Lung Function And Exercise Impairment In Patients With GOLD Stage I And II COPD

O’Donnell, Denis E.; Maltais, François; Pórszász, János; Albers, Frank C.; Deng, Qi; Hernandez, Gemzel; Iqbal, Ahmar; Paden, Heather; Casaburi, Richard

doi:10.1164/ajrccm-conference.2012.185.1_meetingabstracts.a6400

Cited by 2 publications

(3 citation statements)

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“…By contrast, ventilatory equivalent for carbon dioxide (V’ E /V’CO 2 ) output is consistently higher during cycle10,11,18 and treadmill exercise test46 in this patient population. This abnormality may reflect an impaired ability to reduce higher physiologic dead space during exercise in patients with mild COPD, an altered set-point for arterial partial pressure of carbon dioxide, or a combination of the two.…”

Section: Exercise Abnormalities In Copdmentioning

confidence: 70%

“…Peak oxygen consumption (V’O 2 ) and minute ventilation (V’ E ) are reduced, and perceived dyspnea is increased during incremental exercise to tolerance in patients with mild COPD compared with healthy controls 10,11,18,45,46. By contrast, ventilatory equivalent for carbon dioxide (V’ E /V’CO 2 ) output is consistently higher during cycle10,11,18 and treadmill exercise test46 in this patient population.…”

Section: Exercise Abnormalities In Copdmentioning

confidence: 81%

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Activity restriction in mild COPD: a challenging clinical problem

O’Donnell¹,

Gebke²

2014

COPD

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Dyspnea, exercise intolerance, and activity restriction are already apparent in mild chronic obstructive pulmonary disease (COPD). However, patients may not seek medical help until their symptoms become troublesome and persistent and significant respiratory impairment is already present; as a consequence, further sustained physical inactivity may contribute to disease progression. Ventilatory and gas exchange impairment, cardiac dysfunction, and skeletal muscle dysfunction are present to a variable degree in patients with mild COPD, and collectively may contribute to exercise intolerance. As such, there is increasing interest in evaluating exercise tolerance and physical activity in symptomatic patients with COPD who have mild airway obstruction, as defined by spirometry. Simple questionnaires, eg, the modified British Medical Research Council dyspnea scale and the COPD Assessment Test, or exercise tests, eg, the 6-minute or incremental and endurance exercise tests can be used to assess exercise performance and functional status. Pedometers and accelerometers are used to evaluate physical activity, and endurance tests (cycle or treadmill) using constant work rate protocols are used to assess the effects of interventions such as pulmonary rehabilitation. In addition, alternative outcome measurements, such as tests of small airway dysfunction and laboratory-based exercise tests, are used to measure the extent of physiological impairment in individuals with persistent dyspnea. This review describes the mechanisms of exercise limitation in patients with mild COPD and the interventions that can potentially improve exercise tolerance. Also discussed are the benefits of pulmonary rehabilitation and the potential role of pharmacologic treatment in symptomatic patients with mild COPD.

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Section: Exercise Abnormalities In Copdmentioning

confidence: 70%

Section: Exercise Abnormalities In Copdmentioning

confidence: 81%

Activity restriction in mild COPD: a challenging clinical problem

O’Donnell¹,

Gebke²

2014

COPD

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“…This trial is distinguished by its focus on mild-to-moderate COPD, a baseline characterization phase assessing the impact of dyspnea on daily activities, and ontreatment assessment of daily informal physical activity in addition to constant work-rate treadmill testing. Portions of this study were presented to the American Thoracic Society in May 2012 103,104 ; the full manuscript is in preparation.…”

Section: Can Inhaled Bronchodilators Improve Exercise Capacity In Patmentioning

confidence: 99%

Exercise and COPD: Therapeutic Responses, Disease-Related Outcomes, and Activity-Promotion Strategies

Maltais

2013

The Physician and Sportsmedicine

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Chronic obstructive pulmonary disease (COPD) reduces patients' exercise capacities and their abilities to perform daily physical activities, thereby increasing morbidity and mortality rates. The cycle of dyspnea, deconditioning, and declining physical activity not only accelerates the progression of COPD but also increases the risk for developing or aggravating metabolic and cardiovascular diseases. Cardiovascular and metabolic comorbidities also limit physical function, and their disabling effects in combination with COPD may be greater than the effects of each disease alone. The impact of COPD and its treatment on the ability to exercise, and the degree of physical activity in daily life, can be measured by field-based tests (eg, the 6-minute walk test or incremental and endurance shuttle-walk test), laboratory-based tests (eg, incremental or constant work-rate treadmill and cycle-ergometer tests), and physical activity assessments (eg, questionnaires and accelerometers). Walking tests increase oxygen consumption and desaturation in patients with COPD more than cycling tests with similar work-rate profiles and may more closely resemble patients' normal activities. Despite the questionable relevance of exercise testing to patients' daily functionality, exercise parameters remain important predictors of survival in patients with COPD. Treatment of COPD (pharmacotherapy, pulmonary rehabilitation, or both) can increase exercise capacity and physical activity in daily life, which potentially slows the decline of lung function, reduces the frequencies of exacerbations and hospitalizations, decreases mortality, slows the progression of comorbidities, improves health-related quality of life, and increases the activity reserve for routine function. This article examines the interactions of reduced physical activity and decreased exercise capacity with the progression of COPD, comorbidities, and mortality. The article also describes the available exercise tests for patients with COPD and reviews the evidence indicating that treating COPD improves exercise capacity. Notably, it appears that even mild COPD reduces exercise capacity and daily physical activity, indicating the need for early intervention.

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Lung Function And Exercise Impairment In Patients With GOLD Stage I And II COPD

Cited by 2 publications

References 0 publications

Activity restriction in mild COPD: a challenging clinical problem

Activity restriction in mild COPD: a challenging clinical problem

Exercise and COPD: Therapeutic Responses, Disease-Related Outcomes, and Activity-Promotion Strategies

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