Exertional Oxygen Requirements During Exercise Training in Advanced Interstitial Lung Disease

Wickerson, Lisa; Brooks, Dina; Reid, W. Darlene; Singer, Lianne G.; Granton, John; Mathur, Sunita

doi:10.1097/hcr.0000000000000338

Cited by 15 publications

(16 citation statements)

References 21 publications

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“…Upon listing for transplant, LTx candidates underwent supervised exercise training three times a week for the duration of the waiting period. Our center's pre‐habilitation program has been described previously 15 . In brief, pre‐habilitation included 90‐minute sessions of stretching, functional exercises (squats, stair‐stepping), upper and lower extremity resistance training, and continuous moderate intensity aerobic exercise on a treadmill and cycle (20 minutes each).…”

Section: Methodsmentioning

confidence: 99%

“…A Borg leg fatigue score of 3 to 4 was used to guide aerobic training post‐transplant, and upper extremity resistance training was limited to ten pounds or less 18 . Exercise training during pre‐habilitation was recorded for treadmill walking as metabolic equivalent for the task (METS), for cycling as Watts and for biceps and quadriceps isotonic resistance exercise as weight in pounds for one set of 10 repetitions 15 …”

Section: Methodsmentioning

confidence: 99%

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Pre‐transplant short physical performance battery: Response to pre‐habilitation and relationship to pre‐ and early post–lung‐transplant outcomes

Wickerson

Rozenberg

Gottesman

et al. 2020

Clinical Transplantation

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Alongside surgical and medical advancements in lung transplantation, the demographics of lung-transplant candidates have shifted such that older, sicker patients with an increased co-morbidity burden have experienced increased access to transplant. 1 This has led to concern around the impact of physical and medical frailty on pre-transplant outcomes (delisting, death) and post-transplant morbidity and mortality. 2 Frailty is described as a decreased physiological reserve and increased vulnerability to major stressors and adverse outcomes such as disability, surgical complications, and mortality. 3 Different models of frailty exist including physical or phenotypic frailty (strength, endurance, and physiological functioning,) and cumulative deficits frailty (number of accumulated deficits over time incorporating health conditions, laboratory values, and functional impairments). 3-5 Individuals undergo functional testing as part of the lung-transplant (LTx) candidacy assessment to help determine fitness for

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Pre‐transplant short physical performance battery: Response to pre‐habilitation and relationship to pre‐ and early post–lung‐transplant outcomes

Wickerson

Rozenberg

Gottesman

et al. 2020

Clinical Transplantation

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“…Exercise training is recommended in ILD to improve symptoms, exercise capacity and HRQOL [5,6]. Impairment of gas exchange leading to exertional hypoxaemia is commonly observed in many ILDs and contributes to exercise limitation [3,7]. The intensity and duration of exercise training is often guided by an adequate arterial blood oxygen saturation measured by pulse oximetry (S pO 2 ); however, S pO 2 does not provide information about regional oxygenation of the exercising muscle.…”

Section: Introductionmentioning

confidence: 99%

Skeletal muscle oxygenation and regional blood volume during incremental limb loading in interstitial lung disease

et al. 2020

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IntroductionIndividuals with interstitial lung disease (ILD) exhibit reduced exercise capacity and exertional hypoxaemia. The role of peripheral (muscle) limitation to exercise tolerance in ILD is not well studied to date.MethodsA prospective cross-sectional study examined skeletal muscle oxygen saturation (SmO2) and regional blood volume of the knee extensors and elbow flexors during incremental limb loading in healthy people and people with varying severity of ILD. Isotonic concentric exercise was performed on an isokinetic dynamometer. SmO2 and regional blood volume were measured by near-infrared spectroscopy over the vastus lateralis and biceps.ResultsThirteen people who were dependent on oxygen, candidates for lung transplant and with severe ILD (forced vital capacity (FVC) 59±20% predicted), 10 people who were not oxygen dependent with mild ILD (FVC 81±17% predicted) and 13 healthy people (FVC 101±14% predicted) were included. Total haemoglobin, a marker of regional blood volume, was lower at task failure in the knee extensors in participants with severe ILD compared to healthy participants (p=0.05). At task failure for both knee-extensor loading and elbow-flexor loading, SmO2 was decreased to similar levels across all groups, but occurred at lower total workloads in the ILD groups (all p<0.01).ConclusionsOverall, people with severe ILD had lower levels of total work and experienced less increase in blood volume in the knee extensors after knee-extensor loading compared to healthy people. Peripheral muscle dysfunction in severe ILD may have contributed to muscle deoxygenation at lower workloads.

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“…These include chronic heart disease, metabolic syndrome, musculoskeletal or neurological co‐morbidities and many types of cancer. Regular exercise and physical activity are commonly recommended to benefit patients with many chronic morbidities, with aerobic and resistance training modalities suggested as evidence‐based treatment in patients with heart failure and/or type 2 diabetes . Patients with cardiovascular disease should begin supervised exercise training with continuous ECG monitoring and decrease to intermittent or no ECG monitoring after 6–12 sessions.…”

Section: Exercise Training In Patients With Co‐morbiditiesmentioning

confidence: 99%

“…Major risk factors include tobacco smoke, air pollution, occupational exposure to chemicals and dusts and frequent lower respiratory tract infections. CRD are not curable; however, treatment can benefit symptoms and increase the quality of life (QoL) for people with these diseases …”

Section: Introductionmentioning

confidence: 99%

Personalized exercise training in chronic lung diseases

Armstrong

Vogiatzis

2019

Respirology

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Chronic respiratory diseases (CRD) are characterized by exertional dyspnoea, exercise limitation and reduced health-related quality of life (QoL). Exercise training is essential for improving symptoms, physical function and QoL. Current research available supports the effectiveness of exercise training in patients with chronic obstructive pulmonary disease (COPD), cystic fibrosis and interstitial lung disease (ILD). However, recent studies have also shown safety and effectiveness of exercise training in patients with pulmonary arterial hypertension (PAH) and asthma. Despite the lack of clinical guidelines for exercise training in PAH, a recent Cochrane review has reported improvements in functional capacity and effective reductions in mean pulmonary arterial pressure. In the other CRD, a number of Cochrane reviews, supported by numerous randomized controlled trials, have been published outlining the benefits of different types of exercise training. The aim of this review is to establish the principles and modalities of personalized exercise training and the effects of exercise training across a number of CRD. In addition, this review provides information on personalized exercise prescription for CRD patients with co-morbidities.

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Exertional Oxygen Requirements During Exercise Training in Advanced Interstitial Lung Disease

Abstract: Individuals with advanced ILD had high exertional oxygen requirements to participate in moderate-intensity aerobic training, which increased over time. Exertional oxygen needs may affect exercise prescription and response during PR in ILD patients.

Cited by 15 publications

References 21 publications

Pre‐transplant short physical performance battery: Response to pre‐habilitation and relationship to pre‐ and early post–lung‐transplant outcomes

Pre‐transplant short physical performance battery: Response to pre‐habilitation and relationship to pre‐ and early post–lung‐transplant outcomes

Skeletal muscle oxygenation and regional blood volume during incremental limb loading in interstitial lung disease

Personalized exercise training in chronic lung diseases

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