A Systematic Review of the Effects of Bronchodilators on Exercise Capacity in Patients With COPD

Liesker, Jeroen J W; Wijkstra, Peter J.; Hacken, Nick H. T. ten; Koëter, Gerard H.; Postma, Dirkje S.; Kerstjens, Huib A. M.

doi:10.1378/chest.121.2.597

Cited by 78 publications

(61 citation statements)

References 55 publications

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“…With regard to pharmacological interventions, V′O 2 peak can improve after short- [60] and long-acting inhaled bronchodilator therapy [60][61][62][63] in COPD patients, although the magnitude of this response tends to be modest (0.04-0.18 L·min ) [60] and it is not always evident [60,64]. V′O 2 peak has been able to detect the long-term (i.e.…”

Section: Evaluative Aspectsmentioning

confidence: 99%

Use of exercise testing in the evaluation of interventional efficacy: an official ERS statement

et al. 2016

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This document reviews 1) the measurement properties of commonly used exercise tests in patients with chronic respiratory diseases and 2) published studies on their utilty and/or evaluation obtained from MEDLINE and Cochrane Library searches between 1990 and March 2015.Exercise tests are reliable and consistently responsive to rehabilitative and pharmacological interventions. Thresholds for clinically important changes in performance are available for several tests. In pulmonary arterial hypertension, the 6-min walk test (6MWT), peak oxygen uptake and ventilation/carbon dioxide output indices appear to be the variables most responsive to vasodilators. While bronchodilators do not always show clinically relevant effects in chronic obstructive pulmonary disease, high-intensity constant work-rate (endurance) tests (CWRET) are considerably more responsive than incremental exercise tests and 6MWTs. High-intensity CWRETs need to be standardised to reduce interindividual variability. Additional physiological information and responsiveness can be obtained from isotime measurements, particularly of inspiratory capacity and dyspnoea. Less evidence is available for the endurance shuttle walk test. Although the incremental shuttle walk test and 6MWT are reliable and less expensive than cardiopulmonary exercise testing, two repetitions are needed at baseline. All exercise tests are safe when recommended precautions are followed, with evidence suggesting that no test is safer than others. @ERSpublications A review of exercise testing to evaluate interventions aimed to improve exercise tolerance in respiratory patients

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Section: Evaluative Aspectsmentioning

confidence: 99%

Use of exercise testing in the evaluation of interventional efficacy: an official ERS statement

et al. 2016

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“…Traditionally, clinical trials that have evaluated the effects of bronchodilators on exercise performance have utilised field tests, such as the 6-and 12-min walk distance, or laboratory tests, such as incremental cycle ergometry [1]. However, the effects of different bronchodilating agents on walking distance and peak symptom-limited oxygen consumption (peak V9O 2 ) have been quite variable [1][2][3][4].…”

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confidence: 99%

“…However, the effects of different bronchodilating agents on walking distance and peak symptom-limited oxygen consumption (peak V9O 2 ) have been quite variable [1][2][3][4]. Recently, the current authors have used constant-load cycle endurance testing, at a fixed fraction of the patient9s pre-determined peak work rate (Wmax) to evaluate bronchodilator efficacy [5,6].…”

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confidence: 99%

Effects of tiotropium on lung hyperinflation, dyspnoea and exercise tolerance in COPD

O’Donnell¹,

Flüge²,

Gerken³

et al. 2004

Eur Respir J

764

581

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The aim of this study was to test the hypothesis that use of tiotropium, a new long-acting anticholinergic bronchodilator, would be associated with sustained reduction in lung hyperinflation and, thereby, would improve exertional dyspnoea and exercise performance in patients with chronic obstructive pulmonary disease.A randomised, double-blind, placebo-controlled, parallel-group study was conducted in 187 patients (forced expiratory volume in one second 44 ¡ 13% pred): 96 patients received 18 mg tiotropium and 91 patients received placebo once daily for 42 days. Spirometry, plethysmographic lung volumes, cycle exercise endurance and exertional dyspnoea intensity at 75% of each patient9s maximal work capacity were compared.On day 42, the use of tiotropium was associated with the following effects at pre-dose and post-dose measurements as compared to placebo: vital capacity and inspiratory capacity (IC) increased, with inverse decreases in residual volume and functional residual capacity. Tiotropium increased post-dose exercise endurance time by 105¡40 s (21%) as compared to placebo on day 42. At a standardised time near end-exercise (isotime), IC, tidal volume and minute ventilation all increased, whilst dyspnoea decreased by 0.9¡0.3 Borg scale units.In conclusion, the use of tiotropium was associated with sustained reductions of lung hyperinflation at rest and during exercise. Resultant increases in inspiratory capacity permitted greater expansion of tidal volume and contributed to improvements in both exertional dyspnoea and exercise endurance.

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“…En los últimos años ha adquirido una importancia progresiva por su fácil implementación y reproducibilidad. Se ha utilizado ampliamente en pacientes con enfermedades respiratorias y cardiovasculares; para evaluar la capacidad de ejercicio de los pacientes [3][4][5][6][7][8] ; la respuesta a intervenciones terapeúticas 9,10 ; como factor pronóstico de sobrevida 6,7,11,12 ; y como índice de deterioro en la enfermedad pulmonar obstructiva crónica (EPOC) 13,14 .…”

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Prueba de caminata en seis minutos en sujetos chilenos sanos de 20 a 80 años

Yáñez

et al. 2010

Rev. méd. Chile

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A Systematic Review of the Effects of Bronchodilators on Exercise Capacity in Patients With COPD

Cited by 78 publications

References 55 publications

Use of exercise testing in the evaluation of interventional efficacy: an official ERS statement

Use of exercise testing in the evaluation of interventional efficacy: an official ERS statement

Effects of tiotropium on lung hyperinflation, dyspnoea and exercise tolerance in COPD

Prueba de caminata en seis minutos en sujetos chilenos sanos de 20 a 80 años

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