a controlled stepping rate at 70, 80, 90, 100, and 110 steps/min. Every participant performed Incremental SMT (ISMT) with every 3 min incremental load, and the Constant SMT (CSMT) at the peak load. Both exercise tests were terminated at symptom limit. Resting time between ISMT and CSMT was at least 30 minutes. Cardiopulmonary exercise responses, Borg perceived breathlessness (RPB) and exertion (RPE) were monitored every minute during the exercise test. The duration of exercises was recorded. Results: Peak exercise capacity using ISMT was low with the end exercise load at 70, 80, 80, and 90 steps/min which is equivalent to moderate to high intensity at 81%, 62%, 65% and 93% of age-predicted maximum heart rate (HRmax). The exercise test was stopped by breathlessness at RPB 7, 8, 6, and 5. Respiratory rates (RR) were 36, 26, 38, and 38 breaths/min. With CSMT, the results showed very short exercise duration 1.78, 4.60, 2.15, and 2.47 mins with RPB 7, 8, 5, and 5 and RR of 33, 27, 34, and 41 breaths/min respectively. Conclusion: This preliminary report reveals that all four mild COPD GOLD A show low exercise capacity and very poor exercise endurance that should identify the appropriated standard PR program in the future.

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Section: Incremental Spot Marching Exercise Testing (Ismt)mentioning

confidence: 99%

Section: Incremental Spot Marching Exercise Testing (Ismt)mentioning

confidence: 99%