Assessment of Aerobic Exercise Adverse Effects during COPD Exacerbation Hospitalization

Abstract

Introduction. Aerobic exercise performed after hospital discharge for exacerbated COPD patients is already recommended to improve respiratory and skeletal muscle strength, increase tolerance to activity, and reduce the sensation of dyspnea. Previous studies have shown that anaerobic activity can clinically benefit patients hospitalized with exacerbated COPD. However, there is little information on the feasibility and safety of aerobic physical activity performed by patients with exacerbated COPD during hospitalization. Objective. To evaluate the effects of aerobic exercise on vital signs in hospitalized patients with exacerbated COPD. Patients and Methods. Eleven COPD patients (63% female, FEV1: 34.2 ± 13.9% and age: 65 ± 11 years) agreed to participate. Aerobic exercise was initiated 72 hours after admission on a treadmill; speed was obtained from the distance covered in a 6-minute walk test (6MWT). Vital signs were assessed before and after exercise. Results. During the activity systolic blood pressure increased from 125.2 ± 13.6 to 135.8 ± 15.0 mmHg (p = 0.004) and respiratory rate from 20.9 ± 4.4 to 24.2 ± 4.5 rpm (p = 0.008) and pulse oximetry (SpO2) decreased from 93.8 ± 2.3 to 88.5 ± 5.7% (p < 0.001). Aerobic activity was considered intense, heart rate ranged from 99.2 ± 11.5 to 119.1 ± 11.1 bpm at the end of exercise (p = 0.092), and patients reached on average 76% of maximum heart rate. Conclusion. Aerobic exercise conducted after 72 hours of hospitalization in patients with exacerbated COPD appears to be safe.

Evaluation of Inflammatory Markers in Patients Undergoing a Short-Term Aerobic Exercise Program while Hospitalized due to Acute Exacerbation of COPD

“…Although scientific literature is scarce on the feasibility and effectiveness of rehabilitation programs as treatment in hospitalized exacerbated COPD patients, it is believed that rehabilitation can be initiated early during hospitalization [9,10]. However, we did not find other simple aerobic protocols to assess the clinical benefits and any association with systemic inflammation.…”

Effect of interval training with non-invasive ventilation in severe chronic obstructive pulmonary disease—a prospective cohort study with matched control group

“…It also reduces the need for endotracheal intubation (42). Numerous studies have shown that patients undergoing regular endurance training are less likely to be hospitalized for acute exacerbation, and even if they require in-patient care, their symptoms are milder and the number of days spent in hospital is lower compared to non-trainees (43)(44)(45). It is well known that not all the patients with COPD are able to perform intense workouts due to dyspnea, fatigue, and rapid exhaustion, and they rather tolerate IT better than continuous exertion (46).…”

Association of exercise capacity and endothelial function in patients with severe exacerbations of chronic obstructive pulmonary disease

“…In agreement with the literature, we found a reduced distance covered of 38% of the predicted value (230 m) and 43% (268 m) was found in the study of Pitta et al 8 . Another previous study, aimed to evaluate effects of aerobic exercise also find a distance of 224 m 48 h after exacerbation in patients during hospitalization for exacerbation of COPD 36 . Therefore, exercise capacity deserves attention at this moment independently, however with promising association with vascular health.…”